Objective
We aimed to determine the associations between silent cerebrovascular lesions, characterized
by lacunar infarcts and white matter hyperintensity, and future decline in higher
level functional capacity in older community-dwelling adults.
Materials and Methods
For this observational study, we selected individuals from the general population
of Ohasama, a rural Japanese community. Three hundred thirty-one participants who
were free of functional decline at baseline and who were at least 60 years old underwent
brain magnetic resonance imaging and answered a questionnaire on higher level functional
capacity derived from the Tokyo Metropolitan Institute of Gerontology Index of Competence.
Weassessed the relationship between silent cerebrovascular lesions with a decline
in higher level functional capacity at 7 years using multiple logistic regression
analysis adjusted for possible confounding factors.
Results
During the follow-up, 22.1% reported declines in higher level functional capacity.
After adjustment for putative confounding factors, the presence of silent cerebrovascular
lesions (odds ratio [95% confidence interval], 2.10 [1.05-4.21]) and both lacunar
infarcts (2.04 [1.05-3.95]) and white matter hyperintensity (2.02 [1.02-3.95]) was
significantly associated with the risk of functional decline at 7-year follow-up.
In subscale analysis, specifically lacunar infarcts were strongly associated with
the future risk of decline in intellectual activity (3.16 [1.27-7.84]).
Conclusion
Silent cerebrovascular lesions are associated with future risk of decline in higher
level functional capacity. Appropriate management of health risk factors to prevent
silent cerebrovascular lesions may prevent higher level functional decline in the
elderly population.
Key Words
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Article info
Publication history
Published online: October 28, 2016
Accepted:
September 22,
2016
Received in revised form:
September 16,
2016
Received:
July 25,
2016
Footnotes
Funding sources and related paper presentations: This study was supported by Grants for Scientific Research (JP23249036, JP23390171, JP24390084, JP24591060, JP24790654, JP25253059, JP25461083, JP25461205, JP25860156, JP26282200, JP26860093, JP16H05243, JP16K09472, JP16K11850, and JP16K15359) from the Ministry of Education, Culture, Sports, Science, and Technology, Japan; a Grant-in-Aid from the Japan Society for the Promotion of Science (JSPS) fellows (25*7756, 25*9328, 26*857, and 27*656); the Japan Arteriosclerosis Prevention Fund; an Intramural Research Fund (22-4-5) for Cardiovascular Diseases of National Cerebral and Cardiovascular Center; and a Health Labor Sciences Research Grant (H26-Junkankitou [Seisaku]-Ippan-001) from the Ministry of Health, Labour and Welfare.
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2016.09.036
Copyright
© 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.
