MRI-defined subcortical ischemic vascular disease: baseline clinical and neuropsychological findings. The LADIS Study.
BACKGROUND
Subcortical ischemic vascular disease (SIVD) is a common, but often overlooked cause of vascular cognitive impairment. Diagnostic research criteria for SIVD are based on magnetic resonance imaging (MRI) findings including substantial white matter lesions (WML) and multiple lacunar infarcts. Empirical studies validating these imaging criteria are still few. The purpose of the study was to describe the clinical and cognitive characteristics of the MRI-defined SIVD in a mixed sample of functionally independent elderly subjects with WML.


METHODS
The subjects of the Leukoaraiosis and Disability (LADIS) study, aged 65-84 years, underwent comprehensive clinical and neuropsychological examinations, and brain MRI at the baseline assessment. The subjects meeting the SIVD imaging criteria (n = 89) were compared to the other subjects of the sample (n = 524).


RESULTS
SIVD was associated with lower education, hypertension and, independently, with obesity. The subjects with SIVD had more often motor impairment, a history of falls, and subtle impairment in activities of daily living, but they did not differ for depressive symptoms. SIVD subjects performed significantly inferiorly in tests of global cognitive function, psychomotor speed, attention and executive functions, verbal fluency, and working memory.


CONCLUSIONS
In this population of nondisabled older adults with WML, SIVD was related to specific clinical and functional characteristics. Neuropsychological features included psychomotor slowing as well as deficits in attention and executive functions.
Jokinen
Hanna
H
Department of Psychology, University of Helsinki, Helsinki, Finland. hanna.jokinen@helsinki.fi
Kalska
Hely
H
Ylikoski
Raija
R
Madureira
Sofia
S
Verdelho
Ana
A
Gouw
Alida
A
Scheltens
Philip
P
Barkhof
Frederik
F
Visser
Marieke C
MC
Fazekas
Franz
F
Schmidt
Reinhold
R
O'Brien
John
J
Hennerici
Michael
M
Baezner
Hansjorg
H
Waldemar
Gunhild
G
Wallin
Anders
A
Chabriat
Hugues
H
Pantoni
Leonardo
L
Inzitari
Domenico
D
Erkinjuntti
Timo
T
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000473:pathology*; D003071:Cognition; D015140:Dementia, Vascular / Q000175:diagnosis / Q000473:pathology* / Q000523:psychology*; D004185:Disability Evaluation; D004522:Educational Status; D005060:Europe; D005260:Female; D006801:Humans; D006973:Hypertension; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D009483:Neuropsychological Tests; D009765:Obesity; D011597:Psychomotor Performance