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Cerebral white matter disease is associated with Alzheimer pathology in a prospective cohort

Abhay Moghekar1, Michael Kraut, Wendy Elkins

  • 1Department of Neurology, Johns Hopkins Bayview Medical Center, Baltimore, MD, USA.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|October 2, 2012
PubMed
Abstract

Insights

Alzheimer's disease (AD) pathology is linked to white matter disease detected by MRI in older adults. This finding helps explain why white matter disease is associated with cognitive decline in the elderly.

Area of Science:

  • Neurology
  • Gerontology
  • Neuroimaging

Background:

  • White matter disease on MRI correlates with cognitive decline in the elderly.
  • The primary cause of cognitive decline in relation to white matter disease remains unclear.

Purpose of the Study:

  • To investigate the association between Alzheimer's disease (AD) pathology and MRI-detected cerebral white matter disease.
  • To clarify the relationship between AD pathology, white matter disease, and cognitive decline.

Main Methods:

  • Examined autopsy data and MRI scans from 50 participants in the Baltimore Longitudinal Study of Aging Autopsy Program.
  • Quantitated white matter disease using Cardiovascular Health Study (CHS) criteria on pre- and postmortem MRI scans.
  • Assessed Alzheimer's disease pathology using established scoring systems (CERAD, Braak).

Main Results:

  • Significant associations were found between measures of AD pathology (CERAD score, Braak score, composite AD score) and CHS white matter scores.
  • Hypertension was also significantly associated with white matter disease.
  • Amyloid angiopathy was not independently associated with white matter disease; the association between dementia diagnosis and white matter disease disappeared after accounting for AD pathology.

Conclusions:

  • Autopsy-confirmed Alzheimer's disease pathology is associated with cerebral white matter disease detected by MRI.
  • This relationship provides a potential explanation for the link between white matter disease and cognitive decline in older individuals.

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