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From the Center for Health Sciences (Drs. Swan and Carmelli), SRI International, Menlo Park, CA; the Department of Neurology (Dr. DeCarli), University of Kansas Medical Center, Kansas City; the University of California (Dr. Miller), San Francisco, CA; the Department of Medical & Molecular Genetics (Dr. Reed), Indiana University School of Medicine, Indianapolis; and the Boston University Medical Center (Dr. Wolf), MA.
Address correspondence and reprint requests to Dr. Gary E. Swan, Center for Health Sciences, SRI International, 333 Ravenswood Avenue, Menlo Park, CA 94025.
OBJECTIVE: To characterize the risk factors and neuropsychological performance of two subgroups of community-dwelling, white elderly men free of severe cognitive impairment (n = 383; mean age, 72.9 ± 3.0 years) who differ on volumetric measurements of total brain parenchyma and white matter hyperintensity (WMH) volumes.
METHODS: Group comparisons were made of cerebrovascular disease risk factors measured at the time of imaging and at three prior examinations extending over 25 years of adult life. Measures of verbal memory and speed psychomotor processing at the time of imaging and 10 years before imaging were also available.
RESULTS: Compared with those in the "nonatrophy" group, individuals in the subgroup with "atrophy" (defined by low total brain volume and high WMH volume) were older, reported a higher level of depressive symptomatology, experienced a steeper decline in diastolic blood pressure (DBP) and a steeper increase in pulse pressure, were less physically active, had smoked for more years, and had a higher prevalence of several cardiovascular disease indicators, including an ankle/arm systolic blood pressure ratio less than 0.9, and hypertension. After multivariate analysis, the 25-year decline in DBP, the number of years smoked, and an ankle/arm index of less than 0.9 remained significant discriminators of the two groups. Lower levels of speeded performance at the time of imaging and a steeper 10-year decline in cognitive performance on selected tests were also observed in the atrophic group.
CONCLUSION: Community-dwelling older adults with volumetric brain measurements associated with accelerated aging are distinguishable on the basis of several health-related characteristics. These individuals also perform less well on certain tasks involving executive functioning.
Key words: MRI—Aging—White matter hyperintensities—Atrophy—Neuropsychological function.
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