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Abstract Details

Cardiovascular and metabolic risk factors for the development of cerebral small vessel disease: Longitudinal FLAIR imaging in the Mayo Clinic Study of Aging
Cerebrovascular Disease and Interventional Neurology
P5 - Poster Session 5 (5:30 PM-6:30 PM)
3-057
To determine the effects of cardiovascular and metabolic risk factors on the development of white matter hyperintensity (WMH) in a population-based cohort.
Cerebral small vessel disease (CSVD) is a major cause of vascular cognitive impairment and mixed community dementia; it can be assessed by the presence of white matter hyperintensities (WMH) on FLAIR-MRI. Growing evidence suggests an association between cardiometabolic health and the development of WMH. However, the impact of specific cardiovascular and metabolic risk factors on the progression of WMH over time is incompletely understood.
This retrospective cohort included participants enrolled in the Mayo Clinic Study of Aging, a longitudinal population-based study in Olmsted County, Minnesota with at least 2 consecutive WMH assessments on FLAIR-MRIs (n=434 >=65 years with midlife assessments) with baseline measurements of body mass index, resting blood pressure, hemoglobin A1c, fasting glucose, and lipid panel. Mixed models were used to determine the specific components of baseline cardiometabolic risk associated with change in WMH normalized to total intracranial volume. These analyses were controlled for age and sex.  
Age and female gender were associated with greater WMH (p<0.001). Baseline hypertension (p < 0.001), midlife hypertension (p=0.003), and baseline hemoglobin A1c (p=0.027) were predictive of increased WMH over follow up. High density lipoprotein (HDL), low density lipoprotein (LDL), triglycerides, and body mass index (BMI) were not associated with increased WMH. In sensitivity analyses, associations between hypertension and increased WMH progression were stronger in women. 

Hypertension (both mid and late life) and hemoglobin A1c were the strongest modifiable predictors associated with serial increases in WMH in this cohort. The association of hypertension and increased WMH was more pronounced in women. Further investigations should explore how changes in metabolic risk factors influence this aspect of CVSD.

Authors/Disclosures
Eugene L. Scharf, MD (Mayo Clinic)
PRESENTER 		The institution of Dr. Scharf has received research support from American Brain Foundation. The institution of Dr. Scharf has received research support from NIH. Dr. Scharf has received personal compensation in the range of $500-$4,999 for serving as a Presenter with Grand Rounds. Dr. Scharf has a non-compensated relationship as a Steering committee with Johnson and Johnson that is relevant to AAN interests or activities.
Jonathan Graff-Radford, MD, FAAN Dr. Graff-Radford has received personal compensation for serving as an employee of Mayo Clinic. Dr. Graff-Radford has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for NINDS/NIH. Dr. Graff-Radford has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for JAMA Neurology. Dr. Graff-Radford has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Open evidence . The institution of Dr. Graff-Radford has received research support from NIH. The institution of Dr. Graff-Radford has received research support from Eisai. The institution of Dr. Graff-Radford has received research support from Cognition therapeutics. Dr. Graff-Radford has received personal compensation in the range of $5,000-$9,999 for serving as a Faculty Member with IMPACT AD .
Scott Przybelski Scott Przybelski has nothing to disclose.
David S. Knopman, MD, FAAN (Mayo Clinic) Dr. Knopman has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for DIAN TU study. The institution of Dr. Knopman has received research support from NIH.
No disclosure on file
Christopher Schwarz The institution of Christopher Schwarz has received research support from NIH.
Matthew Senjem (Mayo Clinic) Matthew Senjem has received stock or an ownership interest from Align Technology, Inc.. Matthew Senjem has received stock or an ownership interest from Inovio Biomedical Corp.. Matthew Senjem has received stock or an ownership interest from Johnson & Johnson. Matthew Senjem has received stock or an ownership interest from Mesa Laboratories, Inc.. Matthew Senjem has received stock or an ownership interest from Nvidia Inc.. Matthew Senjem has received stock or an ownership interest from LHC Group, Inc.. Matthew Senjem has received stock or an ownership interest from Natus Medical Incorporated. Matthew Senjem has received stock or an ownership interest from Varex Imaging Corporation. Matthew Senjem has received personal compensation in the range of $100,000-$499,999 for serving as a IT Technical Specialist II with Mayo Clinic.
Jeffery Gunter (Mayo Clinic and Foundation) The institution of Jeffery Gunter has received research support from NIH. Jeffery Gunter has received intellectual property interests from a discovery or technology relating to health care.
Kejal Kantarci, MD (Mayo Clinic) The institution of Dr. Kantarci has received research support from Eli Lilly. The institution of Dr. Kantarci has received research support from NIH. The institution of Dr. Kantarci has received research support from ADDF. The institution of Dr. Kantarci has received research support from Eisai. The institution of Dr. Kantarci has received research support from BioArctic.
Michelle M. Mielke, PhD (Wake Forest University School of Medicine) Dr. Mielke has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. Dr. Mielke has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eisai. Dr. Mielke has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eli Lilly. Dr. Mielke has received personal compensation in the range of $500-$4,999 for serving as a Consultant for LabCorp. Dr. Mielke has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Roche. Dr. Mielke has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Siemens Healthineers. Dr. Mielke has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sunbird Bio. Dr. Mielke has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Eisai. Dr. Mielke has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Roche. Dr. Mielke has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novo Nordisk.
Ronald C. Petersen, MD, PhD, FAAN (Mayo Clinic) Dr. Petersen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Petersen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech. Dr. Petersen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eli Lilly and Co.. Dr. Petersen has received personal compensation in the range of $0-$499 for serving as a Consultant for Eisai, Inc.. Dr. Petersen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novo Nordisk. Dr. Petersen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Petersen has received publishing royalties from a publication relating to health care. Dr. Petersen has received publishing royalties from a publication relating to health care. Dr. Petersen has received publishing royalties from a publication relating to health care. Dr. Petersen has a non-compensated relationship as a Board of Directors with American Brain Foundation that is relevant to AAN interests or activities.
Clifford R. Jack, Jr., MD (Mayo Clinic) The institution of Dr. Jack has received research support from NIH. The institution of Dr. Jack has received research support from Alexander Family Alzheimer's Disease Research Professorship of the Mayo Clinic.
Prashanthi Vemuri, PhD (Mayo Clinic) The institution of Dr. Vemuri has received research support from NIH.