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White Matter Hyperintensities in Older Adults and Motoric Cognitive Risk Syndrome
Joanna L Mergeche1, Joe Verghese1,2, Gilles Allali1,3
1Department of Neurology, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
Introduction:
Motoric cognitive risk (MCR) syndrome is a recently described pre-dementia syndrome characterized by slow gait and cognitive complaints that has been implicated as a predictor of cognitive decline and dementia in older adults. Previous work suggests that cerebrovascular disease is associated with MCR. White matter hyperintensities (WMH) are postulated to be a product of cerebrovascular disease, and have been associated with impaired mobility and impaired cognition. This study aimed to determine if MCR is associated with regional WMH.
Methods:
Two cross-cultural cohorts of non-demented older adults were examined: 174 from a French memory clinic (62.1% male, mean age 70.7 ± 4.3 years) and 184 from an Indian community-dwelling cohort (55.4% male, mean age 66.2 ± 5.2 years). Participants were evaluated for slow gait, cognitive complaints, and regional WMH via MRI (fluid attenuated inversion recovery) FLAIR sequence.
Results:
Overall, 20.7% of participants met criteria for MCR, and 72.9% of participants had WMH on FLAIR. WMH in the frontal, parieto-occipital, temporal, basal ganglia, cerebellum, or brainstem were not associated with MCR in either of the two cohorts.
Conclusion:
WMH was not significantly associated with MCR in this studied sample of participants, suggesting that other cerebrovascular pathophysiological mechanisms, or combination of mechanisms, might underlie MCR.
Insights
Motoric cognitive risk (MCR) syndrome, a pre-dementia condition, was not associated with white matter hyperintensities (WMH) in a cross-cultural study. This suggests other factors may contribute to MCR development in older adults.
Area of Science:
- Neurology
- Geriatrics
- Neuroimaging
Background:
- Motoric cognitive risk (MCR) syndrome is a pre-dementia condition linked to cognitive decline.
- Cerebrovascular disease is suspected to play a role in MCR.
- White matter hyperintensities (WMH) are markers of cerebrovascular disease and associated with cognitive and mobility impairments.
Purpose of the Study:
- To investigate the association between MCR and regional white matter hyperintensities (WMH).
Main Methods:
- Examined two cross-cultural cohorts of non-demented older adults (French and Indian).
- Assessed participants for MCR criteria (slow gait, cognitive complaints).
- Evaluated regional WMH using MRI FLAIR sequences.
Main Results:
- 20.7% of participants met MCR criteria; 72.9% had WMH.
- No significant association was found between WMH in various brain regions and MCR in either cohort.
Conclusions:
- WMH were not significantly associated with MCR in this study.
- Other cerebrovascular mechanisms or combinations of factors may underlie MCR.
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