Poster Presentations: P3 P671

(Product approval number Z44023372 of SFDA of China) which can im-

prove the impaired learning and memory in VaD modal rats. This study ex-

amined the efficacy and safety of FFDS tablets in the treatment of mild to

moderate VaD. Methods: In this multicentre, 24-week trial carried out in

China, 240 patients patients with VaD were assigned in a ratio of 1:1 to

the FFDS group and placebo group, respectively received FFDS tablets or

placebo 3 tablets per time, and 3 times per day. 226 patients were valid

for intent-to-treat analysis, which have 114 in the FFDS group, and 112 in

the placebo group. The primary efficacy variables included change from

baseline in the Alzheimer Disease Assessment Scale-cognitive subscale

(ADAS-cog) and the Clinician’s Interview-Based Impression of Change-

Plus (CIBIC-plus) after 24 weeks of treatment. The secondary efficacy mea-

surements include the Mini-mental State Examination (MMSE) and ability

of daily living (ADL).Efficacy analyses were performed on intent-to-treat

(ITT) and fully evaluable (FE) populations. Safety analysis was conducted

in thesafety population. Results: FFDS tablets showed a significant im-

provement on the primary efficacy measure with a mean change from base-

line of the ADAS-cog at the endpoint (-4.01points, p<0.01), versus a mean

change in the placebo group (0.22 points, p<0.01), and the change still re-

mained at the follow-up of 36 weeks after drug withdrawal for either group.

Significant improvements in patients’ global function were seen versus pla-

cebo at week 24 on the CIBIC-plus for patients in the FFDS tablets. Done-

pezil-treated patients showed significant benefits in ADL andMMSE versus

placebo at week 24 from baseline. The frequency of adverse events was sim-

ilar in the two groups (placebo, 8.8%; FFDS tablet, 15.8%, p¼ 0.112). The

FFDS tablets were well tolerated.Conclusions: FFDS tablets demonstrated

significant benefits on patients with mild to moderate VaD, and it was safe

and well tolerated.

P3-310 THE IMPACT OF CAROTID ARTERY STENTING

ON COGNITIVE PROFILES IN PEOPLE WITH

SEVERE CAROTID ARTERY STENOSIS: A

PROSPECTIVE, CASE-CONTROL, FOLLOW-UP

STUDY

Figure. Effects of treatment x baseline cholesterol interaction of changes in

rCBF.

Kyung Won Park1, Byeol A. Yoon2, Sung Jae Kim2, Jae Kwan Cha2,

Jae Kim3, 1Dong-A University College of Medicine, Busan, South Korea;2Dong-A University Medical Center, Busan, South Korea; 3Dong-A

University Hospital, Busan, South Korea. Contact e-mail: neuropark@dau.

ac.kr

Background: Carotid artery stenting (CAS) is emerging as an alternative to

CEA for the treatment of carotid artery stenosis (CS). The effects of CAS on

cognitive function in patients with severe carotid artery stenosis have not

been fully addressed. The aim of this study is to assess the effect of carotid

artery stenting on cognitive function from baseline to 3 months in patients

with severe carotid artery stenosis compared with control subjects using de-

tailed neuropsychological test.Methods:We consecutively recruited 31 pa-

tients underwent CAS with high grade carotid artery stenosis (�70%) and

11 control subjects at baseline, who visited to the clinic or emergency

room between February, 2009 and February, 2012. Twenty three out of 31

patients underwent CAS and 10 out of 11 control subjects were included

in our analyses, who have completed follow-up neuropsychological evalua-

tion after 3 months. Main cognitive outcome measures were the Seoul Neu-

ropsychological Screening Battery-Dementia version (SNSB-D) test which

containing subcategories for testing of general cognitive function, attention,

visuosaptial function, language and related function, memory, and frontal

lobe/executive function. We evaluated the mean differences of cognitive

outcome measures using SNSB-D in our cases between patients with

CAS and control group from baseline to 3 months follow-up period, respec-

tively. We also did factor analysis expected to affect cognitive outcomes,

such as 1) level of patients’ cognitive function, 2) existence of perfusion de-

fect in Brain MRI, 3) the location of stenosis in carotid artery. Results:

There were no significant differences in demographic findings and general

cognitive function between CAS and control group. Twelve out of 23 pa-

tients with CAS had asymptomatic CS. During 3 months follow-up period,

the patients with asymptomatic CS (n¼12) as well as all patients underwent

CAS (n¼23) did not show significant change differences in all cognitive out-

come measures compared with control group (p>0.05). In factor analysis,

we came to the same conclusion. Conclusions: Our results suggest that

the effect of carotid artery stenting on cognitive function were not detected

in patients with carotid stenosis as compared with control group during 3

months follow-up.

P3-311 BASELINE LIPID LEVELS PREDICT CEREBRAL

BLOOD FLOW RESPONSE TO STATIN THERAPY

IN MIDDLE-AGED ADULTS AT RISK FOR

ALZHEIMER’S DISEASE

Cynthia Carlsson1, Benjamin Austin2, Barbara Bendlin3, Hanna Blazel4,

Jodi Barnet1, N. Maritza Dowling1, Carey Gleason1, Mark Sager1,

Sanjay Asthana1, Sterling Johnson5, 1University of Wisconsin School of

Medicine and Public Health, Madison, Wisconsin, United States;2University of Wisconsin-Madison, Madison, Wisconsin, United States;3University of Wisconsin-Madison, Madison, Wisconsin, United States;4Wisconsin Alzheimer’s Disease Research Center, Madison, Wisconsin,

United States; 5VA GRECC, Madison, Wisconsin, United States.

