Vascular risk factors are thought to be important for dementia. However, there is little evidence for a prospective association between cerebral blood flow and the risk of cognitive decline. Twenty-seven cognitively intact hypertensive patients aged 55 years and older with lacunar infarction or white matter lesions in magnetic resonance imaging (MRI) underwent positron emission tomography (PET) to measure cerebral blood flow (CBF) and cerebral vascular reactivity (CVR). Cognitive function was assessed at baseline and 3 years later with the mini-mental state examination (MMSE). Patients whose MMSE score fell by more than three points were classified as having cognitive decline. Six patients showed cognitive decline. Baseline CBF in these patients was significantly lower than that of the 21 patients without cognitive decline (31.2+/-2.4 vs. 42.6+/-5.9 ml per 100 g min(-1), respectively; P<0.001). A moderate linear association was found between CBF and change in MMSE score over a 3-year period (r=0.59, P=0.001), not between CBF and baseline MMSE score. In contrast, no association between CVR and later cognitive decline was found. This study suggests that cerebral hypoperfusion is associated with later cognitive decline.
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机译：血管性危险因素被认为对痴呆症很重要。然而，几乎没有证据表明脑血流量和认知能力下降的风险之间存在前瞻性关联。对年龄在55岁及以上，患有腔隙性梗塞或白质病变的磁共振成像（MRI）的27名认知完好性高血压患者进行了正电子发射断层扫描（PET），以测量脑血流量（CBF）和脑血管反应性（CVR）。在基线时和3年后用小精神状态检查（MMSE）评估认知功能。 MMSE得分下降超过三分的患者被分类为认知能力下降。 6例患者表现出认知能力下降。这些患者的基线脑血流量显着低于21例无认知功能减退的患者（每100 g min（-1）分别为31.2 +/- 2.4 vs. 42.6 +/- 5.9 ml; P <0.001）。在3年期间，CBF与MMSE评分变化之间存在中等程度的线性关联（r = 0.59，P = 0.001），而CBF与基线MMSE评分之间未发现线性相关。相反，没有发现CVR与后来的认知能力下降之间的关联。这项研究表明，脑灌注不足与以后的认知能力下降有关。
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