Abstract
Objective: To report population age-specific prevalence of core cerebrovascular disease lesions (infarctions, cerebral microbleeds, and white-matter hyperintensities detected with magnetic resonance imaging); estimate cut points for white-matter hyperintensity positivity; investigate sex differences in prevalence; and estimate prevalence of any core cerebrovascular disease features. Patients and Methods: Participants in the population-based Mayo Clinic Study of Aging aged 50 to 89 years underwent fluid-attenuated inversion recovery and T2* gradient-recalled echo magnetic resonance imaging to assess cerebrovascular disease between October 10, 2011, and September 29, 2017. We characterized each participant as having infarct, normal versus abnormal white-matter hyperintensity, cerebral microbleed, or a combination of lesions. Prevalence of cerebrovascular disease biomarkers was derived through adjustment for nonparticipation and standardization to the population of Olmsted County, Minnesota. Results: Among 1462 participants without dementia (median [range] age, 68 [50 to 89] y; men, 52.7%), core cerebrovascular disease features increased with age. Prevalence (95% CI) of cerebral microbleeds was 13.6% (11.6%-15.6%); infarcts, 11.7% (9.7%-13.8%); and abnormal white-matter hyperintensity, 10.7% (8.7%-12.6%). Infarcts and cerebral microbleeds were more common among men. In contrast, abnormal white-matter hyperintensity was more common among women ages 60 to 79 y and men, ages 80 y and older. Prevalence of any core cerebrovascular disease feature determined by presence of at least one cerebrovascular disease feature increased from 9.5% (ages 50 to 59 y) to 73.8% (ages 80 to 89 y). Conclusion: Whereas this study focused on participants without dementia, the high prevalence of cerebrovascular disease imaging lesions in elderly persons makes assignment of clinical relevance to cognition and other downstream manifestations more probabilistic than deterministic.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1195-1205 |
| Number of pages | 11 |
| Journal | Mayo Clinic proceedings |
| Volume | 95 |
| Issue number | 6 |
| DOIs | |
| State | Published - Jun 2020 |
ASJC Scopus subject areas
- Medicine(all)
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Prevalence and Heterogeneity of Cerebrovascular Disease Imaging Lesions. / Graff-Radford, Jonathan; Aakre, Jeremiah A.; Knopman, David S.; Schwarz, Christopher G.; Flemming, Kelly D.; Rabinstein, Alejandro A.; Gunter, Jeffrey L.; Ward, Chadwick P.; Zuk, Samantha M.; Spychalla, A. J.; Preboske, Gregory M.; Petersen, Ronald C.; Kantarci, Kejal; Huston, John; Jack, Clifford R.; Mielke, Michelle M.; Vemuri, Prashanthi.
In: Mayo Clinic proceedings, Vol. 95, No. 6, 06.2020, p. 1195-1205.Research output: Contribution to journal › Article › peer-review
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TY - JOUR
T1 - Prevalence and Heterogeneity of Cerebrovascular Disease Imaging Lesions
AU - Graff-Radford, Jonathan
AU - Aakre, Jeremiah A.
AU - Knopman, David S.
AU - Schwarz, Christopher G.
AU - Flemming, Kelly D.
AU - Rabinstein, Alejandro A.
AU - Gunter, Jeffrey L.
AU - Ward, Chadwick P.
AU - Zuk, Samantha M.
AU - Spychalla, A. J.
AU - Preboske, Gregory M.
AU - Petersen, Ronald C.
AU - Kantarci, Kejal
AU - Huston, John
AU - Jack, Clifford R.
AU - Mielke, Michelle M.