Contact e-mail: cmc@medicine.wisc.edu

Background: Hypercholesterolemia in midlife increases risk for Alzheim-

er’s disease (AD) decades later, possibly due in part to its contribution to

cerebrovascular dysregulation and subsequent chronic cerebral hypoperfu-

sion. Statins treat dyslipidemia and increase regional cerebral blood flow

(rCBF) in middle-aged adults at risk for AD. It is unclear if baseline lipid

levels influence statin-induced changes in rCBF in preclinical at-risk adults.

Methods: Asymptomatic adults ages 36-69 years with parental history of

AD were recruited for the ESPRIT study - a randomized, controlled, dou-

ble-blind clinical trial. Participants were randomized to simvastatin 80 mg

nightly or placebo for nine months. At baseline and month 9, MRI sub-study

participants underwent MR imaging on a 1.5 Tesla scanner (Signa, GE,

Waukesha, WI). Dynamic susceptibility contrast (DSC) perfusion-weighted

MRI scans were used to estimate measures of rCBF.Results:Of the 100 ES-

PRIT participants (mean age 52.8 years, 70% women, 38% APOE4 car-

riers), 50 participated in the MRI sub-study. At baseline, participants in

both MRI sub-study treatment arms had similar mean lipid levels (all

p>0.2). At month 9, MRI sub-study participants randomized to simvastatin

(n¼27) showed significant reductions in total cholesterol (TC) (-26%), tri-

glycerides (-33%), and LDL-C (-39%), and a significant increase in HDL-C

(7%) compared to non-significant lipid changes in the placebo group

(n¼23). Treatment interacted with baseline LDL-C and TC levels to predict

increase in rCBF at month 9 in the right precuneus (LDL-C: p FWE-corr

Poster Presentations: P3P672

¼0.002; k¼197; x,y,z¼[24,-64,30]; TC: p FWE-corr ¼0.005; k¼159;

x,y,z¼[18,-52, 10]) such that statin-treated individuals with higher LDL-C

and TC had greater increases in rCBF than statin-treated persons with lower

lipid levels (Figure). Conclusions: In preclinical middle-aged adults at risk

for AD, higher baseline lipid levels predicted greater simvastatin-induced

increases in rCBF in the right precuneus, an area of the brain associated

withmemory retrieval. As personswith AD have reduced rCBF in keymem-

ory areas of the brain, such findings may suggest beneficial effects of statins

in reducing AD risk particularly in individuals with more atherogenic lipid

levels. Further investigation is needed to clarify the clinical implications of

these statin-induced effects on rCBF and other preclinical processes related

to AD.

P3-312 DO "HEALTHY" WOMEN LIVE TOO LONG?

Lewis Kuller1, Oscar Lopez1, Rachel Mackey1, Caterina Rosano1,

James Becker1, Anne Newman2, 1University of Pittsburgh, Pittsburgh,

Pennsylvania, United States; 2University of Pittsburgh Graduate School of

Public Health, Pittsburgh, Pennsylvania, United States.

Contact e-mail: kullerl@edc.pitt.edu

Background: There is a very high prevalence of subclinical atherosclero-

sis, the primary determinant of cardiovascular disease (CVD) in older

individuals. We tested the hypothesis that older individuals free of clinical

CVD with less subclinical CVD at older ages have a reduced risk of death,

CVD and dementia in the Cardiovascular Health Study (CHS). Methods:

In 1998-99, 532 men and women (mean age of 78) were included in the

CHS-Cognition Study: 396 (74%) classified as normal, 136 (26%) mild

cognitive impairment. Of 532, 434 had concurrent coronary artery calcium

(CAC). By 2012, 335 had died and 326 had incident dementia. Results:

The amount of CAC was lower in women than in men; 43% of the women

had CAC Agatston scores (CACS) <100 versus 31% of the men. There

was a significant relationship between the amount of CAC and the risk

of total mortality and CVD. Incidence rates for dementia were not signif-

icantly related to CAC in men and weakly related (p¼0.09) for women;

43% of women with 0 CAC developed dementia, age-adjusted incidence

of 66/1,000, versus 57% with CAC>100, 91/1,000. The mean age at onset

of dementia was 84-85 years for both 0 CAC and high CAC and there was

little difference in time to dementia, 7 versus 5 years. Cognitively normal

individuals had lower rates of both dementia and risk of death. The addi-

tion of other subclinical measures of CVD and biomarkers of CV damage,

such as highly sensitive cardiac troponin, brain natriuretic peptide, cysta-

tin-C, did not affect dementia rates. CAC was positively related to MRI

brain infarcts and white matter grade. Adding these measures did not mod-

ify the relationship of CAC to dementia. Conclusions: Unfortunately,

women who survive to old age (80+) cognitively normal with low preva-

lence of CAC and low risk of death and CVD still have a high risk of de-

mentia. This large group of older women are excellent candidates for both

pharmacological and nonpharmacological clinical trials for prevention or

delay of dementia as compared to men and women with high CAC and

very high risk of death and CVD.