Neurological abnormalities predict disability: the LADIS (Leukoaraiosis And DISability) study

Area of Science:

• Gerontology
• Neurology
• Radiology

Background:

• Age-related white matter changes (ARWMC) are common in elderly individuals.
• Predictors of functional decline in independent elderly subjects require further investigation.
• The Leukoaraiosis And DISability (LADIS) Study cohort provides a valuable resource for examining aging-related changes.

Purpose of the Study:

• To determine if neurological abnormalities and MRI lesions predict global functional decline in independent elderly individuals.
• To evaluate age-related white matter changes (ARWMC) as an independent predictor of disability or death.
• To assess the independent predictive value of neurological examination findings versus MRI features.

Main Methods:

• A 3-year follow-up study of 633 initially independent-living elderly subjects (mean age 74.1 years).
• Baseline assessments included standardized neurological examinations and MRI (ARWMC, infarcts, atrophy).
• Cox regression analyses were used to identify independent predictors of transition to disability or death.

Main Results:

• Over 51% of subjects had at least one neurological abnormality at baseline.
• The presence of any neurological abnormality independently predicted functional decline or death (HR 1.53).
• Severe grade ARWMC on MRI also independently predicted adverse outcomes (HR 2.18).

Conclusions:

• Neurological examination abnormalities are significant independent predictors of functional decline in the elderly.
• The number of neurological abnormalities further increased the risk of disability or death.
• Systematic neurological assessments may be a cost-effective method for identifying elderly individuals at risk of functional decline.