Interrelation between domains of functioning and white matter hyperintensities in geriatric memory clinic patients: a...

To explore interrelations between cognitive, physical, affective, and daily functioning, quality of life and white matter hyperintensities (WMH) in a geriatric memory clinic sample.

Participants received brain imaging, comprehensive geriatric assessment and neuropsychological evaluation including measurements of cognitive, physical, affective, and daily functioning and health-related quality of life. Data was analyzed using multiple linear regressions and network analysis using (moderated) mixed graphical models.

The total sample included 932 patients (age: 79.6 ± 6.0, 49% women). In regression analyses, severe WMH (Fazekas 3) was associated with decreased cognitive (attention/speed, language) and physical functioning, more apathy symptoms and more (instrumental) activities of daily living dependency (All β's -0.40 to -0.24). Within the network analysis, daily functioning was directly associated with memory, attention/speed, and gait speed, while quality of life was associated with gait speed and affective functioning. WMH had no direct network associations with domains of functioning.

Cognitive, physical, and affective changes associated with severe WMH co-occur with decreased daily functioning and lower quality of life in a geriatric memory clinic sample. However, relationships between domains of functioning are independent of WMH. This warrants a holistic and symptom-based approach in clinical care and post-diagnostic support.