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    Ventricular dilation: association with gait and cognition

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    Authors
    Palm, Walter M.
    Saczynski, Jane S.
    van der Grond, J.
    Sigurdsson, Sigurdur
    Kjartansson, Olafur
    Jonsson, Palmi V.
    Eiriksdottir, Gudny
    Gudnason, Vilmundur
    Admiraal-Behloul, Faiza
    Launer, Lenore J.
    van Buchem, Mark A.
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    UMass Chan Affiliations
    Meyers Primary Care Institute
    Department of Quantitative Health Sciences
    Department of Medicine, Division of Geriatric Medicine
    Document Type
    Journal Article
    Publication Date
    2009-10-23
    Keywords
    Aged
    Aged, 80 and over
    Cerebrospinal Fluid
    Cognition Disorders
    Cohort Studies
    Female
    Gait Disorders, Neurologic
    Humans
    Hydrocephalus, Normal Pressure
    Lateral Ventricles
    Male
    Severity of Illness Index
    Biostatistics
    Epidemiology
    Geriatrics
    Health Services Research
    Neurology
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    Link to Full Text
    http://dx.doi.org/10.1002/ana.21739
    Abstract
    OBJECTIVE: Normal pressure hydrocephalus is characterized by gait impairment, cognitive impairment, and urinary incontinence, and is associated with disproportionate ventricular dilation. Here we report the distribution of ventricular volume relative to sulcal cerebrospinal fluid (CSF) volume, and the association of increasing ventricular volume relative to sulcal CSF volume with a cluster of gait impairment, cognitive impairment, and urinary incontinence in a stroke-free cohort of elderly persons from the general population. METHODS: Data are based on 858 persons (35.4% men; age range, 66-92 years) who participated in the Age, Gene/Environment Susceptibility-Reykjavik Study. Gait was evaluated with an assessment of gait speed. Composite scores representing speed of processing, memory, and executive function were constructed from a neuropsychological battery. Bladder function was assessed with a questionnaire. Magnetic resonance brain imaging was followed by semiautomated segmentation of intracranial CSF volume. White matter hyperintensity (WMH) volume was assessed with a semiquantitative scale. For the analysis of ventricular dilation relative to the sulcal spaces, ventricular volume was divided by sulcal CSF volume (VV/SV). RESULTS: Disproportion between ventricular and sulcal CSF volume, defined as the highest quartile of the VV/SV z score, was associated with gait impairment (odds ratio [OR], 1.9; 95% confidence interval [CI], 1.1-3.3) and cognitive impairment (OR, 1.8; 95% CI, 1.1-3.0). We did not find an association between the VV/SV z score and bladder dysfunction. INTERPRETATION: The prevalence and severity of gait impairment and cognitive impairment increases with ventricular dilation in persons without stroke from the general population, independent of WMH volume.
    Source
    Ann Neurol. 2009 Oct;66(4):485-93. Link to article on publisher's site
    DOI
    10.1002/ana.21739
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/47627
    PubMed ID
    19847895
    Related Resources
    Link to Article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.1002/ana.21739
    Scopus Count
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    Population and Quantitative Health Sciences Publications

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