Ventricular volume and dementia progression in the Cardiovascular Health Study

Abstract

Elevated cerebral ventricular volume may be associated with dementia risk and progression. A fully-automated technique that agreed highly with radiological readings was used to estimate lateral ventricle volume on MR scans done at baseline in 1997-99 of 377 subjects in the Cardiovascular Health Study (CHS) from the Pittsburgh Center. 327 subjects were normal or diagnosed with mild cognitive impairment (MCI) at baseline and were evaluated 4 years later. Baseline ventricular volume was analyzed in multivariate models with age, gender, education level, presence and incidence of cerebral infarcts, and dementia category (normal, MCI, or dementia) at baseline and follow-up as fixed effects. Ventricular volume at baseline was significantly higher among subjects normal at baseline and demented 4 years later. Age, gender, education level, and dementia progression were significant factors affecting ventricular volume. Ventricular volume was higher in dementia compared to MCI, higher in MCI compared to controls, and higher in Possible-Alzheimer's-disease (AD) dementia compared to Probable-AD. Larger ventricles in healthy subjects may indicate susceptibility to, or progression of, dementia-related pathology.

Fig. 1

Agreement between visual assessment of ventricular dilation (x-axis) and ventricular volume computed by the fully-automated technique (y-axis) in the cross-sectional pool (N = 377). The best-fit line for the data is also shown. The fraction of variance explained, R², is 0.698.

Fig. 2

Ventricle-to-brain ratio as a function of age, dementia category, and gender in the cross-sectional analysis.

Fig. 3

Plots of significant factors in the prospective model of baseline ventricular volume.