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Cluster analysis and patterns of findings on cranial magnetic resonance imaging of the elderly: the Cardiovascular Health Study.

TitleCluster analysis and patterns of findings on cranial magnetic resonance imaging of the elderly: the Cardiovascular Health Study.
Publication TypeJournal Article
Year of Publication2001
AuthorsLongstreth, WT, Diehr, P, Manolio, TA, Beauchamp, NJ, Jungreis, CA, Lefkowitz, D
Corporate/Institutional AuthorsCardiovascular Health Study Collaborative Research Group,
JournalArch Neurol
Volume58
Issue4
Pagination635-40
Date Published2001 Apr
ISSN0003-9942
KeywordsAged, Brain, Cerebral Infarction, Cerebrovascular Disorders, Cluster Analysis, Cohort Studies, Discriminant Analysis, Female, Humans, Longitudinal Studies, Magnetic Resonance Imaging, Male, Risk Factors
Abstract<p><b>OBJECTIVE: </b>To characterize patterns of findings on cranial magnetic resonance imaging (MRI) of the elderly using a statistical technique called cluster analysis.</p><p><b>SUBJECTS AND METHODS: </b>The Cardiovascular Health Study is a population-based, longitudinal study of 5888 people 65 years and older. Of these, 3230 underwent cranial MRI scans, which were coded for presence of infarcts and grades for white matter, ventricles, and sulci. Cluster analysis separated participants into 5 clusters based solely on patterns of MRI findings. Participants comprising each cluster were contrasted with respect to cardiovascular risk factors and clinical manifestations.</p><p><b>RESULTS: </b>One cluster was low on all the MRI findings (normal) and another was high on all of them (complex infarcts). Another cluster had evidence for infarcts alone (simple infarcts), whereas the last 2 clusters lacked infarcts, one having enlarged ventricles and sulci (atrophy) and the other having prominent white matter changes and enlarged ventricles (leukoaraiosis). Factors that distinguished these clusters in a discriminant analysis were age, sex, several measures of hypertension, internal carotid artery wall thickness, smoking, and prevalent claudication before the MRI. The atrophy group had the highest percentage of men and the normal group had the lowest. Cognitive and motor performance also differed across clusters, with the atrophy cluster performing better than may have been expected.</p><p><b>CONCLUSIONS: </b>These MRI patterns identified participants with different vascular disease risk factors and clinical manifestations. Results of these exploratory analyses warrant consideration in other populations of elderly people. Such patterns may provide clues about the pathophysiology of structural brain changes in the elderly.</p>
DOI10.1001/archneur.58.4.635
Alternate JournalArch Neurol
PubMed ID11295995
Grant ListN01 HC-95100 / HC / NHLBI NIH HHS / United States
N01-HC-85056 / HC / NHLBI NIH HHS / United States
N01-HC-85079 / HC / NHLBI NIH HHS / United States