AU - Vemuri, Prashanthi
N1 - Funding Information: This study was made possible using the resources of the Rochester Epidemiology Project, which is supported by the National Institute on Aging (NIA) of the National Institutes of Health (NIH) under Award Number R01AG034676 . In addition, it is supported by NIH Award Numbers R37AG011378 , K76AG057015-02 , R01AG041851 , R01NS097495 , and RF1AG55151 . The study received support from the GHR Foundation . Its content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or Gerald and Henrietta Rauenhorst. The funding sources had no involvement in study design; in the collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the paper for publication. Jonathan Graff-Radford, MD, had full access to all the data in the study and had final responsibility for the decision to submit for publication. Funding Information: Potential Competing Interests: This study was supported by the National Institute on Aging (NIA), the National Institute for Neurological Disorders and Stroke (NINDS), and the GHR Foundation . Dr Graff-Radford reports grants from the National Institute on Aging . He receives funding from the Alzheimer’s Treatment and Research Institute . He received an honorarium from the American Academy of Neurology for serving as a guest editor of Continuum. Dr Knopman serves on a data safety monitoring board for the Dominantly Inherited Alzheimer Network study. He is an investigator in clinical trials sponsored by Eli Lilly Biogen , and the Alzheimer’s Treatment and Research Institute and receives research support from NIH . Dr Schwarz reports grants from the National Institute on Aging . Dr Flemming reports grants from the National Institute of Neurological Disorders and Stroke , the National Center for Advancing Translational Science , and Boston Scientific Corporation . Dr Rabinstein receives royalties from Elsevier and Oxford University Press and has received research support from DJO Global, Inc . Dr Petersen is a consultant for Roche Holding AG, Biogen, Merck & Co, Eli Lilly and Co, and Genentech. He receives publishing royalties from Mild Cognitive Impairment ( Oxford University Press , 2003) and research support from NIH . Dr Kantarci serves on the data safety monitoring board for Takeda Global Research & Development Center, Inc; receives research support from Avid Radiopharmaceuticals , Inc, and Eli Lilly and Co ; and receives funding from NIH and the Alzheimer's Drug Discovery Foundation . Dr Huston reports patents from the Mayo Foundation for Medical Education and Research and royalties from Resoundant, Inc, and receives stock options in Resoundant, Inc. He reports no competing financial interests to the present article. Dr Jack consults for Eli Lilly and serves on an independent data monitoring board for Roche Holding AG. However, he receives no personal compensation from any commercial entity. He receives research support from the NIA of the NIH and the Alexander Family Professor of Alzheimer’s Disease Research, Mayo Clinic . Dr Mielke is a consultant for Eli Lilly and Co and Lysosomal Therapeutics, Inc. She receives unrestricted research grants from Biogen , Lundbeck , and Roche Holding AG and receives research funding from the NIA of the NIH and the US Department of Defense . Dr Vemuri reports grants from the National Institute for Neurological Disorders and Stroke . The other authors report no disclosures. Funding Information: Potential Competing Interests: This study was supported by the National Institute on Aging (NIA), the National Institute for Neurological Disorders and Stroke (NINDS), and the GHR Foundation. Dr Graff-Radford reports grants from the National Institute on Aging. He receives funding from the Alzheimer's Treatment and Research Institute. He received an honorarium from the American Academy of Neurology for serving as a guest editor of Continuum. Dr Knopman serves on a data safety monitoring board for the Dominantly Inherited Alzheimer Network study. He is an investigator in clinical trials sponsored by Eli Lilly Biogen, and the Alzheimer's Treatment and Research Institute and receives research support from NIH. Dr Schwarz reports grants from the National Institute on Aging. Dr Flemming reports grants from the National Institute of Neurological Disorders and Stroke, the National Center for Advancing Translational Science, and Boston Scientific Corporation. Dr Rabinstein receives royalties from Elsevier and Oxford University Press and has received research support from DJO Global, Inc. Dr Petersen is a consultant for Roche Holding AG, Biogen, Merck & Co, Eli Lilly and Co, and Genentech. He receives publishing royalties from Mild Cognitive Impairment (Oxford University Press, 2003) and research support from NIH. Dr Kantarci serves on the data safety monitoring board for Takeda Global Research & Development Center, Inc; receives research support from Avid Radiopharmaceuticals, Inc, and Eli Lilly and Co; and receives funding from NIH and the Alzheimer's Drug Discovery Foundation. Dr Huston reports patents from the Mayo Foundation for Medical Education and Research and royalties from Resoundant, Inc, and receives stock options in Resoundant, Inc. He reports no competing financial interests to the present article. Dr Jack consults for Eli Lilly and serves on an independent data monitoring board for Roche Holding AG. However, he receives no personal compensation from any commercial entity. He receives research support from the NIA of the NIH and the Alexander Family Professor of Alzheimer's Disease Research, Mayo Clinic. Dr Mielke is a consultant