title: White matter hyperintensities are related to physical disability and poor motor function.
abstract: OBJECTIVE
  To determine the impact of white matter hyperintensities (WMHs) on physical health and cognitive function in 60-64 year old individuals residing in the community.
  
  
  METHODS
  A subsample of 478 persons aged 60-64 from a larger community sample underwent brain magnetic resonance imaging (MRI) scans. WMHs on T2 weighted FLAIR (fluid attenuated inversion recovery) MRI scans were assessed using an automated procedure. Subjects were assessed for global cognitive function, episodic memory, working memory (digit span), information processing speed (Symbol Digit Modalities Test; SDMT), fine motor dexterity (Purdue Pegboard), and grip strength, and completed the Physical Component Summary of the Short Form Health Survey (SF-12). Regression analyses were used to examine the effect of WMHs on physical and cognitive function.
  
  
  RESULTS
  Deep and periventricular WMHs were present in all subjects, with women having slightly more lesions than men. WMHs were significantly associated with poorer reported physical health on the SF-12 scale, after adjusting for depression, cognitive function, and brain atrophy. WMHs were also related to lower scores on the Purdue Pegboard test, grip strength, choice reaction time, and SDMT, but not on tests of episodic memory, working memory, general intellectual function, and global cognitive function. On regression analyses, the Purdue Pegboard test and grip strength were related to physical disability.
  
  
  CONCLUSIONS
  WMHs are common, albeit mild, in middle adult life. They are associated with physical disability, possibly through reduced speed, fine motor coordination, and muscular strength. They are also related to slowed information processing speed but not other cognitive functions.
authors.affiliation: NPI, Prince of Wales Hospital, Barker Street, Randwick NSW 2031, Australia. p.sachdev@unsw.edu.au
authors.forename: P S
authors.initials: PS
authors.lastname: Sachdev
authors.forename: W
authors.initials: W
authors.lastname: Wen
authors.forename: H
authors.initials: H
authors.lastname: Christensen
authors.forename: A F
authors.initials: AF
authors.lastname: Jorm
mesh_terms: D001331:Automation; D001921:Brain / Q000473:pathology*; D001927:Brain Diseases / Q000150:complications* / Q000473:pathology*; D003072:Cognition Disorders / Q000209:etiology*; D003430:Cross-Sectional Studies; D006233:Persons with Disabilities; D005260:Female; D006304:Health Status; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008569:Memory Disorders / Q000209:etiology*; D008606:Mental Processes; D008875:Middle Aged; D019957:Motor Skills Disorders / Q000209:etiology*
references.citation: JAMA. 1999 Nov 10;282(18):1737-44
references.pmid: 10568646
references.citation: J Neurol Neurosurg Psychiatry. 1999 Nov;67(5):658-60
references.pmid: 10519875
references.citation: Ann Neurol. 2000 Feb;47(2):145-51
references.pmid: 10665484
references.citation: Pediatr Neurosurg. 1999 Sep;31(3):150-4
references.pmid: 10708357
references.citation: Neurology. 2000 Mar 28;54(6):1277-83
references.pmid: 10746598
references.citation: Neuropsychology. 2000 Apr;14(2):224-32
references.pmid: 10791862
references.citation: Pediatr Neurosurg. 2000 Mar;32(3):165-6
references.pmid: 10867567
references.citation: Neurology. 2001 Jun 12;56(11):1539-45
references.pmid: 11402112
references.citation: Neurology. 2001 Sep 25;57(6):990-4
references.pmid: 11571322
references.citation: Depress Anxiety. 2002;15(1):23-8
references.pmid: 11816049
references.citation: J Neurol Neurosurg Psychiatry. 2003 Jan;74(1):94-8
references.pmid: 12486275
references.citation: Arch Neurol. 2003 Jun;60(6):835-9
references.pmid: 12810488
references.citation: Neuroimage. 2004 May;22(1):144-54
references.pmid: 15110004
references.citation: J Psychiatr Res. 1975 Nov;12(3):189-98
references.pmid: 1202204
references.citation: Eur J Radiol. 1985 Aug;5(3):186-9
references.pmid: 4029154
references.citation: AJR Am J Roentgenol. 1987 Aug;149(2):351-6
references.pmid: 3496763
references.citation: J Neurosurg Sci. 1987 Apr-Jun;31(2):49-52
references.pmid: 3668658
references.citation: Mov Disord. 1987;2(1):1-8
references.pmid: 3504256
references.citation: Arch Neurol. 1992 Aug;49(8):825-7
references.pmid: 1524515
references.citation: Arch Neurol. 1995 Oct;52(10):970-4
references.pmid: 7575224
references.citation: Med Care. 1996 Mar;34(3):220-33
references.pmid: 8628042
references.citation: Stroke. 1996 Aug;27(8):1274-82
references.pmid: 8711786
references.citation: Stroke. 1997 Mar;28(3):652-9
references.pmid: 9056627
references.citation: Neurology. 1998 Jun;50(6):1535-40
references.pmid: 9633691
references.citation: J Neurosurg. 2000 Jan;92(1):31-8
references.pmid: 10616079