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Early cerebral small vessel disease and brain volume, cognition, and gait
Smith EE, O'Donnell M, Dagenais G, Lear SA, Wielgosz A, Sharma M, Poirier P, Stotts G et al.. Annals of neurology, 2015-02-01
Topic: Risk, prevention and care in population studies
Objective Decline in cognitive function begins by the 40s, and may be related to future dementia risk. We used data from a community-representative study to determine whether there are age-related differences in simple cognitive and gait tests by the 40s, and whether these differences were associated with covert cerebrovascular disease on magnetic resonance imaging (MRI). Methods Between 2010 and 2012, 803 participants aged 40 to 75 years in the Prospective Urban Rural Epidemiological (PURE) study, recruited from prespecified postal code regions centered on 4 Canadian cities, underwent brain MRI and simple tests of cognition and gait as part of a substudy (PURE-MIND). Results Mean age was 58 ± 8 years. Linear decreases in performance on the Montreal Cognitive Assessment, Digit Symbol Substitution Test (DSST), and Timed Up and Go test of gait were seen with each age decade from the 40s to the 70s. Silent brain infarcts were observed in 3% of 40- to 49-year-olds, with increasing prevalence up to 18.9% in 70-year-olds. Silent brain infarcts were associated with slower timed gait and lower volume of supratentorial white matter. Higher volume of supratentorial MRI white matter hyperintensity was associated with slower timed gait and worse performance on DSST, and lower volumes of the supratentorial cortex and white matter, and cerebellum. Interpretation Covert cerebrovascular disease and its consequences on cognitive and gait performance and brain atrophy are manifest in some clinically asymptomatic persons as early as the 5th decade of life.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Smith, E. E., O'Donnell, M., Dagenais, G., Lear, S. A., Wielgosz, A., Sharma, M., et al. (2015). Early cerebral small vessel disease and brain volume, cognition, and gait. Annals of neurology. https://doi.org/10.1002/ana.24320
Vancouver
Smith EE, O'Donnell M, Dagenais G, Lear SA, Wielgosz A, Sharma M, et al. Early cerebral small vessel disease and brain volume, cognition, and gait. Annals of neurology. 2015. doi:10.1002/ana.24320. PMID: 25428654.
BibTeX
@article{smith2015-25428654,
author = {Smith, E. E. and O'Donnell, M. and Dagenais, G. and Lear, S. A. and Wielgosz, A. and Sharma, M. and Poirier, P. and Stotts, G. and others},
title = {{Early cerebral small vessel disease and brain volume, cognition, and gait}},
journal = {Annals of neurology},
year = {2015},
doi = {10.1002/ana.24320},
pmid = {25428654},
url = {https://doi.org/10.1002/ana.24320}
}
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Key findings
- We used data from a community-representative study to determine whether there are age-related differences in simple cognitive and gait tests by the 40s, and whether these differences were associated with covert cerebrovascular disease on magnetic resonance imaging (MRI).
- Silent brain infarcts were associated with slower timed gait and lower volume of supratentorial white matter.
- Higher volume of supratentorial MRI white matter hyperintensity was associated with slower timed gait and worse performance on DSST, and lower volumes of the supratentorial cortex and white matter, and cerebellum.
Why it matters
This study found that in a community-representative sample, silent brain infarcts and higher volumes of white matter hyperintensity were associated with slower timed gait and worse performance on cognitive tests. It suggests that covert cerebrovascular disease may be related to early cognitive and gait decline.
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Study details
- Participants803
- Effect size18.9%
- Evidence strengthLow
How this study scored 57/100
Published in a leading specialty journal. Scored zero for study design and randomised / blinded because the record does not state it. We have no data on senior author's track record, so that was left out: it earned 55 of the 96 points we could judge it on, which is 57 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Annals of neurology) |
| Journal's citation record | 3 / 4 | Annals of Neurology: journal h-index 437 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2015 — within 20 year(s) of the newest study here |
| Sample size | 2 / 4 | 803 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 206 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 15.8 citations a year over 13 year(s) since 2015 |
| Impact for its field and year | 3 / 6 | Cited 6.8× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 8 other studies in this library |
| Still being cited | 2 / 4 | Cited 40 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | 2 / 3 | University of Toronto: institution h-index 1,923 (OpenAlex) |
| Multi-centre collaboration | 3 / 3 | OpenAlex lists 11 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 25428654) |
| Free to read | 2 / 2 | Free to read |
| Points | 55 / 96 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 55 of the 96 points we could judge it on is 57 out of 100. |
| Total | 57 / 100 | — |
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