03089nas a2200385 4500008004100000022001400041245013300055210006900188260001300257300001100270490000700281520198100288653003102269653000902300653002202309653001002331653001102341653002202352653000902374653001102383653001402394653003102408653000902439653003202448653002602480653001702506653001802523100002102541700002102562700001702583700002102600700002702621700002002648856003502668 2005 eng d a0002-861400aSubclinical brain magnetic resonance imaging abnormalities predict physical functional decline in high-functioning older adults.0 aSubclinical brain magnetic resonance imaging abnormalities predi c2005 Apr a649-540 v533 a

OBJECTIVES: To determine whether severity of subclinical brain magnetic resonance imaging (MRI) abnormalities predicts incident self-reported physical impairment or rate of decline in motor performance.

DESIGN: Longitudinal analysis, average follow-up time: 4.0 years.

SETTING: Cardiovascular Health Study (CHS).

PARTICIPANTS: CHS participants with modified Mini-Mental State Examination (3MS) score of 80 or greater, no self-reported disability, no history of stroke, and at least one assessment of mobility (n=2,450, mean age=74.4).

MEASUREMENTS: Brain MRI abnormalities (ventricular enlargement, white matter hyperintensities, subcortical and basal ganglia small brain infarcts), self-reported physical impairment (difficulty walking half a mile or with one or more activities of daily living), and motor performance (gait speed, timed chair stand).

RESULTS: After adjusting for demographics, cardiovascular risk factors, and diseases, risk of incident self-reported physical impairment was 35% greater for those with severe ventricular enlargement than for those with minimal ventricular enlargement, 22% greater for those with moderate white matter hyperintensities than for those with minimal white matter hyperintensities, and 26% greater for participants with at least one brain infarct than for those with no infarcts. Those with moderate to severe brain abnormalities experienced faster gait speed decline (0.02 m/s per year) than those with no MRI abnormalities (0.01 m/s per year). Further adjustment for incident stroke, incident dementia, and 3MS score did not substantially attenuate hazard ratios for incident self-reported physical impairment or coefficients for decline in gait speed.

CONCLUSION: Subclinical structural brain abnormalities in high-functioning older adults can increase the risk of developing physical disabilities and declining in motor performance.

10aActivities of Daily Living10aAged10aAged, 80 and over10aBrain10aFemale10aFollow-Up Studies10aGait10aHumans10aIncidence10aMagnetic Resonance Imaging10aMale10aProportional Hazards Models10aPsychomotor Disorders10aRisk Factors10aUnited States1 aRosano, Caterina1 aKuller, Lewis, H1 aChung, Hyoju1 aArnold, Alice, M1 aLongstreth, William, T1 aNewman, Anne, B uhttps://chs-nhlbi.org/node/830