Abstract T MP115: Association Between Cerebral Large/Small Vessel Disease and Incident Dementia in Patients with Vascular Risk Factors - Sub-analysis of OSACA2 follow-up study
Background and Purpose: Involvement of vascular risk factors on dementia has attracted much attention. Several prospective studies have shown that the presence of cerebral small vessel disease (SVD) is associated with incident dementia. However, the significance of cerebral large vessel disease (LVD) on dementia development has not been examined thoroughly.
Methods: OSACA2 is a prospective cohort study for cardiovascular events and dementia in which patients with vascular risk factors undergo carotid ultrasound and blood sampling. Between 2001 and 2009, 1106 outpatients were enrolled. Among them, 600 patients who underwent brain MRI and had normal cognitive function were included in this study. Follow-up data for dementia occurrence were collected in June 2011. Baseline MRI was used to determine lacunar infarction as a sign of SVD. The presence of carotid stenosis as a sign of cerebral LVD was defined with 50% or more stenosis in carotid ultrasound.
Results: Among 600 subjects (mean: 68 years, male: 57%), 264 patients (44%) had lacunar infarction, and 94 patients (16%) showed carotid stenosis. During the follow-up period of median 7.5 years, 50 patients had incident dementia (24 AD, 18 vascular dementia, 5 mixed type, 3 others). The presence of lacunar infarction had close association with dementia in Kaplan-Meier plots analysis (p<0.001). The association remained significant after adjustment with modifiable factors including history of stroke, APOE genotype and education year (HR:2.20, 95% CI [1.11-4.53]). However, the presence of carotid stenosis was not associated with incident dementia (p value=0.07).
Conclusion: This study suggested that carotid stenosis have little association with future dementia while lacunar infarction had significant association. The impact of SVD on dementia could be much greater than that of cerebral LVD.
Author Disclosures: K. Kitagawa: None. K. Miwa: None. Y. Yagita: None. S. Okazaki: None. M. Sakaguchi: None. H. Mochizuki: None.
- © 2014 by American Heart Association, Inc.