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Department of Epidemiology and Biostatistics (Drs. Breteler, Bots, Grobbee, Claus, and Hofman), Erasmus University Medical School, Rotterdam; the University Department of Neurology (Drs. van Swieten and van Gijn), University of Utrecht, Utrecht; the University Department of Neurology (Drs. Claus and van Harskamp), Erasmus University, Rotterdam; the University Department of Radiology (Dr. van den Hout), University of Utrecht, Utrecht; and the University Departments of Radiology (Dr. Tanghe) and Ophthalmology (Dr. de Jong), Erasmus University, Rotterdam, The Netherlands.
Cerebral white matter lesions are a common finding on MRI in elderly persons. We studied the prevalence of white matter lesions and their relation with classic cardiovascular risk factors, thrombogenic factors, and cognitive function in an age- and gender-stratified random sample from the general population that consisted of 111 subjects 65 to 84 years of age. Overall, 27% of subjects had white matter lesions. The prevalence and severity of lesions increased with age. A history of stroke or myocardial infarction, factor VIIc activity, and fibrinogen level were each significantly and independently associated with the presence of white matter lesions. Significant relations with blood pressure level, hypertension, and plasma cholesterol were present only for subjects aged 65 to 74 years. White matter lesions tended to be associated with lower scores on tests of cognitive function and were significantly associated with subjective mental decline. This study suggests that classic cardiovascular risk factors, as well as thrombogenic factors, are associated with white matter lesions in subjects over 65 years of age in the general population, and that these lesions may be related to cognitive function.
Address correspondence and reprint requests to Dr. M.M.B. Breteler, Department of Epidemiology and Biostatistics, Erasmus University Medical School, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands.
Supported in part by the NESTOR program for geriatric research (Ministry of Health and Ministry of Education), the Netherlands Heart Foundation, the Netherlands Organisation for Scientific Research (NWO), and the Municipality of Rotterdam.
Received March 3, 1993. Accepted in final form January 25, 1994.
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J M Starr, S A Leaper, A D Murray, H A Lemmon, R T Staff, I J Deary, and L J Whalley Brain white matter lesions detected by magnetic resosnance imaging are associated with balance and gait speed J. Neurol. Neurosurg. Psychiatry, January 1, 2003; 74(1): 94 - 98. [Abstract] [Full Text] [PDF]
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 S. C. Ferguson, A. Blane, P. Perros, R. J. McCrimmon, J. J.K. Best, J. Wardlaw, I. J. Deary, and B. M. Frier Cognitive Ability and Brain Structure in Type 1 Diabetes: Relation to Microangiopathy and Preceding Severe Hypoglycemia Diabetes, January 1, 2003; 52(1): 149 - 156. [Abstract] [Full Text] [PDF]
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L. Pantoni, M. Simoni, G. Pracucci, R. Schmidt, F. Barkhof, and D. Inzitari Visual Rating Scales for Age-Related White Matter Changes (Leukoaraiosis): Can the Heterogeneity Be Reduced? Stroke, December 1, 2002; 33(12): 2827 - 2833. [Abstract] [Full Text] [PDF]
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D. S. Knopman, W. A. Rocca, R. H. Cha, S. D. Edland, and E. Kokmen Incidence of Vascular Dementia in Rochester, Minn, 1985-1989 Arch Neurol, October 1, 2002; 59(10): 1605 - 1610. [Abstract] [Full Text] [PDF]
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 A. J. Thomas, J. T. O'Brien, S. Davis, C. Ballard, R. Barber, R. N. Kalaria, and R. H. Perry Ischemic Basis for Deep White Matter Hyperintensities in Major Depression: A Neuropathological Study Arch Gen Psychiatry, September 1, 2002; 59(9): 785 - 792. [Abstract] [Full Text] [PDF]
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C. C. Wu, D. Mungas, C. I. Petkov, J. L. Eberling, P. A. Zrelak, M. H. Buonocore, J. A. Brunberg, M. N. Haan, and W. J. Jagust Brain structure and cognition in a community sample of elderly Latinos Neurology, August 13, 2002; 59(3): 383 - 391. [Abstract] [Full Text] [PDF]
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 T. Y. Wong, R. Klein, A. R. Sharrett, D. J. Couper, B. E. K. Klein, D.-P. Liao, L. D. Hubbard, T. H. Mosley, and for the ARIC Investigators Cerebral White Matter Lesions, Retinopathy, and Incident Clinical Stroke JAMA, July 3, 2002; 288(1): 67 - 74. [Abstract] [Full Text] [PDF]
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H Koga, T Yuzuriha, H Yao, K Endo, S Hiejima, Y Takashima, F Sadanaga, T Matsumoto, A Uchino, K Ogomori, et al. Quantitative MRI findings and cognitive impairment among community dwelling elderly subjects J. Neurol. Neurosurg. Psychiatry, June 1, 2002; 72(6): 737 - 741. [Abstract] [Full Text] [PDF]
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White matter hyperintensities and neuropsychological outcome following carbon monoxide poisoning Neurology, May 28, 2002; 58(10): 1525 - 1532.
