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Microinfarcts, brain atrophy, and cognitive function: the Honolulu Asia Aging Study Autopsy Study
Lenore J Launer1, Timothy M Hughes, Lon R White
1Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, MD 20892, USA. launerl@nia.nih.gov
Annals of Neurology
|December 14, 2011
Summary
Micro brain infarcts (MBIs) impact cognitive function, especially before dementia is evident. Brain weight mediates this association in non-demented individuals, while Alzheimer
Area of Science:
- Neurology
- Neuroscience
- Pathology
Background:
- Micro brain infarcts (MBIs) are small lesions in the brain.
- Cognitive function (CF) can decline with age.
- Alzheimer's disease is characterized by neurofibrillary tangles (NFTs) and neuritic plaques (NPs).
Purpose of the Study:
- To investigate the association between MBIs and antemortem CF.
- To determine if brain weight (BW) and Alzheimer's lesions (NFTs/NPs) mediate this association.
Main Methods:
- Analysis of 436 male decedents from the Honolulu Asia Aging Autopsy Study.
- Standardized assessment of brain pathology, CF using the Cognitive Abilities Screening Instrument.
- Mediation analyses adjusted for age, education, and time between last CF measure and death.
Main Results:
- In non-demented individuals, MBIs strongly correlated with CF, mediated by BW.
- In demented individuals, NFTs showed the strongest association with BW and CF; MBIs had a modest association with CF.
- Alzheimer's lesions (NFTs/NPs) did not mediate the MBI-CF association in non-demented subjects.
Conclusions:
- Microinfarct pathology is an independent contributor to brain atrophy and cognitive impairment.
- Vascular damage may play a differing role in neurodegeneration depending on lesion development timing.
- MBIs are significant in cognitive decline prior to clinical dementia diagnosis.
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