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on May 25, 2006

Stroke. 2006
Published online before print May 25, 2006, doi: 10.1161/01.STR.0000226403.00963.af
A more recent version of this article appeared on July 1, 2006
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Submitted on March 28, 2006
Accepted on April 13, 2006

Midlife Respiratory Function Related to White Matter Lesions and Lacunar Infarcts in Late Life. The Prospective Population Study of Women in Gothenburg, Sweden

Xinxin Guo MD, PhD*; Leonardo Pantoni MD, PhD; Michela Simoni MD; Deborah Gustafson PhD; Calle Bengtsson MD, PhD; Bo Palmertz MD; and Ingmar Skoog MD, PhD

From the Neuropsychiatric Epidemiology Unit (X.G., D.G., I.S.), Institute of Neurosciences and Physiology, Sahlgrenska Academy at Göteborg University, Sweden; Department of Neurological and Psychiatric Sciences (L.P., M.S.), University of Florence, Italy; Department of Primary Health Care (C.B.), Sahlgrenska Academy at Göteborg University, Sweden; and Department of Radiology (B.P.), Östra Hospital, Göteborg, Sweden.

* To whom correspondence should be addressed. E-mail: xinxin.guo{at}neuro.gu.se.

Background and Purpose--Increased evidence suggests that poor respiratory function increases risk of ischemic damage to the brain. Longitudinal studies on respiratory function and cerebral small-vessel disease are lacking. We examined midlife and late-life respiratory function in relation to small-vessel disease on computed tomography (CT) in women followed for 26 years.

Methods--White matter lesions (WMLs) and lacunar infarcts were rated on brain CT scans in 2000 in 379 women 70 to 92 years of age from a longitudinal population study in Göteborg, Sweden. Respiratory function was measured by peak expiratory flow (PEF) in 1974 and 2000 and by forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) in 1980 and 2000.

Results--Lower FVC and FEV1 in 1980 and 2000 were associated with presence and severity of WMLs and lacunar infarcts in 2000. Per 1-SD decrease of FVC in 1980, odds ratios (95% CIs) were 1.49 (1.11 to 2.02) for presence of WMLs and 1.95 (1.34 to 2.84) for lacunar infarcts after adjustment for potential confounders. Per 1-SD decrease of FEV1 in 1980, adjusted odds ratios were 1.46 (1.06 to 2.00) for presence of WMLs and 1.42 (1.02 to 1.97) for lacunar infarcts. PEF in 1974 and 2000 was not associated with WMLs or lacunar infarcts.

Conclusions--WMLs and lacunar infarcts in elderly women were related to lower midlife respiratory function. Although our data may not establish causation between lower respiratory function and small-vessel disease, they imply the importance of good respiratory function in midlife.


Key words: lacunar infarction • respiratory function tests • leukoaraiosis




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