title: Risk factors for cerebral hypoperfusion, mild cognitive impairment, and dementia.
abstract: Putative risk factors accelerating mild cognitive decline and dementia were correlated with repeated measures of cerebral atrophy, CT, densitometry, perfusions, and cognitive testing among neurologically and cognitively normative aging volunteers. A total of 224 normative subjects at increased risk for cognitive decline were admitted to the study. Mean entry age was 59.5 +/- 15.8 years. Mean follow-up is 5.8 +/- 3.3 years. At follow-up, 22 developed mild cognitive impairment (41 CCSE >/= -3), 19 became demented-8 with Vascular type (VAD), 11 with Alzheimer's type (DAT)-and 183 remain cognitively unchanged. Cerebral atrophy, tissue densities, and perfusions were measured by Xe-CT. After age 60, cerebral atrophy, ventricular enlargement, and polio- and leuko-araiosis geometrically increased as perfusions declined. Risk factors accelerating perfusional decline, cerebral atrophy, polio-araiosis, and leuko-araiosis were: transient ischemic attacks (TIAs), hypertension, smoking, hyperlipidemia, and male gender. At age 71.5 +/- 11.9, mild cognitive impairment began accelerated by TIAs, hypertension and heart disease. Leuko-araiosis began before cognitive decline. TIAs, hypertension, and hyperlipidemia correlated with VAD. Excessive cortical perfusional decrease, gray and white matter hypodensities, and cerebral atrophy correlate with cognitive decline.
authors.affiliation: Cerebral Blood Flow Laboratory, Veterans Administration Medical Center, 77030, Houston, TX, USA. jmeyer@bcm.tmc.edu
authors.forename: J S
authors.initials: JS
authors.lastname: Meyer
authors.forename: G
authors.initials: G
authors.lastname: Rauch
authors.forename: R A
authors.initials: RA
authors.lastname: Rauch
authors.forename: A
authors.initials: A
authors.lastname: Haque
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology; D000428:Alcohol Drinking / Q000453:epidemiology; D001921:Brain / Q000000981:diagnostic imaging; D002560:Cerebrovascular Circulation / Q000502:physiology; D002561:Cerebrovascular Disorders / Q000150:complications / Q000453:epidemiology* / Q000523:psychology; D003072:Cognition Disorders / Q000453:epidemiology* / Q000523:psychology; D015140:Dementia, Vascular / Q000453:epidemiology* / Q000523:psychology; D003720:Densitometry; D048909:Diabetes Complications; D004493:Education; D005260:Female; D006331:Heart Diseases / Q000150:complications; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011859:Radiography; D012307:Risk Factors; D012737:Sex Factors