title: Associations among vascular risk factors, carotid atherosclerosis, and cortical volume and thickness in older adults.
abstract: OBJECTIVE
  The purpose of this study was to investigate whether the Framingham Cardiovascular Risk Profile and carotid artery intima-media thickness are associated with cortical volume and thickness.
  
  
  METHODS
  Consecutive subjects participating in a prospective cohort study of aging and mild cognitive impairment enriched for vascular risk factors for atherosclerosis underwent structural MRI scans at 3-T and 4-T MRI at 3 sites. Freesurfer (Version 5.1) was used to obtain regional measures of neocortical volumes (mm3) and thickness (mm). Multiple linear regression was used to determine the association of Framingham Cardiovascular Risk Profile and carotid artery intima-media thickness with cortical volume and thickness.
  
  
  RESULTS
  One hundred fifty-two subjects (82 men) were aged 78 (±7) years, 94 had a clinical dementia rating of 0, 58 had a clinical dementia rating of 0.5, and the mean Mini-Mental State Examination was 28±2. Framingham Cardiovascular Risk Profile score was inversely associated with total gray matter volume and parietal and temporal gray matter volume (adjusted P<0.04). Framingham Cardiovascular Risk Profile was inversely associated with parietal and total cerebral gray matter thickness (adjusted P<0.03). Carotid artery intima-media thickness was inversely associated with thickness of parietal gray matter only (adjusted P=0.04). Including history of myocardial infarction or stroke and radiological evidence of brain infarction, or apolipoprotein E genotype did not alter relationships with Framingham Cardiovascular Risk Profile or carotid artery intima-media thickness.
  
  
  CONCLUSIONS
  Increased cardiovascular risk was associated with reduced gray matter volume and thickness in regions also affected by Alzheimer disease independent of infarcts and apolipoprotein E genotype. These results suggest a "double hit" toward developing dementia when someone with incipient Alzheimer disease also has high cardiovascular risk.
authors.affiliation: University of California, San Francisco, Department of Veterans Affairs Medical Center, 4150 Clement Street (114M), San Francisco, CA 94121, USA. valerie.cardenas-nicolson@ieee.org
authors.forename: Valerie A
authors.initials: VA
authors.lastname: Cardenas
authors.forename: Bruce
authors.initials: B
authors.lastname: Reed
authors.forename: Linda L
authors.initials: LL
authors.lastname: Chao
authors.forename: Helena
authors.initials: H
authors.lastname: Chui
authors.forename: Nerses
authors.initials: N
authors.lastname: Sanossian
authors.forename: Charles C
authors.initials: CC
authors.lastname: DeCarli
authors.forename: Wendy
authors.initials: W
authors.lastname: Mack
authors.forename: Joel
authors.initials: J
authors.lastname: Kramer
authors.forename: Howard N
authors.initials: HN
authors.lastname: Hodis
authors.forename: Mingzhu
authors.initials: M
authors.lastname: Yan
authors.forename: Michael H
authors.initials: MH
authors.lastname: Buonocore
authors.forename: Owen
authors.initials: O
authors.lastname: Carmichael
authors.forename: William J
authors.initials: WJ
authors.lastname: Jagust
authors.forename: Michael W
authors.initials: MW
authors.lastname: Weiner
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000150:complications* / Q000473:pathology; D002340:Carotid Artery Diseases / Q000150:complications* / Q000473:pathology; D059168:Carotid Intima-Media Thickness; D002540:Cerebral Cortex / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012307:Risk Factors