title: Leukoaraiosis predicts hidden global functioning impairment in nondisabled older people: the LADIS (Leukoaraiosis and Disability in the Elderly) Study.
abstract: OBJECTIVE
  To determine whether leukoaraiosis severity is independently associated with differences in global functioning in nondisabled elderly patients.
  
  
  METHODS
  Cross-sectional data analysis from an ongoing longitudinal multicenter and multinational study.
  
  
  METHODS
  The Leukoaraiosis and Disability Study, a collaboration aimed at assessing leukoaraiosis as an independent predictor of the transition to disability in older people.
  
  
  METHODS
  Six hundred thirty-nine nondisabled subjects (288 men, 351 women, mean age+/-standard deviation 74.1+/-5.0) with magnetic resonance imaging-detected leukoaraiosis of different severity and presenting with one of the following: mild cognitive or motor disturbances, minor cerebrovascular events, or mood alterations or in whom leukoaraiosis was incidentally identified.
  
  
  METHODS
  Centralized assessment of leukoaraiosis severity according to the three severity degrees of the Fazekas scale; Disability Assessment for Dementia (DAD) Scale for measurement of global functioning.
  
  
  RESULTS
  At baseline, 44% of participants had a mild, 31% a moderate, and 25% a severe degree of leukoaraiosis. A significant trend toward declining performance on the DAD Scale was apparent with increasing leukoaraiosis score severity (total score=98.8, 98.6, 97.5, respectively, in the three leukoaraiosis categories, analysis of variance P=.002). Similar trends were obtained for basic (P=.01) and instrumental (P<.001) function items. The statistical significance of these differences was confirmed in a multiple linear regression analysis correcting for numerous factors known to influence disability in older people. Executive function test performance declined along with increasing leukoaraiosis severity and was significantly related to DAD total score.
  
  
  CONCLUSIONS
  Even in nondisabled elderly patients, levels of functional ability are related to white matter lesion severity. Executive dysfunction may mediate this relationship.
authors.affiliation: Department of Neurological and Psychiatric Sciences, University of Florence, Florence, Italy. pantoni@neuro.unifi.it
authors.forename: Leonardo
authors.initials: L
authors.lastname: Pantoni
authors.forename: Anna
authors.initials: A
authors.lastname: Poggesi
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Basile
authors.forename: Giovanni
authors.initials: G
authors.lastname: Pracucci
authors.forename: Frederik
authors.initials: F
authors.lastname: Barkhof
authors.forename: Hugues
authors.initials: H
authors.lastname: Chabriat
authors.forename: Timo
authors.initials: T
authors.lastname: Erkinjuntti
authors.forename: José M
authors.initials: JM
authors.lastname: Ferro
authors.forename: Michael
authors.initials: M
authors.lastname: Hennerici
authors.forename: John
authors.initials: J
authors.lastname: O'Brien
authors.forename: Reinhold
authors.initials: R
authors.lastname: Schmidt
authors.forename: Marieke C
authors.initials: MC
authors.lastname: Visser
authors.forename: Lars-Olof
authors.initials: LO
authors.lastname: Wahlund
authors.forename: Gunhild
authors.initials: G
authors.lastname: Waldemar
authors.forename: Anders
authors.initials: A
authors.lastname: Wallin
authors.forename: Domenico
authors.initials: D
authors.lastname: Inzitari
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000209:etiology* / Q000473:pathology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D049292:Leukoaraiosis / Q000150:complications* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D009048:Motor Skills; D013687:Telencephalon / Q000473:pathology