Abstract

Asymptomatic brain abnormalities are common incidental findings on brain MRI in the elderly population and can be regarded as imaging markers of early stroke and dementia. We initiated the Taizhou Imaging Study (TIS) to examine the prevalence and correlates of incidental findings using brain MRI among an elderly population residing in a rural area of China. A total of 562 individuals, at the age of 55 to 65 years, participated in the TIS study with a response rate of 90%. The prevalence of lacunes, white matter hyperintensity (WMH), cerebral microbleeds (CMB), perivascular space, and intracranial arterial stenosis was 26.69%, 10.68%, 18.51%, 27.76%, and 12.81%, respectively. Age and hypertension were the major correlates of these incidental findings. Per each year increase in age, the risks of WMH and CMB increased by 15% and 14%. Compared to individuals with normal blood pressure, individuals with hypertension had an increased risk of all incidental findings, with the adjusted odds ratios of 2.28 to 5.45. Correlations of age, gender and body mass index with brain gray matter fraction were also observed. The high prevalence of these findings indicates a need of preventative strategy to help prevent future stroke and dementia in this population.

Highlights

  • Ageing-related diseases, such as stroke and dementia, have posed great burden to our society

  • In 2017, American Heart Association/American Stroke Association (AHA/ASA) published another statement demonstrating that silent brain infarcts and white matter hyperintensity (WMH) are associated with the risk of future symptomatic stroke, and primary stroke prevention should be indicated in patients with silent brain infarcts, WMH, or CMB17

  • Given the known clinical relevance of brain magnetic resonance imaging (MRI) incidental findings in the pathophysiology of stroke and dementia, understanding the burden of these preclinical lesions in the Chinese population will provide important information regarding the future burden of healthcare service in China

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Summary

Introduction

Ageing-related diseases, such as stroke and dementia, have posed great burden to our society. Only three population-based studies, including the Risk Index for Subclinical brain lesions in Hong Kong (RISK) study[21], the Shanghai Aging Study (SAS)[22], and the Shunyi study[23], have made efforts to study incidental findings from brain MRI in the Chinese population[24]. Results of these studies showed that the prevalence of some incidental MRI findings was different from other populations[24]. We aimed to report on the prevalence and correlates of incidental findings using brain MRI scan in this population

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