TY - JOUR
T1 - Sex differences in cerebrovascular pathologies on FLAIR in cognitively unimpaired elderly
AU - Fatemi, Farzan
AU - Kantarci, Kejal
AU - Graff-Radford, Jonathan
AU - Preboske, Gregory M.
AU - Weigand, Stephen D.
AU - Przybelski, Scott A.
AU - Knopman, David S.
AU - MacHulda, Mary M.
AU - Roberts, Rosebud O.
AU - Mielke, Michelle M.
AU - Petersen, Ronald C.
AU - Jack, Clifford R.
AU - Vemuri, Prashanthi
N1 - Funding Information:
This work was supported by NIH grants R01 NS097495 (principal investigator [PI] Vemuri), R01 AG056366 (PI Vemuri), U01 AG006786 (PI Petersen), P50 AG016574/P1 (PI Vemuri), P50 AG016574 (PI Petersen), R01 AG034676 (PI Rocca), R01 AG011378 (PI Jack Jr.), R01 AG041851 (PIs Jack and Knopman), R01 AG055151 (PI Mielke); the GHR Foundation grant, the Alexander Family Alzheimer’s Disease Research Professorship of the Mayo Foundation, the Elsie and Marvin Dekelboum Family Foundation, and Opus building NIH grant C06 RR018898. The funding sources were not involved in the manuscript review or approval.
Funding Information:
This study was funded by the NIH, the GHR Foundation, the Mayo Foundation, and the Elsie and Marvin Dekelboum Family Foundation. The authors report no competing interests. Go to Neurology.org/N for full disclosures.
Publisher Copyright:
© 2018 American Academy of Neurology.
PY - 2018/2/6
Y1 - 2018/2/6
N2 - Objective To examine sex differences in cerebrovascular pathologies (CVPs) as seen on fluid-attenuated inversion recovery (FLAIR) MRI and in cardiovascular and metabolic risk factors in a population-based cognitively unimpaired cohort and to examine whether sex is independently associated with FLAIR findings after accounting for differences in important midlife risk factors. Methods We identified 1,301 cognitively normal participants (663 men and 638 women) enrolled in the Mayo Clinic Study of Aging (age ≥70 years) who had FLAIR MRI and ascertained total burden of white matter (WM) hyperintensities (WMH), subcortical infarctions, and cortical infarctions. We compared CVPs and midlife and late-life vascular risk factors between men and women. We fit regression models with each CVP as an outcome, treating age, sex, and midlife risk factors as predictors. Results Women had significantly greater WMH volume relative to their WM volume compared to men (2.8% vs 2.4% of WM, p < 0.001), while men had a greater frequency of cortical infarctions compared to women (9% vs 4%, p < 0.001). Subcortical infarctions were equally common in men and women (20%). In regression modeling after adjustment for WM volume, the mean WMH volume difference between men and women was of the same magnitude as a 7-year difference in age. In contrast, men had 2.2-greater relative odds of having a cortical infarction compared to women. These sex differences persisted even after adjustment for midlife vascular risk factors. Conclusions There were important sex differences in CVP findings on FLAIR in cognitively unimpaired elderly. Understanding these sex differences could aid in the development of sex-specific preventive strategies.
AB - Objective To examine sex differences in cerebrovascular pathologies (CVPs) as seen on fluid-attenuated inversion recovery (FLAIR) MRI and in cardiovascular and metabolic risk factors in a population-based cognitively unimpaired cohort and to examine whether sex is independently associated with FLAIR findings after accounting for differences in important midlife risk factors. Methods We identified 1,301 cognitively normal participants (663 men and 638 women) enrolled in the Mayo Clinic Study of Aging (age ≥70 years) who had FLAIR MRI and ascertained total burden of white matter (WM) hyperintensities (WMH), subcortical infarctions, and cortical infarctions. We compared CVPs and midlife and late-life vascular risk factors between men and women. We fit regression models with each CVP as an outcome, treating age, sex, and midlife risk factors as predictors. Results Women had significantly greater WMH volume relative to their WM volume compared to men (2.8% vs 2.4% of WM, p < 0.001), while men had a greater frequency of cortical infarctions compared to women (9% vs 4%, p < 0.001). Subcortical infarctions were equally common in men and women (20%). In regression modeling after adjustment for WM volume, the mean WMH volume difference between men and women was of the same magnitude as a 7-year difference in age. In contrast, men had 2.2-greater relative odds of having a cortical infarction compared to women. These sex differences persisted even after adjustment for midlife vascular risk factors. Conclusions There were important sex differences in CVP findings on FLAIR in cognitively unimpaired elderly. Understanding these sex differences could aid in the development of sex-specific preventive strategies.
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U2 - 10.1212/WNL.0000000000004913
DO - 10.1212/WNL.0000000000004913
M3 - Article
C2 - 29343465
AN - SCOPUS:85049777316
SN - 0028-3878
VL - 90
SP - e466-e473
JO - Neurology
JF - Neurology
IS - 6
ER -