Lower pulmonary function and cerebral subclinical abnormalities detected by MRI: The atherosclerosis risk in communities study

Study objectives: To investigate the association between pulmonary function and (1) cerebral infarction and (2) white matter lesions (WMLs), identified by MRI and believed to represent subclinical lesions of arteriosclerosis, generalized hypoperfusion, or ischemia of the brain. Design: Population-based, cross-sectional study. Setting: Two communities in the United States. Participants: A sample of 1,917 African-American and white men and women 55 to 72 years old who were selected from the second follow-up examination of the Atherosclerosis Risk in Communities Study cohort. Interventions: Observational study. Measurements and results: The lung function indexes, FEV₁ and FVC, were assessed according to American Thoracic Society criteria. Subclinical cerebral infarction and WMLs were assessed by MRI. After adjusting for age, ethnicity, gender, height, and height squared, a 1-SD decrease of FEV₁ in nonsmokers was associated with odds ratios (95% confidence interval [CI], 1.31 to 2.03) of 1.63 for infarction and 1.35(95% CI, 1,08 to 1.69) for WMLs. Of those in the lowest quartile of FEV₁ 15% had infarction and WMLs, in contrast to 6% of the individuals in the uppermost quartile of FEV₁. Consistent associations were also observed by using FVC as an index of pulmonary function. Similar patterns of association were found among current smokers. The associations were not altered by additional adjustment of conventional risk factors of cardiovascular disease, comorbidity, or cognitive function Conclusion: The results from this population-based study suggest that lower pulmonary function is associated with subclinical cerebral abnormalities.