Предклиническое сосудистое когнитивное нарушение повышает риск смертности и сердечно-сосудистых заболеваний

TOPLINE A community-based study found that MRI-defined preclinical vascular cognitive impairment (VCID) was associated with higher risk for cardiovascular disease and all-cause mortality. METHODOLOGY - Researchers conducted a longitudinal analysis of 1236 community-dwelling adults aged 50 years or older (mean age, 62.7 years; 52.9% women) without dementia or prior stroke at baseline from Taiwan. - Participants underwent comprehensive brain MRI and neuropsychological assessments to classify VCID spectrum groups according to the VasCog-2-WSO criteria. - The VasCog-2-WSO neuroimaging criteria for vascular etiology included multiple or strategically located infarcts, multiple lacunes, extensive white matter hyperintensity, or intracerebral hemorrhage. - The researchers assessed baseline 10-year Framingham cardiovascular disease risk score and all-cause mortality. The mean follow-up was 9.4 years. TAKEAWAY - MRI evidence of cerebrovascular disease was present in 19.6% of participants. Preclinical VCID was identified in 19.2% of participants, while 0.4% had vascular mild cognitive impairment (vaMCI). - Preclinical VCID without objective cognitive impairment was associated with a 1.5-fold increased risk for all-cause mortality (adjusted hazard ratio [HR], 1.5; 95% CI, 1.0-2.2), while preclinical VCID with objective cognitive impairment conferred a 1.7-fold increased risk (adjusted HR, 1.7; 95% CI, 1.2-2.5), compared with the non-VCID group. - Overt vaMCI was was associated with a 7.2-fold higher risk for all-cause mortality (95% CI, 2.4-21.1). IN PRACTICE "The inclusion of preclinical VCID enabled identification of individuals with MRI-defined cerebrovascular disease who were already at increased cardiovascular and mortality risk despite preserved cognition. These data support the application of the VasCog-2–WSO framework for early detection and risk stratification of vascular cognitive vulnerability," the authors wrote. SOURCE The study was led by Yu-Ruei Lin, Taipei Veterans General Hospital, Taipei, Taiwan. It was published online on August 4 in Neurology. LIMITATIONS Cognitive domains were represented by limited tests and vaMCI prevalence was low. The small sample size of the vaMCI group limited statistical power for detecting differences in cognitive performance and domain-specific impairment rates. Generalizability may be limited to similar community-dwelling populations without overt cerebrovascular events. DISCLOSURES The study was supported by grants from the National Health Research Institutes, Taipei Veterans General Hospital, National Science and Technology Council, Taiwan, and the Yin Shu-Tien Foundation. The authors reported no relevant conflicts of interest. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.