for Eli Lilly and Co and Lysosomal Therapeutics, Inc. She receives unrestricted research grants from Biogen, Lundbeck, and Roche Holding AG and receives research funding from the NIA of the NIH and the US Department of Defense. Dr Vemuri reports grants from the National Institute for Neurological Disorders and Stroke. The other authors report no disclosures.This study was made possible using the resources of the Rochester Epidemiology Project, which is supported by the National Institute on Aging (NIA) of the National Institutes of Health (NIH) under Award Number R01AG034676. In addition, it is supported by NIH Award Numbers R37AG011378, K76AG057015-02, R01AG041851, R01NS097495, and RF1AG55151. The study received support from the GHR Foundation. Its content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or Gerald and Henrietta Rauenhorst. The funding sources had no involvement in study design; in the collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the paper for publication. Jonathan Graff-Radford, MD, had full access to all the data in the study and had final responsibility for the decision to submit for publication. Publisher Copyright: © 2020 Mayo Foundation for Medical Education and Research
PY - 2020/6
Y1 - 2020/6
N2 - Objective: To report population age-specific prevalence of core cerebrovascular disease lesions (infarctions, cerebral microbleeds, and white-matter hyperintensities detected with magnetic resonance imaging); estimate cut points for white-matter hyperintensity positivity; investigate sex differences in prevalence; and estimate prevalence of any core cerebrovascular disease features. Patients and Methods: Participants in the population-based Mayo Clinic Study of Aging aged 50 to 89 years underwent fluid-attenuated inversion recovery and T2* gradient-recalled echo magnetic resonance imaging to assess cerebrovascular disease between October 10, 2011, and September 29, 2017. We characterized each participant as having infarct, normal versus abnormal white-matter hyperintensity, cerebral microbleed, or a combination of lesions. Prevalence of cerebrovascular disease biomarkers was derived through adjustment for nonparticipation and standardization to the population of Olmsted County, Minnesota. Results: Among 1462 participants without dementia (median [range] age, 68 [50 to 89] y; men, 52.7%), core cerebrovascular disease features increased with age. Prevalence (95% CI) of cerebral microbleeds was 13.6% (11.6%-15.6%); infarcts, 11.7% (9.7%-13.8%); and abnormal white-matter hyperintensity, 10.7% (8.7%-12.6%). Infarcts and cerebral microbleeds were more common among men. In contrast, abnormal white-matter hyperintensity was more common among women ages 60 to 79 y and men, ages 80 y and older. Prevalence of any core cerebrovascular disease feature determined by presence of at least one cerebrovascular disease feature increased from 9.5% (ages 50 to 59 y) to 73.8% (ages 80 to 89 y). Conclusion: Whereas this study focused on participants without dementia, the high prevalence of cerebrovascular disease imaging lesions in elderly persons makes assignment of clinical relevance to cognition and other downstream manifestations more probabilistic than deterministic.
AB - Objective: To report population age-specific prevalence of core cerebrovascular disease lesions (infarctions, cerebral microbleeds, and white-matter hyperintensities detected with magnetic resonance imaging); estimate cut points for white-matter hyperintensity positivity; investigate sex differences in prevalence; and estimate prevalence of any core cerebrovascular disease features. Patients and Methods: Participants in the population-based Mayo Clinic Study of Aging aged 50 to 89 years underwent fluid-attenuated inversion recovery and T2* gradient-recalled echo magnetic resonance imaging to assess cerebrovascular disease between October 10, 2011, and September 29, 2017. We characterized each participant as having infarct, normal versus abnormal white-matter hyperintensity, cerebral microbleed, or a combination of lesions. Prevalence of cerebrovascular disease biomarkers was derived through adjustment for nonparticipation and standardization to the population of Olmsted County, Minnesota. Results: Among 1462 participants without dementia (median [range] age, 68 [50 to 89] y; men, 52.7%), core cerebrovascular disease features increased with age. Prevalence (95% CI) of cerebral microbleeds was 13.6% (11.6%-15.6%); infarcts, 11.7% (9.7%-13.8%); and abnormal white-matter hyperintensity, 10.7% (8.7%-12.6%). Infarcts and cerebral microbleeds were more common among men. In contrast, abnormal white-matter hyperintensity was more common among women ages 60 to 79 y and men, ages 80 y and older. Prevalence of any core cerebrovascular disease feature determined by presence of at least one cerebrovascular disease feature increased from 9.5% (ages 50 to 59 y) to 73.8% (ages 80 to 89 y). Conclusion: Whereas this study focused on participants without dementia, the high prevalence of cerebrovascular disease imaging lesions in elderly persons makes assignment of clinical relevance to cognition and other downstream manifestations more probabilistic than deterministic.
UR - http://www.scopus.com/inward/record.url?scp=85085483652&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85085483652&partnerID=8YFLogxK
U2 - 10.1016/j.mayocp.2020.01.028
DO - 10.1016/j.mayocp.2020.01.028
M3 - Article
C2 - 32498775
AN - SCOPUS:85085483652
VL - 95
SP - 1195
EP - 1205
JO - Mayo Clinic Proceedings
JF - Mayo Clinic Proceedings
SN - 0025-6196
IS - 6
ER -