Objective: To examine the association between prevalent cerebral abnormalitie s identified on MRI and cognitive functioning in a predominantly middle- aged, population- based study cohort. Methods: Cerebral MRI was performed on 1,538 in dividuals (aged 55 to 72) from the Atherosclerosis Risk in Communities (ARIC) co hort, with no history of stroke or TIA, at study sites in Forsyth County, NC, an d Jackson, MS. White matter hyperintensities (WMHs)- , ventricular size, and su lcal size were graded by trained neuroradiologists on a semiquantitative, 10- p oint scale. Cognitive functioning was assessed using the Delayed Word Recall Tes t (DWRT), Digit Symbol Substitution Test (DSST), and Word Fluency Test (WFT). Re sults: High ventricular grade was independently associated with significantly lo wer scores on the DWRT and DSST and greater risk (odds ratio [OR] 2.32, 95% co nfidence interval [CI] 1.51 to 3.56) of impaired scores (i.e., < 10th percentile ) on the DWRT. High sulcal grade was associated with a modest decrement in score s on the DWRT. The presence of coexisting high grade WMHs and silent infarcts wa s independently associated with lower scores on all cognitive tests and greater risk of impaired functioning on the DSST (OR 2.91, 95% CI: 1.23 to 6.89) and W FT (OR 2.28, 95% CI 1.03 to 5.08). The presence of two or more high- grade ab normalities was as sociated with increased risk of impaired functioning on all cognitive tests ( DWRT: OR 2.23, 95% CI 1.40 to 3.55; DSST: OR 2.06, 95% CI 1.13 to 3.76; WFT: OR 2.07, 95% CI 1.23 to 3.49) independent of multiple covariates and silent i nfarcts. Conclusion: Common changes in brain morphology are associated with dimi nished cognitive functioning in middle- aged and young- elderly individuals.
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