Late-Life Vascular Risk Score in Association With Postmortem Cerebrovascular Disease Brain Pathologies
- 12 April 2021
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Stroke
- Vol. 52 (6), 2060-2067
- https://doi.org/10.1161/strokeaha.120.030226
Abstract
Background and Purpose: The general cardiovascular Framingham risk score (FRS) identifies adults at increased risk for stroke. We tested the hypothesis that baseline FRS is associated with the presence of postmortem cerebrovascular disease (CVD) pathologies. Methods: We studied the brains of 1672 older decedents with baseline FRS and measured CVD pathologies including macroinfarcts, microinfarcts, atherosclerosis, arteriolosclerosis, and cerebral amyloid angiopathy. We employed a series of logistic regressions to examine the association of baseline FRS with each of the 5 CVD pathologies. Results: Average age at baseline was 80.5±7.0 years and average age at death was 89.2±6.7 years. A higher baseline FRS was associated with higher odds of macroinfarcts (odds ratio, 1.10 [95% CI, 1.07–1.13], PP=0.009), atherosclerosis (odds ratio, 1.07 [95% CI, 1.04–1.11], PP=0.005). C statistics for these models ranged from 0.537 to 0.595 indicating low accuracy for predicting CVD pathologies. FRS was not associated with the presence of cerebral amyloid angiopathy. Conclusions: A higher FRS score in older adults is associated with higher odds of some, but not all, CVD pathologies, with low discrimination at the individual level. Further work is needed to develop a more robust risk score to identify adults at risk for accumulating CVD pathologies.Keywords
This publication has 36 references indexed in Scilit:
- Small Brain Lesions and Incident Stroke and MortalityAnnals of Internal Medicine, 2015
- Purpose in Life and Cerebral Infarcts in Community-Dwelling Older PeopleStroke, 2015
- Executive dysfunction is a strong stroke predictorJournal of the Neurological Sciences, 2015
- Cerebral Microvascular Lesions on High-Resolution 7-Tesla MRI in Patients With Type 2 DiabetesDiabetes, 2014
- Brain Pathology Contributes to Simultaneous Change in Physical Frailty and Cognition in Old AgeThe Journals of Gerontology, Series A: Biological Sciences and Medical Sciences, 2014
- Genetic Susceptibility for Ischemic Infarction and Arteriolosclerosis Based on Neuropathologic EvaluationsCerebrovascular Diseases, 2013
- Association of silent lacunar infarct with brain atrophy and cognitive impairmentJournal of Neurology, Neurosurgery & Psychiatry, 2013
- Cerebrovascular Disease Pathology and Parkinsonian Signs in Old AgeStroke, 2011
- Microinfarct Pathology, Dementia, and Cognitive SystemsStroke, 2011
- General Cardiovascular Risk Profile for Use in Primary CareJournal of the American College of Cardiology, 2008