{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T02:39:17Z","timestamp":1792118357033,"version":"4.4.0"},"reference-count":30,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2015,2,3]],"date-time":"2015-02-03T00:00:00Z","timestamp":1422921600000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000222","name":"Heart and Stroke Foundation of Canada","doi-asserted-by":"publisher","award":["G-13-0002726"],"award-info":[{"award-number":["G-13-0002726"]}],"id":[{"id":"10.13039\/501100000222","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"crossref","award":["301577"],"award-info":[{"award-number":["301577"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100015098","name":"Canadian Stroke Network","doi-asserted-by":"crossref","award":["no number"],"award-info":[{"award-number":["no number"]}],"id":[{"id":"10.13039\/100015098","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Annals of Neurology"],"published-print":{"date-parts":[[2015,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Decline in cognitive function begins by the 40s, and may be related to future dementia risk. We used data from a community\u2010representative study to determine whether there are age\u2010related 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).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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\u2010MIND).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Mean age was 58\u2009\u00b1\u20098 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\u2010 to 49\u2010year\u2010olds, with increasing prevalence up to 18.9% in 70\u2010year\u2010olds. 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>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. Ann Neurol 2015;77:251\u2013261<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ana.24320","type":"journal-article","created":{"date-parts":[[2014,11,26]],"date-time":"2014-11-26T13:16:19Z","timestamp":1417007779000},"page":"251-261","source":"Crossref","is-referenced-by-count":188,"title":["Early cerebral small vessel disease and brain volume, cognition, and gait"],"prefix":"10.1002","volume":"77","author":[{"given":"Eric E.","family":"Smith","sequence":"first","affiliation":[{"name":"Hotchkiss Brain Institute"},{"name":"Department of Clinical Neurosciences"},{"name":"Department of Radiology"},{"name":"Seaman Family Centre University of Calgary Calgary Alberta"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"O'Donnell","sequence":"additional","affiliation":[{"name":"Population Health Research Institute, McMaster University Hamilton 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