The application presents the CHS as a unique opportunity to evaluate major determinants of the risk of dementia and specific type of dementia in a population sample. It proposes to test the hypothesis that MRI changes, including infarct-like lesions (ILLs), high white matter grade, high sulci grade, high ventricular grade, and focal brain atrophy are associated with an increased risk of dementia among the 3660 Cardiovascular Health Study participants that had their initial MRI in 1992-93 and, for many, a second MRI in 1997-98 and are now approximately 82 years of age. The plan is to evaluate the relationship between apolipoprotein E (ApoE) genotype, measures of inflammation, subclinical cardiovascular disease, and incident clinical diseas (including stroke and myocardial infarction), cardiovascular risk factors such as hypertension and diabetes, and risk of dementia in relation to these MRI variables. Most of the data for these independent variables have already been collected. There will be 524 Black participants in the sample. All of the participants will have detailed neuropsychological testing and clinical, neurological, and psychiatric evaluation information from next-of-kin and informants in order to determine classification of a possible diagnosis of dementia based on all the available information from the CHS and the neuropsychological and clinical neurological psychiatric evaluation. The application suggests that the CHS will be able to determine whether MRI findings, specifically related to both vascular disease, ventricular grade and hippocampal volume are major predictors of dementia and type of dementia, especially in combination with measurements of ApoE, markers of inflammation, prior scores on cognitive tests and, possibly, subclinical vascular disease. I states that these relationships will be strong enough to allow better methods for early identification of subjects at-risk of dementia and, possibly, new approaches to prevention.
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