title: Harm avoidance and cerebral infarction.
abstract: OBJECTIVE
  Harm avoidance, a trait indicative of behavioral inhibition, is associated with disability and dementia in old age, but the basis of these associations is uncertain. We test the hypothesis that higher level of harm avoidance is associated with increased likelihood of cerebral infarction.
  
  
  METHODS
  Older persons without dementia completed a standard measure of harm avoidance. During a mean of 3.5 years of follow-up, 257 (of 1,082) individuals died of whom 206 (80%) underwent brain autopsy. The number of chronic cerebral infarcts (microscopic plus gross; expressed as 0, 1, or >1) was assessed on neuropathologic examination, completed in 192 individuals at the time of analyses.
  
  
  RESULTS
  On postmortem examination, chronic cerebral infarcts were found in 89 (42 with 1, 47 with >1). Higher harm avoidance was associated with higher likelihood of infarcts (odds ratio = 1.083, 95% confidence interval = 1.040-1.128). A moderately high level of the trait (score = 17, 75th percentile) was associated with a 2.4-fold increase in the likelihood of infarction compared with a moderately low level of the trait (score = 6, 25th percentile). These associations persisted in models that controlled for other cardiovascular risk factors.
  
  
  CONCLUSIONS
  Higher level of the harm avoidance trait may be a risk factor for cerebral infarction.
authors.affiliation: Rush Alzheimer's Disease Center.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Wilson
authors.affiliation: Rush Alzheimer's Disease Center.
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Boyle
authors.affiliation: Department of Neurology, SUNY Downstate Medical Center.
authors.forename: Steven R
authors.initials: SR
authors.lastname: Levine
authors.affiliation: Rush Alzheimer's Disease Center.
authors.forename: Lei
authors.initials: L
authors.lastname: Yu
authors.affiliation: Rush Alzheimer's Disease Center.
authors.forename: George M
authors.initials: GM
authors.lastname: Hoganson
authors.affiliation: Rush Alzheimer's Disease Center.
authors.forename: Aron S
authors.initials: AS
authors.lastname: Buchman
authors.affiliation: Rush Alzheimer's Disease Center.
authors.forename: Julie A
authors.initials: JA
authors.lastname: Schneider
authors.affiliation: Rush Alzheimer's Disease Center.
authors.forename: David A
authors.initials: DA
authors.lastname: Bennett
mesh_terms: D000369:Aged, 80 and over; D001007:Anxiety / Q000150:complications* / Q000523:psychology*; D002544:Cerebral Infarction / Q000150:complications* / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D010551:Personality; D012307:Risk Factors