Journal
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
Volume 53, Issue 4, Pages 649-654Publisher
BLACKWELL PUBLISHING INC
DOI: 10.1111/j.1532-5415.2005.53214.x
Keywords
mobility impairment; subclinical brain structural abnormality
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Funding
- NHLBI NIH HHS [N01 HC 85084, N01 HC 85085, N01 HC 35129, N01 HC 85086, N01 HC 15103, N01 HC 85083, N01 HC 85082, N01 HC 85081, N01 HC 85080, N01 HC 85079] Funding Source: Medline
- NIA NIH HHS [T32 AG 00181-11] Funding Source: Medline
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OBJECTIVES: To determine whether severity of subclinical brain magnetic resonance imaging (MRI) abnormalities predicts incident self-reported physical impairment or rate of decline in motor performance. DESIGN: Longitudinal analysis, average follow-up time: 4.0 years. SETTING: Cardiovascular Health Study (CHS). PARTICIPANTS: CHS participants with modified Mini-Mental State Examination (3MS) score of 80 or greater, no self-reported disability, no history of stroke, and at least one assessment of mobility (n=2,450, mean age=74.4). MEASUREMENTS: Brain MRI abnormalities (ventricular enlargement, white matter hyperintensities, subcortical and basal ganglia small brain infarcts), self-reported physical impairment (difficulty walking half a mile or with one or more activities of daily living), and motor performance (gait speed, timed chair stand). RESULTS: After adjusting for demographics, cardiovascular risk factors, and diseases, risk of incident self-reported physical impairment was 35% greater for those with severe ventricular enlargement than for those with minimal ventricular enlargement, 22% greater for those with moderate white matter hyperintensities than for those with minimal white matter hyperintensities, and 26% greater for participants with at least one brain infarct than for those with no infarcts. Those with moderate to severe brain abnormalities experienced faster gait speed decline (0.02 m/s per year) than those with no MRI abnormalities (0.01 m/s per year). Further adjustment for incident stroke, incident dementia, and 3MS score did not substantially attenuate hazard ratios for incident self-reported physical impairment or coefficients for decline in gait speed. CONCLUSION: Subclinical structural brain abnormalities in high-functioning older adults can increase the risk of developing physical disabilities and declining in motor performance.
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