title: Severe cerebral white matter hyperintensities predict severe cognitive decline in patients with cerebrovascular disease history.
abstract: OBJECTIVE
  Cerebral white matter hyperintensities (WMHs) are believed to be the consequence of small vessel disease, and it is uncertain whether their extent predicts the risk of dementia in patients with vascular disease history. Method- Brain MRI was performed in 226 participants of the PROGRESS study. WMH severity was assessed using a visual rating scale. During follow-up, patients were classified for incident severe cognitive deterioration (including dementia) using standard criteria.
  
  
  RESULTS
  Over 4-year follow-up, the incidence of severe cognitive deterioration ranged from 1.1 to 9.1 per 100 person-years in patients with respectively no or severe WMHs at baseline. In multivariable analysis, incident severe cognitive deterioration was associated with baseline severe WMHs (odds ratio=7.7, P<0.005).
  
  
  CONCLUSIONS
  Higher WMH load is a strong predictor of dementia and cognitive decline in patients with cerebrovascular disease history.
authors.forename: Carole
authors.initials: C
authors.lastname: Dufouil
authors.forename: Ophélia
authors.initials: O
authors.lastname: Godin
authors.forename: John
authors.initials: J
authors.lastname: Chalmers
authors.forename: Oghuzan
authors.initials: O
authors.lastname: Coskun
authors.forename: Stephen
authors.initials: S
authors.lastname: MacMahon
authors.forename: Nathalie
authors.initials: N
authors.lastname: Tzourio-Mazoyer
authors.forename: Marie-Germaine
authors.initials: MG
authors.lastname: Bousser
authors.forename: Craig
authors.initials: C
authors.lastname: Anderson
authors.forename: Bernard
authors.initials: B
authors.lastname: Mazoyer
authors.forename: Christophe
authors.initials: C
authors.lastname: Tzourio
mesh_terms: D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D001921:Brain / Q000473:pathology*; D002561:Cerebrovascular Disorders / Q000473:pathology* / Q000523:psychology*; D003072:Cognition Disorders / Q000473:pathology* / Q000523:psychology*; D003704:Dementia / Q000473:pathology / Q000523:psychology; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002546:Ischemic Attack, Transient / Q000473:pathology / Q000523:psychology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D020913:Perindopril / Q000627:therapeutic use; D011237:Predictive Value of Tests; D012008:Recurrence; D020521:Stroke / Q000473:pathology / Q000523:psychology
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D020913:Perindopril