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Does leukoaraiosis predict morbidity and mortality?

D P Briley1, S Haroon, S M Sergent

  • 1Department of Medicine, Marshall University School of Medicine, and Huntington VAMC, WV, USA. dbriley@nildram.co.uk

Neurology
|January 15, 2000
PubMed
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Severe leukoaraiosis, a brain imaging finding, significantly predicts increased risk of death and illness in older adults. This risk is amplified when combined with gait disturbances, indicating a poor prognosis.

Area of Science:

  • Neurology
  • Geriatrics
  • Radiology

Background:

  • Gait disturbance and leukoaraiosis are prevalent in the elderly.
  • Gait disturbance is a known predictor of mortality.
  • Leukoaraiosis may be a common underlying factor linking gait disturbance and mortality.

Purpose of the Study:

  • To investigate the predictive value of leukoaraiosis for morbidity and mortality in elderly patients.
  • To assess whether leukoaraiosis serves as an independent predictor of adverse health outcomes.

Main Methods:

  • Prospective study of 221 patients.
  • Neurologic deficits assessed using the NIH Stroke Scale.
  • Leukoaraiosis severity graded (absent, mild, severe) via CT scan across seven brain regions.
  • End points included pneumonia, fractures, and death.

Related Experiment Videos

Main Results:

  • Severe leukoaraiosis independently predicted death (HR=2.91), pneumonia (HR=5.1), and falls (HR=6.8).
  • Severe leukoaraiosis predicted a combined endpoint of death, pneumonia, and falls (HR=3.5).
  • The combination of severe leukoaraiosis and gait disturbance showed the highest risk (HR=4.4).

Conclusions:

  • Severe leukoaraiosis is an independent predictor of morbidity and mortality, irrespective of pre-existing neurological deficits.
  • The coexistence of leukoaraiosis and gait disturbance indicates a significantly poor prognosis.