The Prevalence and Prognosis of Patients with Enlarged Ventricles (P4.034)

Objective: Ventriculomegaly associates with age, degenerative diseases, vascular and congenital factors. The Mayo Clinic Study of Aging, a population based study started in 2004, includes non- demented individuals 70 to 89 followed every 15 months. We evaluated the ventriculomegaly prevalence and cognitive and gait prognosis. Methods:We reviewed 1794 baseline MRIs for ventriculomegaly, cortical atrophy, tight sulci, entrapped sulci, white matter change. An Evans Index ≥0.3 defined enlarged ventricles. We identified three groups: hydrocephalus without atrophy (H), hydrocephalus ex vacuo (HEV), and controls (C). We compared groups with respect to baseline and rate of change on GaitRite measures, a timed 25 foot walk, the United Parkinson Disease Rating Scale gait items and cognitive measures (attention, language, memory and visuospatial and global score), and baseline vascular risk burden. Results: H prevalence was 8.9[percnt] and HEV 5.7[percnt]. H was more common in men (11.7[percnt]) than women (5.8[percnt]). Proportions of baseline gait UPDRS scores>1 were higher in H (p=0.036) and HEV (p=0.028) than in controls. Annualized change in timed gait and global GaitRite were also higher in H (p=0.07 and 0.002) and HEV (p=0.001 and p=0.001). After 7 years , the proportion with gait UPDR>1 increased from 35 to 70[percnt] in H, 45 to 80[percnt] in HEV, and 25 to 45[percnt] in controls. Baseline cognitive scores were all significantly lower in H (all p≤0.006) and HEV (all p≤0.018). Cognitive decline rate was faster in H (p<0.001), but not in HEV (p=0.16). Vascular disease burden was more common in H (p=0.048) but not HEV (p=0.13). Conclusions: Ventriculomegaly is common in persons over 70 (8.9[percnt]), more common in men (11.7[percnt]), and associated with gait abnormality, cognitive impairment and decline of both. It is associated with vascular risk burden. These associations indicate ventriculomegaly may be an important biomarker of quality of life. Disclosure: Dr. Graff-Radford has received personal compensation for activities with Codman as a Scientific Advisory Board member and Cytox as a consultant. Dr. Jones has nothing to disclose. Dr. Gunter has nothing to disclose. Dr. Thomas has nothing to disclose. Dr. Crook has nothing to disclose. Dr. Boeve has received personal compensation for activities with Isis Pharmaceuticals. Dr. Boeve has received research support from GE Healthcare and FORUM Pharmaceuticals. Dr. Knopman has received personal compensation for activities with Lundbeck Pharmaceuticals. Dr. Knopman has received personal compensation in an editorial capacity for Neurology. Dr. Knopman has received research support from Lilly Pharmaceuticals and Ta Dr. Jack has received personal compensation for activities with Janssen Research & Development, LLC by providing consulting services. Dr. Jack has received research support from the National Institutes of Health (R01-AG011378, RO1-AG041851, RO1-AG037551. Dr. Ronald Petersen received personal compensation from Pfizer, Inc., Janssen Alzheimer9s Immunotherapy. Merck, inc. Roche, Inc. Genentech, Inc. Biogen, Inc. Eli Lilly and Co. as a consultant or speaker.