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 G. T. Lim, M. F. Mendez, Y. L. Bronstein, L. Jouben-Steele, and H. V. Vinters Clinicopathologic Case Report: Akinetic Mutism With Findings of White Matter Hyperintensity J Neuropsychiatry Clin Neurosci, May 1, 2002; 14(2): 214 - 221. [Full Text] [PDF]
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F.-E. de Leeuw, J. C. de Groot, M. Oudkerk, J. C. M. Witteman, A. Hofman, J. van Gijn, and M. M. B. Breteler Hypertension and cerebral white matter lesions in a prospective cohort study Brain, March 1, 2002; 125(4): 765 - 772. [Abstract] [Full Text] [PDF]
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 O. Hanon and D. Leys Cognitive decline and dementia in the elderly hypertensive Journal of Renin-Angiotensin-Aldosterone System, March 1, 2002; 3(1_suppl): S32 - S38. [PDF]
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C. Sierra, A. Coca, E. Gomez-Angelats, E. Poch, J. Sobrino, and A. de la Sierra Renin-Angiotensin System Genetic Polymorphisms and Cerebral White Matter Lesions in Essential Hypertension Hypertension, February 1, 2002; 39(2): 343 - 347. [Abstract] [Full Text] [PDF]
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J. Taylor and D. J. Stott Chronic heart failure and cognitive impairment: co-existence of conditions or true association? Eur J Heart Fail, January 1, 2002; 4(1): 7 - 9. [Full Text] [PDF]
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G. Zuccala, G. Onder, C. Pedone, L. Carosella, M. Pahor, R. Bernabei, and A. Cocchi Hypotension and cognitive impairment: Selective association in patients with heart failure Neurology, December 11, 2001; 57(11): 1986 - 1992. [Abstract] [Full Text] [PDF]
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S. A. Leaper, A. D. Murray, H. A. Lemmon, R. T. Staff, I. J. Deary, J. R. Crawford, and L. J. Whalley Neuropsychologic Correlates of Brain White Matter Lesions Depicted on MR Images: 1921 Aberdeen Birth Cohort Radiology, October 1, 2001; 221(1): 51 - 55. [Abstract] [Full Text] [PDF]
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M. C. Morris, P. A. Scherr, L. E. Hebert, R. J. Glynn, D. A. Bennett, and D. A. Evans Association of Incident Alzheimer Disease and Blood Pressure Measured From 13 Years Before to 2 Years After Diagnosis in a Large Community Study Arch Neurol, October 1, 2001; 58(10): 1640 - 1646. [Abstract] [Full Text] [PDF]
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K. J. Mukamal, W. T. Longstreth Jr, M. A. Mittleman, R. M. Crum, D. S. Siscovick, and D. Bereczki Alcohol Consumption and Subclinical Findings on Magnetic Resonance Imaging of the Brain in Older Adults: The Cardiovascular Health Study Editorial Comment: The Cardiovascular Health Study Stroke, September 1, 2001; 32(9): 1939 - 1946. [Abstract] [Full Text] [PDF]
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J.C. de Groot, F.-E. de Leeuw, M. Oudkerk, A. Hofman, J. Jolles, and M.M.B. Breteler Cerebral white matter lesions and subjective cognitive dysfunction: The Rotterdam Scan Study Neurology, June 12, 2001; 56(11): 1539 - 1545. [Abstract] [Full Text] [PDF]
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R. P. Kivisaari, O. Salonen, A. Servo, T. Autti, J. Hernesniemi, and J. Ohman MR Imaging After Aneurysmal Subarachnoid Hemorrhage and Surgery: A Long-term Follow-up Study AJNR Am. J. Neuroradiol., June 1, 2001; 22(6): 1143 - 1148. [Abstract] [Full Text] [PDF]
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L. O. Wahlund, F. Barkhof, F. Fazekas, L. Bronge, M. Augustin, M. Sjogren, A. Wallin, H. Ader, D. Leys, L. Pantoni, et al. A New Rating Scale for Age-Related White Matter Changes Applicable to MRI and CT Stroke, June 1, 2001; 32(6): 1318 - 1322. [Abstract] [Full Text] [PDF]
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C. Dufouil, A. de Kersaint-Gilly, V. Besancon, C. Levy, E. Auffray, L. Brunnereau, A. Alperovitch, and C. Tzourio Longitudinal study of blood pressure and white matter hyperintensities: The EVA MRI Cohort Neurology, April 10, 2001; 56(7): 921 - 926. [Abstract] [Full Text] [PDF]
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A.-S. Rigaud and B. Forette Hypertension in Older Adults J. Gerontol. A Biol. Sci. Med. Sci., April 1, 2001; 56(4): 217M - 225. [Abstract] [Full Text]
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 R. H. Paul, R. A. Cohen, D. Moser, B. R. Ott, T. Zawacki, N. Gordon, S. Bell, and W. Stone Performance on the Mattis Dementia Rating Scale in Patients with Vascular Dementia: Relationships to Neuroimaging Findings J Geriatr Psychiatry Neurol, March 1, 2001; 14(1): 33 - 36. [Abstract] [PDF]
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D. Knopman, L.L. Boland, T. Mosley, G. Howard, D. Liao, M. Szklo, P. McGovern, and A. R. Folsom Cardiovascular risk factors and cognitive decline in middle-aged adults Neurology, January 9, 2001; 56(1): 42 - 48. [Abstract] [Full Text] [PDF]
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F-E de Leeuw, J C de Groot, E Achten, M Oudkerk, L M P Ramos, R Heijboer, A Hofman, J Jolles, J van Gijn, and M M B Breteler Prevalence of cerebral white matter lesions in elderly people: a population based magnetic resonance imaging study. The Rotterdam Scan Study J. Neurol. Neurosurg. Psychiatry, January 1, 2001; 70(1): 9 - 14. [Abstract] [Full Text] [PDF]
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 C. D. McCullagh, D. Craig, S. P. McIlroy, and A. P. Passmore Risk factors for dementia Adv. Psychiatr. Treat., January 1, 2001; 7(1): 24 - 31. [Full Text]
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D. Sander, K. Winbeck, J. Klingelhofer, and B. Conrad Extent of Cerebral White Matter Lesions Is Related to Changes of Circadian Blood Pressure Rhythmicity Arch Neurol, September 1, 2000; 57(9): 1302 - 1307. [Abstract] [Full Text] [PDF]
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