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- W4253761323 abstract "Changes to the cerebral white matter, observed as white matter hyperintensities (WMHs) on T2 or FLAIR MRI sequences, are extremely common in cognitively intact elderly. Those with increased baseline and rates of WMH accumulation have been shown to have an increased risk of conversion to mild cognitive impairment (MCI), a likely precursor of progressive dementia. The acceleration of this WMH increase relative to the time of the clinical transition to MCI has not been established. 184 subjects, mean age 83.8 ± 6.6, who transited to MCI in the Oregon Brain Aging Study during their follow-up were used in the current study. Subjects underwent annual cognitive and MRI assessments. MCI was defined by the first of two consecutive semiannual CDR scores ≥ 0.5 to minimize the possible inclusion of subjects with transient or reversible cognitive impairment. WMH volumes were determined from T2 sequences using a semi-automated computer program. The outcome was % WMH out of intracranial volume. The time before MCI, when the change in WMH burden accelerates, was assessed using a mixed-effects model with a change point for subjects who developed MCI during follow-up of over 15 years (mean duration: 6.3 yrs ± 4.7), adjusting for age and gender. The presence of the following cerebrovascular risk factors was controlled in the models: stroke or transient ischemic attack, hypertension, diabetes, and smoking history. Acceleration in %WMH volume increase occurred 5.0 years (95% Confidence Interval: 2.8-10.5) before the onset of MCI. Before the change point, WMH increased by 0.49% annually (p < 0.0001), but after the change point, the increase accelerated by an additional 0.25% (p = 0.001). That is, after the change point, WMH increased by 0.74% of ICV annually. Acceleration in %CNS volume loss occurred 4.0 years (95% Confidence Interval: 3.2-5.0) before the onset of MCI. Acceleration in WMH burden (a common indicator of cerebrovascular disease in the elderly) is a pathological change that emerges early in the pre-symptomatic phase leading to MCI. Longitudinal changes in WMH may thus be useful in determining those at risk for cognitive impairment and for planning strategies for introducing disease modifying therapies prior to dementia onset." @default.
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- W4253761323 date "2011-07-01" @default.
- W4253761323 modified "2023-10-16" @default.
- W4253761323 title "P1-349: Trajectory of white matter hyperintensity burden preceding mild cognitive impairment" @default.
- W4253761323 doi "https://doi.org/10.1016/j.jalz.2011.05.629" @default.
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