Cerebral MRI findings and cognitive functioning: the Atherosclerosis Risk in Communities study.
OBJECTIVE
To examine the association between prevalent cerebral abnormalities identified on MRI and cognitive functioning in a predominantly middle-aged, population-based study cohort.


METHODS
Cerebral MRI was performed on 1,538 individuals (aged 55 to 72) from the Atherosclerosis Risk in Communities (ARIC) cohort, with no history of stroke or TIA, at study sites in Forsyth County, NC, and Jackson, MS. White matter hyperintensities (WMHs), ventricular size, and sulcal size were graded by trained neuroradiologists on a semiquantitative, 10-point scale. Cognitive functioning was assessed using the Delayed Word Recall Test (DWRT), Digit Symbol Substitution Test (DSST), and Word Fluency Test (WFT).


RESULTS
High ventricular grade was independently associated with significantly lower scores on the DWRT and DSST and greater risk (odds ratio [OR] 2.32, 95% confidence interval [CI] 1.51 to 3.56) of impaired scores (i.e., < or =10th percentile) on the DWRT. High sulcal grade was associated with a modest decrement in scores on the DWRT. The presence of coexisting high grade WMHs and silent infarcts was independently associated with lower scores on all cognitive tests and greater risk of impaired functioning on the DSST (OR 2.91, 95% CI: 1.23 to 6.89) and WFT (OR 2.28, 95% CI 1.03 to 5.08). The presence of two or more high-grade abnormalities was associated with increased risk of impaired functioning on all cognitive tests (DWRT: OR 2.23, 95% CI 1.40 to 3.55; DSST: OR 2.06, 95% CI 1.13 to 3.76; WFT: OR 2.07, 95% CI 1.23 to 3.49) independent of multiple covariates and silent infarcts.


CONCLUSIONS
Common changes in brain morphology are associated with diminished cognitive functioning in middle-aged and young-elderly individuals.
Mosley
T H
TH
Department of Medicine, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216-4505, USA. tmosley@medicine.umsmed.edu
Knopman
D S
DS
Catellier
D J
DJ
Bryan
N
N
Hutchinson
R G
RG
Grothues
C A
CA
Folsom
A R
AR
Cooper
L S
LS
Burke
G L
GL
Liao
D
D
Szklo
M
M
D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000453:epidemiology*; D001284:Atrophy / Q000453:epidemiology / Q000473:pathology; D015984:Causality; D002536:Cerebral Arteries / Q000473:pathology / Q000503:physiopathology; D002540:Cerebral Cortex / Q000098:blood supply / Q000473:pathology* / Q000503:physiopathology; D002544:Cerebral Infarction / Q000453:epidemiology / Q000473:pathology; D002561:Cerebrovascular Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D003072:Cognition Disorders / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009413:Nerve Fibers, Myelinated / Q000473:pathology; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D011446:Prospective Studies; D014481:United States / Q000453:epidemiology