目的:脑小血管病(CSVD)与认知功能下降和痴呆有关。CSVD的神经影像学改变在80岁以上非常普遍。只有很少的研究报告CSVD在高年龄的发病率。我们调查了一般老年人群中CSVD的磁共振成像(MRI)标志物的发生率和患病率以及危险因素。
方法:作为一般人群的一部分,Skáne队列研究中的良好老龄化,241人(平均年龄76.3岁)接受了两次脑部MRI检查,3-T扫描仪,平均间隔为5.9年。白质高信号(WMH)的发生率,腔隙性脑梗塞,计算脑萎缩和脑微出血(CMB),并通过多变量回归分析分析与危险因素的关系.内侧颞叶萎缩(MTA)根据Scheltens\'18量表进行分级,CMB定义为具有>1个小(0.2-0.5cm)低信号病变。
结果:CMB的6年发病率,WMH和MTA是,19%,分别为17%和13%,对应于170/1,000py。,172/1,000py。,分别为167/1,000py。根据改良STRIVE评分,CSVD的发生率为33%,169/1,000py,基线时的患病率为73%。中度至高度饮酒与MTA发病率增加和STRIVE评分升高有关。暴露于吸烟与CMB的较高发生率和较高的STRIVE评分有关,调整其他已知的风险因素。
结论:CSVD在一般老年人群中非常普遍,WMH的6年发病率高,CMB和MTA的范围从13%到19%。可改变的生活方式因素:吸烟,适度饮酒与CSVD相关。
OBJECTIVE: Cerebral small vessel disease (CSVD) is associated to cognitive decline and dementia. Neuroimaging changes of CSVD are highly prevalent above 80 years. Only few studies report on incidence of CSVD in high age. We have investigated the incidence and prevalence of magnetic resonance imaging (MRI) markers of CSVD and risk factors in the general older population.
METHODS: As part of the general population Good Aging in Skåne cohort study (GÅS), 241 persons (mean age 76.3 years) underwent two brain MRI, 3-T scanner with a mean interval of 5.9 years. The incidence of white matter hyperintensities (WMH), lacunar infarction, cerebral atrophies and cerebral microbleeds (CMB) were calculated and the relationship to risk factors analysed by a multivariate regression analysis. Medial temporal lobe atrophy (MTA) was graded according to Scheltens\'18 scale and CMB were defined as having > 1 small (0.2-0.5 cm) hypointense lesion.
RESULTS: The 6-year incidence of CMB, WMH and MTA were, 19%, 17% and 13% respectively, corresponding to 170/1,000 py., 172/1,000 py., and respectively 167/1,000 py. The incidence of CSVD according to the modified STRIVE score was 33%, 169/1,000 py and the prevalence at baseline was 73%. Moderate to high intake of alcohol was related to increased incidence of MTA and higher STRIVE score. Exposure to smoking was related to higher incidence of CMB and higher STRIVE score, adjusted for other known risk factors.
CONCLUSIONS: CSVD is highly prevalent in the general older population and the 6-year incidence of WMH, CMB and MTA ranges from 13 to 19 percent. The modifiable lifestyle factors: smoking, and moderate alcohol intake are related to incident CSVD.