Development of small vesell disease score in middle-age to stratify the risk of Alzheimer's disease

2023 Fiscal Year Final Research Report

• Project/Area Number: 21K10510
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 58030:Hygiene and public health-related: excluding laboratory approach
• Research Institution: Kansai Medical University
• Principal Investigator: YAKUSHIJI Yusuke 関西医科大学, 医学部, 教授 (80418813)
• Co-Investigator(Kenkyū-buntansha): 松本 明子 佐賀大学, 医学部, 准教授 (10330979) ; 原 めぐみ 佐賀大学, 医学部, 准教授 (90336115)
• Project Period (FY): 2021-04-01 – 2024-03-31
• Keywords: Dementia / Brain MRI / small vessel disease

Outline of Final Research Achievements

We sent the Japanese version of Informant Questionnaire on Cognitive Decline in the Elderly（IQCODE -J）questionnaire to 1,698 people who underwent brain checkups. We analyzed 686 people (mean age 58 years, 50% male) who provided valid responses. Those with an IQCODE-J average score of 3.3 or higher were classified as the cognitive decline group, and those below the threshold were classified as the non-cognitive decline group. Univariate analysis showed that hypertension was associated with cognitive decline as a modifiable factor. In a multivariate logistic regression analysis adjusted for age, hypertension, and education history, only age remained as an associated factor for cognitive decline group. As a result, we were unable to prove that baseline higher SVD burden (total SVD score 2 or higher) contributes to future cognitive decline, as hypothesized.

Free Research Field

Neurology

Academic Significance and Societal Importance of the Research Achievements

今回は残念ながら脳MRI上の脳小血管病負債過多が将来の認知症発症に関与することを証明できなかった。本研究のリミテーションとして、当初予定していた認知症移行候補者への直接面談がCOVID-19パンデミックにより実現できなかった点があげられる。今回の結果が真実なのか否かは本領域の今後の研究の積み重ねを待つしかないが、単変量解析で得られた高血圧と認知機能低下に関しては啓蒙の余地があるかもしれない。また違うMRIパラメータを加えた（例えば脳萎縮率など）研究の必要性も反省としてあげられた。