Cardiovascular Diseases Clinical Trial
Official title:
The ARIC Neurocognitive Longitudinal Study
To perform a follow-up study of cerebrovascular disease in the Atherosclerosis Risk in Communities (ARIC) magnetic resonance imaging subcohort.
BACKGROUND:
Although the clinical manifestations of cerebrovascular disease (CVD) typically appear
acutely, the deleterious effects of CVD on brain structure and function likely begin in a
presymptomatic fashion at a younger age than clinical strokes. In an effort to characterize
the prevalence, risk factors, and cognitive correlates of subclinical CVD, the
Atherosclerosis Risk in Communities (ARIC) Study funded by the National Heart, Lung, and
Blood Institute performed cerebral magnetic resonance imaging (MRI) and cognitive
assessments on a large, bi-racial sample of middle-aged and young-elderly adults. Results
from the ARIC MRI baseline study revealed a remarkably high prevalence of subclinical CVD
including silent cerebral infarctions, white matter hyperintensities, and brain atrophy.
Moreover, these subclinical abnormalities were found to be associated with reduced cognitive
functioning and with clinical CVD outcomes such as incident stroke. Surprisingly little is
known about risk factors related to the incidence or progression of subclinical CVD or how
progression of these markers may relate to clinical outcomes such as stroke or
neurocognitive decline.
DESIGN NARRATIVE:
This is a follow-up study of the ARIC MRI cohort, with repeated semiquantitative MR imaging
and cognitive assessments. The study will also take advantage of recent advances in MR
imaging and obtain volumetric measurements of selected brain regions and expand upon the
baseline cognitive assessment to further characterize neurocognitive functioning. The
longitudinal design of the proposed study will fill salient gaps in current understanding of
subclinical CVD. Moreover, conducting this study within ARIC takes advantage of ARIC's
baseline MRI data, unique African American population, and extensive vascular risk factor
data (including new genetic and biochemical factors as well as subclinical markers of both
large and small vessel disease), making an efficient study to provide new insights into the
incidence, progression, and outcomes associated with subclinical CVD.
;
Observational Model: Cohort, Time Perspective: Prospective
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