Cerebral white matter lesions and the risk of dementia.
OBJECTIVE
To study the association between white matter lesions (WML) in specific locations and the risk of dementia.


METHODS
The Rotterdam Scan Study, a prospective population-based cohort study. We scored periventricular and subcortical WML on magnetic resonance imaging and observed participants until January 2002 for incident dementia.


METHODS
General population.


METHODS
We included 1077 people aged 60 to 90 years who did not have dementia at baseline.


METHODS
Incident dementia by Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM III-R) criteria.


RESULTS
During a mean follow-up of 5.2 years, 45 participants developed dementia. Higher severity of periventricular WML increased the risk of dementia, whereas the association between subcortical WML and dementia was less prominent. The adjusted hazard ratio of dementia for each standard deviation increase in periventricular WML severity was 1.67 (95% confidence interval, 1.25-2.24). This increased risk was independent of other risk factors for dementia and partly independent of other structural brain changes on magnetic resonance imaging.


CONCLUSIONS
White matter lesions, especially in the periventricular region, increase the risk of dementia in elderly people.
Department of Epidemiology, Erasmus Medical Center, 3000 DR Rotterdam, The Netherlands.
Niels D
ND
Prins
Ewoud J
EJ
van Dijk
Tom
T
den Heijer
Sarah E
SE
Vermeer
Peter J
PJ
Koudstaal
Matthijs
M
Oudkerk
Albert
A
Hofman
Monique M B
MM
Breteler
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001927:Brain Diseases / Q000150:complications* / Q000473:pathology; D002540:Cerebral Cortex / Q000293:injuries / Q000473:pathology*; D003430:Cross-Sectional Studies; D003704:Dementia / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008279:Magnetic Resonance Imaging; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D011446:Prospective Studies; D012306:Risk; D013223:Statistics as Topic