title: Leukoaraiosis is associated with functional impairment in older patients with Alzheimer's disease but not vascular dementia.
abstract: BACKGROUND
  Leukoaraiosis (LA) is a common finding in older persons, and might be associated with reduced cognitive performance, gait abnormalities, and functional impairment. Although LA is more frequent in persons affected by dementia, scant data are available about its clinical consequences in this group of patients.
  
  
  OBJECTIVE
  To study the association between presence of LA and functional performance in basic activities of daily living in a sample of older persons affected by dementia.
  
  
  METHODS
  We conducted a cross-sectional study on 214 patients; 77 affected by late onset Alzheimer's disease (LOAD), and 137 by vascular dementia (VD). Functional status was assessed using Barthel Index (BI). LA was assessed using computed tomography.
  
  
  RESULTS
  In LOAD patients, LA (OR: 7.87; 1.26-48.94), and MMSE score (OR: 0.83; 0.71-0.98) were associated with the risk of severe disability, independent of age, gender, diabetes, hypertension, coronary heart disease, left ventricular hypertrophy, atrial fibrillation, and brain atrophy. In VD patients, MMSE score (OR: 0.77; 0.64-0.93), and CHD (OR: 7.41; 1.09-50.21), but not LA (OR: 2.07; 0.45-9.45) were associated with a severe functional impairment after multivariate adjustment.
  
  
  CONCLUSIONS
  Our study suggests that LA might be associated with a worse functional status in basic activities of daily living in patients affected by LOAD but not VD. LA might act synergistically with cognitive and behavioural disturbances to the onset and progression of disability of these patients.
authors.affiliation: Department of Clinical and Experimental Medicine, Section of Internal Medicine, Gerontology and Geriatrics; University of Ferrara, Via Savonarola no. 9, 44100 Ferrara, ITALY.
authors.forename: A
authors.initials: A
authors.lastname: Ble
authors.forename: M
authors.initials: M
authors.lastname: Ranzini
authors.forename: A
authors.initials: A
authors.lastname: Zurlo
authors.forename: L
authors.initials: L
authors.lastname: Menozzi
authors.forename: A R
authors.initials: AR
authors.lastname: Atti
authors.forename: M R
authors.initials: MR
authors.lastname: Munari
authors.forename: S
authors.initials: S
authors.lastname: Volpato
authors.forename: G
authors.initials: G
authors.lastname: Scaramelli
authors.forename: R
authors.initials: R
authors.lastname: Fellin
authors.forename: G
authors.initials: G
authors.lastname: Zuliani
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000473:pathology*; D000704:Analysis of Variance; D001921:Brain / Q000000981:diagnostic imaging; D003430:Cross-Sectional Studies; D015140:Dementia, Vascular / Q000473:pathology*; D005260:Female; D006801:Humans; D049292:Leukoaraiosis / Q000150:complications* / Q000473:pathology* / Q000503:physiopathology; D016015:Logistic Models; D008297:Male; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed