title: White matter lesions on brain magnetic resonance imaging scan and 5-year cognitive decline: the Honolulu-Asia aging study.
abstract: OBJECTIVE
  To study white matter lesions (WMLs) and 5-year cognitive decline in elderly Japanese-American men.
  
  
  METHODS
  Longitudinal cohort study.
  
  
  METHODS
  Population-based study in Honolulu, Hawaii.
  
  
  METHODS
  Japanese-American men aged 74 to 95 from the Honolulu-Asia Aging Study (HAAS) who were free of prevalent dementia, underwent a protocol brain MRI scan at the fifth HAAS examination (1994-1996), and returned for cognitive testing 5 years later (N=267).
  
  
  METHODS
  WMLs were dichotomized as present (grade 3-9, 38.2%) or absent (grade 1-2, 61.8%). Cognitive function was measured using the Cognitive Abilities Screening Instrument (CASI), and 5-year cognitive decline was defined as a drop in CASI score of 12 points or more (1 standard deviation).
  
  
  RESULTS
  Men with WMLs on MRI at baseline were significantly more likely to experience cognitive decline at 5 years than those without (22.4% vs 34.4%, P=.03). Using multiple logistic regression, adjusting for age, education, apolipoprotein (Apo)E4 allele, large or small infarcts on MRI, baseline CASI score, and hypertension, those with WMLs were significantly more likely to develop 5-year cognitive decline (odds ratio=2.00, 95% confidence interval=1.10-3.65, P=.02). This association was stronger in men who were cognitively intact and free of the ApoE4 genotype and clinical stroke at baseline.
  
  
  CONCLUSIONS
  Presence of WMLs on MRI was significantly associated with higher odds of 5-year cognitive decline in older Japanese-American men. Presence of WMLs may help identify people at risk for developing dementia, who may benefit from early intervention.
authors: Department of Geriatric Medicine, John A. Hartford Center of Excellence in Geriatrics, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii, USA. mckinaba@hotmail.com
authors: Michiko
authors: M
authors: Inaba
authors: Lon
authors: L
authors: White
authors: Christina
authors: C
authors: Bell
authors: Randi
authors: R
authors: Chen
authors: Helen
authors: H
authors: Petrovitch
authors: Lenore
authors: L
authors: Launer
authors: Robert D
authors: RD
authors: Abbott
authors: G Webster
authors: GW
authors: Ross
authors: Kamal
authors: K
authors: Masaki
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis / Q000208:ethnology; D001213:Asian; D001921:Brain / Q000473:pathology; D003072:Cognition Disorders / Q000175:diagnosis / Q000208:ethnology*; D015331:Cohort Studies; D004185:Disability Evaluation; D018450:Disease Progression; D006254:Hawaii; D006306:Health Surveys; D006801:Humans; D056784:Leukoencephalopathies / Q000208:ethnology*; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008609:Mental Status Schedule / Q000706:statistics & numerical data; D011594:Psychometrics; D012307:Risk Factors; D014057:Tomography, X-Ray Computed