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White matter changes and diabetes predict cognitive decline in the elderly: the LADIS study
A Verdelho1, S Madureira, C Moleiro
1Neurosciences Department, Lisbon University, Santa Maria Hospital, Lisbon, Portugal. averdelho@fm.ul.pt
Neurology
|July 14, 2010
Summary
White matter changes (WMC) and diabetes independently predict cognitive decline in older adults. WMC severity and prior stroke are linked to vascular dementia, while medial temporal atrophy (MTA) predicts Alzheimer's disease.
Area of Science:
- Neurology
- Geriatrics
- Neuroimaging
Background:
- Age-related white matter changes (WMC) are common in the elderly.
- Vascular risk factors may influence cognitive decline.
- The Leukoaraiosis and Disability (LADIS) study investigates WMC impact on independent elderly individuals.
Purpose of the Study:
- To determine if WMC and vascular risk factors predict cognitive decline in independent elderly individuals with WMC.
- To differentiate predictors for overall cognitive decline, dementia, and specific dementia subtypes.
Main Methods:
- Prospective multinational European study (LADIS) with 639 independent elderly participants.
- 3-year follow-up with annual clinical and neuropsychological assessments.
- Brain MRI at baseline and study end to evaluate WMC and medial temporal atrophy (MTA).
Main Results:
- WMC severity independently predicted cognitive decline (dementia and non-dementia), irrespective of age, education, and MTA.
- Diabetes was the sole vascular risk factor independently predicting cognitive decline.
- Alzheimer's disease was predicted by MTA, while vascular dementia was associated with prior stroke and WMC severity.
Conclusions:
- WMC severity and diabetes are independent predictors of cognitive decline in initially nondisabled elderly individuals.
- Vascular dementia is predicted by stroke history and WMC, whereas Alzheimer's disease is primarily linked to MTA.
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