心血管健康研究中载脂蛋白E、磁共振成像结果与认知功能之间的关系。

Relationship between ApoE, MRI findings, and cognitive function in the Cardiovascular Health Study.

作者信息

Kuller L H, Shemanski L, Manolio T, Haan M, Fried L, Bryan N, Burke G L, Tracy R, Bhadelia R

机构信息

University of Pittsburgh, Pa 15261, USA. kuller+@pitt.edu

出版信息

Stroke. 1998 Feb;29(2):388-98. doi: 10.1161/01.str.29.2.388.

DOI:10.1161/01.str.29.2.388

PMID:9472879

Abstract

BACKGROUND AND PURPOSE

We determined the relationship between apolipoprotein (Apo)E, MRI, and low cognitive scores.

METHODS

The relationship between age, education, ApoE genotype, MRI examination of the brain, subclinical and clinical cardiovascular disease, and low (<80) score on the Modified Mini-Mental State Examination (3MSE, as modified by Teng and Chui) was evaluated for 3469 black and white participants in the Cardiovascular Health Study (CHS) in years 5 and 6 of the study. The participants were followed for up to 3 years.

RESULTS

The prevalence of scores <80 in years 5 and 6 of the CHS was 8.2% for participants without and 20.4% for those with prior history of stroke. Age, race, and education were important determinants of low 3MSE scores. The prevalence of ApoE-4 (odds ratio [OR], 1.6 [1.1 to 2.1]) was directly related to scores <80, as was high ventricular volume (OR, 1.6 [1.2 to 2.3]), high white matter grade (OR, 1.4 [1.1 to 1.9]), and infarctlike lesions (OR, 1.6 [1.2 to 2.1]) on the MRI in the multivariate analysis. A five-point or greater decline in scores over up to 3 years was more often observed for participants with low 3MSE scores at year 5, at older ages, with lower education, and experiencing incident stroke (OR, 3.6 [1.2 to 10.6]), ApoE-4 genotype (OR, 1.8 [1.4 to 2.3]), and with MRI findings of high ventricular volume (OR, 2.0 [1.5 to 2.7]), and infarctlike lesions (OR, 1.2 [0.9 to 1.5]).

CONCLUSIONS

These results demonstrate that vascular changes on MRI, measures of brain atrophy, ApoE-4, and age, education, and race are associated with low cognitive scores among older individuals. The MRI of the brain provides valuable information related to cognitive tests and decline over time. The potential exists for using MRI measurements to identify high-risk individuals for dementia and to test potential interventions to reduce the risk of dementia.

摘要

背景与目的

我们确定了载脂蛋白（Apo）E、磁共振成像（MRI）与低认知评分之间的关系。

方法

在心血管健康研究（CHS）的第5年和第6年，对3469名黑人和白人参与者评估了年龄、教育程度、ApoE基因型、脑部MRI检查、亚临床和临床心血管疾病，以及改良简易精神状态检查表（由Teng和Chui改良后的3MSE）评分低于80分的情况。对参与者进行了长达3年的随访。

结果

在CHS的第5年和第6年，无中风病史的参与者中评分低于80分的患病率为8.2%，有中风病史的参与者中为20.4%。年龄、种族和教育程度是3MSE低评分的重要决定因素。在多变量分析中，ApoE-4的患病率（优势比[OR]，1.6[1.1至2.1]）与评分低于80分直接相关，MRI上的高脑室容积（OR，1.6[1.2至2.3]）、高白质分级（OR，1.4[1.1至1.9]）和梗死样病变（OR，1.6[1.2至2.1]）也与之相关。在第5年3MSE评分低、年龄较大、教育程度较低且发生中风（OR，3.6[1.2至10.6]）、ApoE-4基因型（OR，1.8[1. to 2.3]）以及MRI显示高脑室容积（OR，2.0[1.5至2.7]）和梗死样病变（OR，1.2[0.9至1.5]）的参与者中，更常观察到在长达3年的时间里评分下降5分或更多。