B. Reinhart

Estrogen replacement therapy in older women: a neuropsychological and brain MRI study.

OBJECTIVE: To determine if postmenopausal women receiving estrogen perform better on demanding cognitive tests than women without estrogen replacement and if this beneficial effect on cognition is caused by estrogen‐related prevention of silent ischemic brain damage.

The Mattis Dementia Rating Scale Normative data from 1,001 healthy volunteers

Article abstract We administered the Mattis Dementia Rating Scale (MDRS) to 1,001 healthy volunteers, aged 50 to 80 years, randomly selected from our community. Multivariate regression analysis revealed educational level (p = 0.000004) and age (p = 0.00001), but no other sociodemographic or risk factors for stroke, to be significantly associated with the MDRS score. The age- and education-specific lowest quintile cutoff scores ranged from 140 in subjects aged 50 to 59 years with at least college experience to 130 in subjects aged 70 to 80 years with only 4 to 9 years of schooling. These percentile distributions obtained for decades of age and different levels of education should be useful reference values for clinicians and investigators when applying the MDRS to assess cognitive functioning.

Plasma Antioxidants and Cognitive Performance in Middle‐Aged and Older Adults: Results of the Austrian Stroke Prevention Study

OBJECTIVES: To study the association between cognitive status and plasma concentrations of various antioxidants in middle‐aged and older individuals without neuropsychiatric disease.

β-Fibrinogen Gene Polymorphism (C148→T) Is Associated With Carotid Atherosclerosis

Abstract—Polymorphisms at the β-fibrinogen locus have been shown to be associated with plasma concentration of fibrinogen and coronary heart disease. The effect of the genetic heterogeneity of fibr...

Assessment of Cerebrovascular Risk Profiles in Healthy Persons: Definition of Research Goals and the Austrian Stroke Prevention Study (ASPS)

The advent of new laboratory methods and noninvasive imaging modalities has extended the diagnostic possibilities in normal individuals. This article elaborates the new options for the assessment of stroke risk offered by these techniques. In this context we present the Austrian Stroke Prevention Study, which is the first prospective long-term investigation of normals that includes Doppler sonography, magnetic resonance imaging and single photon emission computed tomography. The design, utility and limitations of this study are discussed.

Mini Mental State Examination: Influence of Sociodemographic, Environmental and Behavioral Factors, and Vascular Risk Factors

Age and education have been found to affect the Mini Mental State Examination (MMSE) score of elderly normals, but there have been no studies assessing the influence of environmental and behavioral factors on this test. We therefore administered the MMSE to 1437 normal elderly subjects in the setting of a stroke prevention study and correlated their results to 16 sociodemographic, environmental, and behavioral factors, and vascular risk factors. Study statistics composed of a multiple logistic regression analysis and graphical models revealed the relations between variables in greater detail. Logistic regression yielded education level, occupational status, living as a single, general life stress, physical strain, and physical inactivity to be independent predictors of the MMSE score. Age was not included in this model. Graphical models demonstrated similar results, but did not include living as a single and physical inactivity. As shown in our independence graph, general life stress is the crucial predictor and links other environmental and sociodemographic variables with the test performance of elderly normals.

Sociodemographic predictors and concurrent validity of the Mini Mental State Examination and the Mattis Dementia Rating Scale

The Mini Mental State Examination (MMSE) and the Mattis Dementia Rating Scale (MDRS) are among the most commonly used screening tests for dementia. The goals of our study were, firstly, to identify sociode-mographic factors which may explain the variance of test results in a community sample and, secondly, to investigate the interrelationship of these two dementia screening tests in order to evaluate the concurrent validity. A total of 1947 subjects were investigated in the setting of the Austrian Stroke Prevention Study (ASPS). Our study confirms most previous results demonstrating a relationship of higher dementia test scores with both younger age and higher educational level. Interestingly, the results we obtained suggest only a weak relationship and poor concurrent validity of the two tests. The total scores of the two tests show poor joint variance. This could lead to the conclusion that these tests evaluate different cognitive domains.

White matter lesions on magnetic resonance imaging in a healthy elderly population: Correlations to vascular risk factors and carotid atherosclerosis

We performed magnetic resonance imaging (MRI) and extensive risk factor evaluation on 196 randomly selected, clinically asymptomatic participants of the Austrian Stroke Prevention Study to determine the clinical correlates of MRI white matter lesions (WML) in normals. WML were present in 103 (52.6%) individuals. There were 69 (35.2%) subjects with Grade 1 (punctate), 26 (13.3%) with Grade 2 (beginning confluent), and 8 (4.1%) with Grade 3 (confluent) WML Multivariate stepwise forward regression analysis created a model of independent predictors of the WML score including arterial hypertension (p = 0.001) and age (p = 0.04). Only 24.7% of WML score variance could be explained by the two variables, however. No other demographic or clinical factors, such as cardiac disease, diabetes mellitus, smoking, lipid status, serum fibrinogen, hematocrit, antiphospholipid antibody titer, or ultrasound results of the carotid arteries entered the model. These data imply the presence of yet undetermined factors in the pathogenesis of WML, probably independent of those known to be associated with atherothrombotic brain infarction.