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dc.contributor.authorSigurdsson, Sigurdur*
dc.contributor.authorAspelund, Thor*
dc.contributor.authorKjartansson, Olafur*
dc.contributor.authorGudmundsson, Elias F.*
dc.contributor.authorJonsdottir, Maria K.*
dc.contributor.authorEiriksdottir, Gudny*
dc.contributor.authorJonsson, Palmi V.*
dc.contributor.authorvan Buchem, Mark A.*
dc.contributor.authorGudnason, Vilmundur*
dc.contributor.authorLauner, Lenore J.*
dc.date.accessioned2018-03-26T12:07:47Z
dc.date.available2018-03-26T12:07:47Z
dc.date.issued2017-09
dc.date.submitted2018
dc.identifier.citationIncidence of Brain Infarcts, Cognitive Change, and Risk of Dementia in the General Population 2017, 48 (9):2353 Strokeen
dc.identifier.issn0039-2499
dc.identifier.issn1524-4628
dc.identifier.doi10.1161/STROKEAHA.117.017357
dc.identifier.urihttp://hdl.handle.net/2336/620520
dc.descriptionTo access publisher's full text version of this article click on the hyperlink belowen
dc.description.abstractBACKGROUND AND PURPOSE: The differentiation of brain infarcts by region is important because their cause and clinical implications may differ. Information on the incidence of these lesions and association with cognition and dementia from longitudinal population studies is scarce. We investigated the incidence of infarcts in cortical, subcortical, cerebellar, and overall brain regions and how prevalent and incident infarcts associate with cognitive change and incident dementia. METHODS: Participants (n=2612, 41% men, mean age 74.6±4.8) underwent brain magnetic resonance imaging for the assessment of infarcts and cognitive testing at baseline and on average 5.2 years later. Incident dementia was assessed according to the international guidelines. RESULTS: Twenty-one percent of the study participants developed new infarcts. The risk of incident infarcts in men was higher than the risk in women (1.8; 95% confidence interval, 1.5-2.3). Persons with both incident and prevalent infarcts showed steeper cognitive decline and had almost double relative risk of incident dementia (1.7; 95% confidence interval, 1.3-2.2) compared with those without infarcts. Persons with new subcortical infarcts had the highest risk of incident dementia compared with those without infarcts (2.6; 95% confidence interval, 1.9-3.4). CONCLUSIONS: Men are at greater risk of developing incident brain infarcts than women. Persons with incident brain infarcts decline faster in cognition and have an increased risk of dementia compared with those free of infarcts. Incident subcortical infarcts contribute more than cortical and cerebellar infarcts to incident dementia which may indicate that infarcts of small vessel disease origin contribute more to the development of dementia than infarcts of embolic origin in larger vessels.
dc.description.sponsorshipNational Institutes of Health National Institute on Aging Intramural Research Program, Hjartavernd Icelandic Parliamenten
dc.language.isoenen
dc.publisherLippincott Williams & Wilkinsen
dc.relation.urlhttp://stroke.ahajournals.org/lookup/doi/10.1161/STROKEAHA.117.017357en
dc.rightsArchived with thanks to Strokeen
dc.subjectHeilablóðfallen
dc.subjectHeilabilunen
dc.subjectDAI12en
dc.subject.meshBrain Infarctionen
dc.subject.meshStrokeen
dc.subject.meshDementiaen
dc.titleIncidence of Brain Infarcts, Cognitive Change, and Risk of Dementia in the General Populationen
dc.typeArticleen
dc.contributor.department1 ] Iceland Heart Assoc, IS-201 Kopavogur, Iceland Show more [ 2 ] Univ Iceland, Reykjavik, Iceland Show more [ 3 ] Leiden Univ, Med Ctr, Dept Radiol, Leiden, Netherlands Show more [ 4 ] NIA, Lab Epidemiol & Populat Sci Demog & Biometry, NIH, Bethesda, MD 20892 USA Show more [ 5 ] Reykjavik Univ, Dept Psychol, Reykjavik, Icelanden
dc.identifier.journalStrokeen
dc.rights.accessLandspitali Access - LSH-aðganguren
dc.departmentcodeDAI12
html.description.abstractBACKGROUND AND PURPOSE: The differentiation of brain infarcts by region is important because their cause and clinical implications may differ. Information on the incidence of these lesions and association with cognition and dementia from longitudinal population studies is scarce. We investigated the incidence of infarcts in cortical, subcortical, cerebellar, and overall brain regions and how prevalent and incident infarcts associate with cognitive change and incident dementia. METHODS: Participants (n=2612, 41% men, mean age 74.6±4.8) underwent brain magnetic resonance imaging for the assessment of infarcts and cognitive testing at baseline and on average 5.2 years later. Incident dementia was assessed according to the international guidelines. RESULTS: Twenty-one percent of the study participants developed new infarcts. The risk of incident infarcts in men was higher than the risk in women (1.8; 95% confidence interval, 1.5-2.3). Persons with both incident and prevalent infarcts showed steeper cognitive decline and had almost double relative risk of incident dementia (1.7; 95% confidence interval, 1.3-2.2) compared with those without infarcts. Persons with new subcortical infarcts had the highest risk of incident dementia compared with those without infarcts (2.6; 95% confidence interval, 1.9-3.4). CONCLUSIONS: Men are at greater risk of developing incident brain infarcts than women. Persons with incident brain infarcts decline faster in cognition and have an increased risk of dementia compared with those free of infarcts. Incident subcortical infarcts contribute more than cortical and cerebellar infarcts to incident dementia which may indicate that infarcts of small vessel disease origin contribute more to the development of dementia than infarcts of embolic origin in larger vessels.


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