Clinical Epidemiology and Ageing

White Matter Lesions: Prevalence and Clinical Phenotype in Asymptomatic Individuals Aged ≥50 Years.

David J-P, Ferrat E, Parisot J, Naga H, Lakroun S, Menasria F, Saddedine S, Natella P-A, Paillaud E, Fromantin I, Bastuji-Garin S Dement Geriatr Cogn Disord. 2016;42(3-4):159-168.

<p><b>BACKGROUND: </b>To assess the prevalence of early confluent/confluent white matter lesions (ec/cWMLs) in asymptomatic individuals aged ≥50 years and to identify associated clinical phenotypes.</p><p><b>METHODS: </b>Cross-sectional analysis of 141 asymptomatic individuals aged ≥50 years assessed at an outpatient department in France. Brain magnetic resonance imaging was rated using the Fazekas scale. Age-adjusted odds ratios (ORs) and 95% confidence intervals were estimated using logistic models to investigate factors associated with ec/cWMLs; independent risk factors were identified by multivariate analysis.</p><p><b>RESULTS: </b>Median age was 63 years; 53.9% were women, 32.6% had hypertension, and 76.6% had ≥1 cardiovascular risk factors. The prevalence of ec/cWMLs was 26.2%. Apart from age, independent risk factors were family history of cardiovascular event (OR = 5.55; 1.13-27.32) and hypertension (2.47; 1.05-5.81). Patients with ec/cWMLs had lower cognitive dual-task walking speed (1.15; 0.98-1.40), MMSE (1.41; 1.06-1.89), and FAB scores (5.21; 1.49-19.84). The Scheltens score was independently associated with the WML severity score.</p><p><b>CONCLUSION: </b>ec/cWMLs are common in asymptomatic community-dwelling individuals aged ≥50 years. They are associated with cardiovascular risk factors, impairments in global and executive cognitive function, and Scheltens score elevation.</p>

MeSH terms: Aged; Asymptomatic Diseases; Brain; Cardiovascular Diseases; Cognition; Cross-Sectional Studies; Female; France; Humans; Hypertension; Leukoencephalopathies; Logistic Models; Magnetic Resonance Imaging; Male; Middle Aged; Multivariate Analysis; Odds Ratio; Phenotype; Prevalence; Risk Factors; Task Performance and Analysis; Walking Speed; White Matter
DOI: 10.1159/000448991