Clinical Correlates of White Matter Findings on Cranial Magnetic Resonance Imaging of 3301 Elderly People

作者：W. T. Longstreth, Teri A. Manolio, Alice M. Arnold, Gregory L. Burke, Nick Bryan, Charles A. Jungreis, Paul Enright, Daniel E. O’Leary, Linda P. Fried · 发表于：Stroke · 年份：1996 · DOI：10.1161/01.str.27.8.1274 · 被引用次数：1475 · 研究领域：Acute Ischemic Stroke Management、Dementia and Cognitive Impairment Research、Cerebrovascular and Carotid Artery Diseases

BACKGROUND AND PURPOSE: Our aim was to identify potential risk factors for and clinical manifestations of white matter findings on cranial MRI in elderly people. METHODS: Medicare eligibility lists were used to obtain a representative sample of 5888 community-dwelling people aged 65 years or older. Correlates of white matter findings were sought among 3301 participants who underwent MRI scanning and denied a history of stroke or transient ischemic attack. Participants underwent extensive standardized evaluations at baseline and on follow-up, including standard questionnaires, physical examination, multiple blood tests, electrocardiogram, pulmonary function tests, carotid sonography, and M-mode echocardiography. Neuroradiologists graded white matter findings from 0 (none) to 9 (maximal) without clinical information. RESULTS: Many potential risk factors were related to the white matter grade, but in the multivariate model the factors significantly (all P < .01) and independently associated with increased grade were greater age, clinically silent stroke on MRI, higher systolic blood pressure, lower forced expiratory volume in 1 second (FEV1), and income less than $50,000 per year. If excluded, FEV1 was replaced in the model by female sex, history of smoking, and history of physician-diagnosed hypertension at the baseline examination. Many clinical features were correlated with the white matter grade, especially those indicating impaired cognitive and lower extremity function. CO...