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Brain imaging findings in elderly adults and years of life, healthy life, and able life over the ensuing 16 years: the Cardiovascular Health Study.
Wednesday,2015-03-04 13:02 America/Los_Angeles — zdrager
| Title | Brain imaging findings in elderly adults and years of life, healthy life, and able life over the ensuing 16 years: the Cardiovascular Health Study. |
| Publication Type | Journal Article |
| Year of Publication | 2014 |
| Authors | Longstreth, WT, Diehr, PH, Yee, LM, Newman, AB, Beauchamp, NJ |
| Journal | J Am Geriatr Soc |
| Volume | 62 |
| Issue | 10 |
| Pagination | 1838-43 |
| Date Published | 2014 Oct |
| ISSN | 1532-5415 |
| Keywords | Activities of Daily Living, Aged, Atrophy, Brain, Brain Infarction, Cohort Studies, Disability Evaluation, Female, Health Status, Humans, Leukoaraiosis, Longevity, Longitudinal Studies, Magnetic Resonance Imaging, Male, Prognosis, Regression Analysis, United States |
| Abstract | <p><b>OBJECTIVES: </b>To determine whether elderly people with different patterns of magnetic resonance imaging (MRI) findings have different long-term outcomes.</p><p><b>DESIGN: </b>Longitudinal cohort study.</p><p><b>SETTING: </b>Cardiovascular Health Study.</p><p><b>PARTICIPANTS: </b>Individuals aged 65 and older were recruited (N = 5,888); 3,660 of these underwent MRI, and 3,230 without a stroke before MRI were included in these analyses.</p><p><b>MEASUREMENTS: </b>Cluster analysis of brain MRI findings was previously used to define five clusters: normal, atrophy, simple infarct, leukoaraiosis, and complex infarct. Participants were subsequently classified as healthy if they rated their health as excellent, very good, or good and as able if they did not report any limitations in activities of daily living (ADLs). Mean years of life (YoL), years of healthy life (YHL), and years of able life (YAL) were calculated over 16 years after the MRI and compared between clusters using unadjusted and adjusted regression analyses.</p><p><b>RESULTS: </b>Mean age of participants was 75.0. With 16 years of follow-up, mean YoL was 11.3; YHL, 8.0; and YAL, 8.4. Outcomes differed significantly between clusters. With or without adjustments, outcomes were all significantly better in the normal than complex infarct cluster. The three remaining clusters had intermediate results, significantly different from the normal and complex infarct clusters but not usually from one another. Over 16 years of follow-up, participants in the complex infarct cluster (n = 368) spent the largest percentage of their 8.4 years alive being sick (38%) and not able (38%).</p><p><b>CONCLUSION: </b>Findings on MRI scans in elderly adults are associated not only with long-term survival, but also with long-term self-rated health and limitation in ADLs. The combination of infarcts and leukoaraiosis carried the worst prognosis, presumably reflecting small vessel disease.</p> |
| DOI | 10.1111/jgs.13068 |
| Alternate Journal | J Am Geriatr Soc |
| PubMed ID | 25333525 |
| PubMed Central ID | PMC4205483 |
| Grant List | N01HC55222 / HC / NHLBI NIH HHS / United States N01HC85080 / HC / NHLBI NIH HHS / United States U01 HL080295 / HL / NHLBI NIH HHS / United States HHSN268200800007C / HL / NHLBI NIH HHS / United States N01 HC015103 / HC / NHLBI NIH HHS / United States N01HC55222 / HL / NHLBI NIH HHS / United States N01HC85086 / HL / NHLBI NIH HHS / United States N01HC85081 / HC / NHLBI NIH HHS / United States N01HC85079 / HC / NHLBI NIH HHS / United States HHSN268201200036C / HL / NHLBI NIH HHS / United States N01HC85086 / HC / NHLBI NIH HHS / United States R01 HL080295 / HL / NHLBI NIH HHS / United States N01HC85082 / HC / NHLBI NIH HHS / United States HHSN268200800007C / / PHS HHS / United States N01HC85082 / HL / NHLBI NIH HHS / United States N01HC85083 / HL / NHLBI NIH HHS / United States N01HC15103 / HC / NHLBI NIH HHS / United States HL080295 / HL / NHLBI NIH HHS / United States N01HC85083 / HC / NHLBI NIH HHS / United States N01HC85079 / HL / NHLBI NIH HHS / United States R01 AG023629 / AG / NIA NIH HHS / United States N01HC85080 / HL / NHLBI NIH HHS / United States AG023629 / AG / NIA NIH HHS / United States R56 AG023629 / AG / NIA NIH HHS / United States N01HC85081 / HL / NHLBI NIH HHS / United States HSN268201200036C / / PHS HHS / United States |