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Association Between Subclinical Brain Infarcts and Functional Decline Trajectories
Mandip S Dhamoon1, Ying-Kuen Cheung2, Janet T DeRosa3
1Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York.
Journal of the American Geriatrics Society
|September 26, 2018
Summary
Subclinical brain infarcts (SBIs) are linked to faster functional decline in older adults, independent of other risk factors. Early detection of these brain changes may help prevent disability.
Area of Science:
- Neurology
- Geriatrics
- Vascular Medicine
Background:
- Subclinical brain infarcts (SBIs) are common in aging populations.
- Their independent association with functional decline requires further investigation.
Purpose of the Study:
- To assess the relationship between SBIs and functional decline.
- To determine if this association persists independently of vascular risk factors and events.
Main Methods:
- A population-based prospective cohort study of 1,290 stroke-free individuals.
- Longitudinal follow-up for an average of 7.3 years with annual functional assessments (Barthel Index).
- Generalized estimating equation models were used, adjusting for various risk factors and clinical events.
Main Results:
- SBIs were not associated with baseline function.
- Individuals with SBIs experienced an additional annual decline of 0.88 points in the Barthel Index.
- No significant association was found between perivascular spaces (PVSs) and functional decline.
Conclusions:
- Subclinical brain injury markers, like SBIs, are independently associated with significant functional decline.
- These findings highlight the clinical importance of subclinical cerebrovascular changes.
- Further research is needed to understand the progression of SBIs and develop preventive strategies.
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