Brain abnormalities in the elderly: frequency and predictors in the United States (the Cardiovascular Health Study). Cardiovascular Health Study Collaborative Research Group

J Neural Transm Suppl. 1998;53:9-16. doi: 10.1007/978-3-7091-6467-9_2.


Purpose: Characterize brain abnormalities in elderly people using cranial magnetic resonance imaging (MRI).

Methods: Comprehensive lists of people 65 years and older living in the United States of America were used to obtain a representative sample of 5,888 community-dwelling participants who underwent extensive standardized evaluations. A subset of 3,660 underwent MRI. Without clinical information, neuroradiologists evaluated each scan.

Results: Enlarged ventricles and sulci and prominent white matter changes were relatively common, even in a subset of the healthiest participants. Infarcts 3 mm or greater were present in 31% of all participants and 28% of those without a history of stroke. Most infarcts were clinically silent, small, and in the basal ganglia. Among those without a history of stroke, white matter changes were common but mostly of a mild degree. These changes were independently related to greater age, silent stroke, higher systolic blood pressure, lower forced expiratory volume in one second and income less than $50,000 per year. Changes were also associated with dysfunction, especially of cognition and the lower extremities.

Conclusion: MRI abnormalities are common in elderly people. Cautious interpretation is appropriate because participants are healthier than the general population and the study's design is cross-sectional.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Brain / pathology*
  • Brain Diseases / epidemiology
  • Brain Diseases / pathology*
  • Cerebral Infarction / epidemiology
  • Cerebral Infarction / pathology
  • Cerebrovascular Disorders / epidemiology
  • Cerebrovascular Disorders / pathology
  • Humans
  • Magnetic Resonance Imaging
  • United States / epidemiology