title: Midlife cardiovascular risk factors and brain morphology in identical older male twins.
abstract: OBJECTIVE
  Structural changes in the human brain have been reported to a greater extent in subjects with cardiovascular risk factors. We conducted a matched co-twin analysis of elderly monozygotic twins from the National Heart, Lung, and Blood Institute Twin Study to examine the association between midlife cardiovascular risk factors and MRI-based measures of brain atrophy.
  
  
  METHODS
  Brain MRIs (1.5-T) were obtained from 74 monozygotic, white, male, World War II veteran twins born in the United States from 1917 to 1927 and age 68 to 79 at the time of the brain scan. A semiautomated algorithm was used to segment brain images into total brain, CSF, and white matter hyperintensity volumes. Cardiovascular risk factors, medical history variables, and health practices were available from data collected over 25 years of adult life.
  
  
  RESULTS
  Independent of shared genetic or familial influences, within-pair differences in midlife glucose levels, high-density lipoprotein cholesterol, and systolic blood pressure were significantly associated with differences in white matter hyperintensities. Within-pair differences in coronary heart disease history and in current consumption of alcohol and level of physical activity were significantly associated with differences in brain parenchyma. In addition, within-pair differences in white matter hyperintensity volumes were significantly associated with differences in performance on cognitive and physical function tests and self-reports of depression symptoms.
  
  
  CONCLUSIONS
  Independent of age effects and shared genetic or familial influences, midlife cardiovascular risk factors and lifetime health practices were predictive of structural brain changes in old age.
authors.affiliation: Center for Health Sciences, SRI International, Menlo Park, CA 94025, USA. doritc@unix.sri.com
authors.forename: D
authors.initials: D
authors.lastname: Carmelli
authors.forename: G E
authors.initials: GE
authors.lastname: Swan
authors.forename: T
authors.initials: T
authors.lastname: Reed
authors.forename: P A
authors.initials: PA
authors.lastname: Wolf
authors.forename: B L
authors.initials: BL
authors.lastname: Miller
authors.forename: C
authors.initials: C
authors.lastname: DeCarli
mesh_terms: D001921:Brain / Q000473:pathology*; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000473:pathology*; D003072:Cognition Disorders / Q000473:pathology; D004200:Diseases in Twins; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors