Silent brain infarction is associated with executive dysfunction in community-dwelling older adults: the...

The most representative form of cognitive impairment in vascular cognitive impairment (VCI) is executive dysfunction caused by cerebral small vessel disease (CSVD). The aim of the present study is to investigate the effects of CSVD, particularly silent brain infarction (SBI), on executive function. We performed a cross-sectional observational study of 652 community-dwelling older adults (mean age, 69.7 years), who were independent in their daily activities and had no apparent dementia. All participants underwent the Mini-Mental State Examination (MMSE) or Montreal Cognitive Assessment (MoCA), the modified Stroop test (Model 1: cut-off values according to our previous study, and Model 2: the total score above the fifth quintile for each given decade), and apathy scale. Imaging was performed using a 1.5 T MRI scanner for CSVD evaluation and the Voxel-based Specific Regional analysis system for Alzheimer's Disease (VSRAD). SBI was detected in 65 of the 652 participants (10.0%). Logistic regression analysis revealed that cognitive dysfunction defined by MMSE or MoCA was primarily associated with hippocampal atrophy, whereas executive dysfunction was associated with SBI in Model 1 (OR, 2.392, 95% CI, 1.215-4.708) and in Model 2 (OR, 2.040, 95% CI, 1.157-3.598). Executive dysfunction, defined by prolonged performance on the modified Stroop test, was associated with SBI (i.e., VCI caused by CSVD), in addition to age. The future study should address the possibility that VCI or CSVD-related cognitive decline could be prevented by controlling vascular risk factors. Graphical abstract: Community-dwelling older adults without dementia underwent brain MRI. A total of 652 consecutive volunteers with a mean age of 69.7 years and a mean educational level of 12.2 years were included in the study. All participants underwent the MMSE or MoCA for the assessment of global cognition and the modified Stroop test for the assessment of executive function. Performance on the cognitive screening tests was associated with hippocampal atrophy, suggesting underlying AD pathology. Executive dysfunction, as indicated by prolonged performance on the modified Stroop test, was associated with age and SBI.