Department of Radiology, Royal Melbourne Hospital, University of Melbourne, Parkville, Melbourne, VIC, 3010, Australia.
Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Parkville, Melbourne, VIC, 3050, Australia.
Brain Imaging Behav. 2020 Feb;14(1):51-61. doi: 10.1007/s11682-018-9970-5.
Cerebral White Matter Hyperintensity (WMH) lesions have been identified as markers of cerebrovascular diseases and they are associated with increased risk of cognitive impairment. In this study, we investigated the relationship between midlife cardiovascular risk factors and late life WMH volumes two decades later, and examined their association with cognitive performance. 135 participants from the Women's Healthy Ageing Project had completed midlife cardiovascular risk measurement in 1992 and late life brain MRI scan and cognitive assessment in 2012. In these community-dwelling normal aging women, we found that higher midlife Framingham Cardiovascular Risk Profile (FCRP) score was associated with greater WMH volume two decades later, and was predominantly driven by the impact of HDL cholesterol level, controlling for age, education and APOE ε4 status. Structural equation modelling demonstrated that the relationship between midlife FCRP score and late life executive function was mediated by WMH volume. These findings suggest intervention strategies that target major cardiovascular risk factors at midlife might be effective in reducing the development of WMH lesions and thus late life cognitive decline.
脑白质高信号（WMH）病变已被确定为脑血管疾病的标志物，它们与认知障碍风险增加有关。在这项研究中，我们调查了中年心血管危险因素与 20 年后的晚年 WMH 体积之间的关系，并研究了它们与认知表现的关系。来自妇女健康衰老项目的 135 名参与者在 1992 年完成了中年心血管风险测量，在 2012 年完成了晚年大脑 MRI 扫描和认知评估。在这些居住在社区的正常衰老女性中，我们发现，中年弗雷明汉心血管风险评分（FCRP）越高，20 年后的 WMH 体积越大，这主要是由高密度脂蛋白胆固醇水平的影响所驱动，控制了年龄、教育程度和 APOE ε4 状态。结构方程模型表明，中年 FCRP 评分与晚年执行功能之间的关系是通过 WMH 体积介导的。这些发现表明，在中年针对主要心血管危险因素采取干预策略可能有助于减少 WMH 病变的发展，从而减缓晚年认知能力下降。
