학술논문

Determinants of vascular dementia in the Cardiovascular Health Cognition Study
Document Type
article
Source
Neurology. 64(9)
Subject
Biomedical Imaging
Prevention
Neurosciences
Dementia
Stroke
Neurodegenerative
Alzheimer's Disease
Brain Disorders
Alzheimer's Disease including Alzheimer's Disease Related Dementias (AD/ADRD)
Aging
Vascular Cognitive Impairment/Dementia
Cardiovascular
Acquired Cognitive Impairment
2.1 Biological and endogenous factors
Aetiology
Neurological
Good Health and Well Being
Age Factors
Aged
Aged
80 and over
Alzheimer Disease
Atrophy
Brain
Cardiovascular Diseases
Cerebral Arteries
Cerebral Infarction
Cohort Studies
Comorbidity
Dementia
Vascular
Female
Humans
Lateral Ventricles
Magnetic Resonance Imaging
Male
Nerve Fibers
Myelinated
Neuropsychological Tests
Racial Groups
Risk Factors
Sex Factors
Clinical Sciences
Cognitive Sciences
Neurology & Neurosurgery
Language
Abstract
ObjectiveThe authors evaluated 3,375 participants without dementia at the time of MRI in 1991 to 1994 over 5.7 years for incident dementia and type of dementia.MethodsIncidence of and risk factors for vascular dementia (VaD) were measured using both pre-MRI and modified State of California Alzheimer's Disease Diagnostic and Treatment Centers (ADDTC) post-MRI review and further classified Alzheimer disease (AD) by the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association (NINCDS-ADRDA) criteria.ResultsApproximately 44% (213) of 480 incident dementia cases were classified as possible or probable VaD by ADDTC. The incidence of VaD increased with age and was greater in blacks than whites. Risk factors for VaD included age, Modified Mini-Mental State Examination, high white matter grade, number of MRI infarcts, ventricular size, and history of stroke.ConclusionsVascular disease in the brain is prevalent among incident dementia cases. There is a substantial overlap between cases classified as Alzheimer disease by Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association and vascular dementia (VaD) by modified State of California Alzheimer's Disease Diagnostic and Treatment Centers criteria. The substantial contribution of vascular disease would be missed without inclusion of MRI. Treatment of risk factors for VaD could have an important impact on incidence of dementia.