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Cerebral small-vessel disease and decline in information processing speed, executive function and memory.
Niels D Prins1, Ewoud J van Dijk, Tom den Heijer
1Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands.
Brain : a Journal of Neurology
|June 11, 2005
Summary
Cerebral small-vessel disease in older adults is linked to faster cognitive decline, particularly in processing speed and executive function. Stroke may mediate this relationship, highlighting the impact of vascular health on brain aging.
Area of Science:
- Neurology
- Neuroimaging
- Geriatrics
Background:
- Cerebral small-vessel disease (CSVD) is prevalent in aging populations and implicated in dementia.
- MRI-detectable markers of CSVD include white matter lesions (WML), infarcts, and brain atrophy.
Purpose of the Study:
- To investigate the association between CSVD markers on MRI and the rate of cognitive decline in specific domains.
- To explore the role of vascular risk factors, mood, and stroke in this relationship.
Main Methods:
- Prospective, population-based Rotterdam Scan Study with 832 participants (aged 60-90) free from dementia at baseline.
- Baseline MRI assessed WML, infarcts, and atrophy; repeated neuropsychological testing over ~5.2 years.
- Random-effects models analyzed associations between MRI measures and cognitive decline in global function, processing speed, executive function, and memory.
Main Results:
- Increased severity of periventricular WML, brain atrophy, and presence of infarcts correlated with steeper cognitive decline.
- These structural changes were specifically linked to declines in information processing speed and executive function.
- Associations persisted after adjusting for vascular risk factors and mood, but weakened after excluding stroke cases, suggesting stroke's intermediate role.
Conclusions:
- CSVD contributes to cognitive decline in older adults, primarily impacting information processing speed and executive function.
- Interventions targeting CSVD and stroke prevention may be crucial for maintaining cognitive health in aging populations.