title: What are the differences between younger and older patients with symptomatic small vessel disease?
abstract: OBJECTIVE
  Although typically linked to aging, small vessel disease (SVD) is also observed in younger adult patients, with common vascular risk factors (RF). We aimed to investigate features of SVD occurrence at an early adult age.
  
  
  METHODS
  Vascular RF, functional and cognitive status and severity of lesions on MRI expressed as total score on Age-Related White Matter Changes (ARWMC) scale were analyzed in 200 consecutive patients with cerebral SVD admitted to a tertiary neurological hospital. Variables were compared between younger (35-55 years) and older (>56 years) patients.
  
  
  RESULTS
  In this study, 63 (31.5%) of patients were 55 years or younger. Both age groups had comparable RF profiles, but smoking emerged as an independent predictor for SVD at a younger age (OR 2.9; 95% CI 1.5-5.5; p=0.002). Younger patients had better functional (OR 1.8; 95% CI 1.3-2.5; p=0.0001) and cognitive (χ(2) 13.94; p=0.0009) status compared to older patients. However, two thirds of younger patients had some degree of cognitive deficit. Total score on ARWMC scale was lower in younger patients (mean 12.3 in younger versus 15.2 in older, OR 1.11; 95% CI 1.0-1.18; p=0.001). There was a strong correlation in both groups between functional score, cognitive status and ARWMC score (p<0.0001).
  
  
  CONCLUSIONS
  In our dataset, younger patients with SVD shared common vascular RF with older patients. In the group aged ≤55, better functional and cognitive status and less severe MRI changes were noted. However, a substantial number of younger SVD patients presenting with TIA or ischemic stroke had various deficits.
authors: Clinic for Neurology, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia. aleksandrapavlovic@hotmail.com
authors: Aleksandra M
authors: AM
authors: Pavlović
authors: Tatjana
authors: T
authors: Pekmezović
authors: Jasna
authors: J
authors: Zidverc-Trajković
authors: Zagorka
authors: Z
authors: Jovanović
authors: Milija
authors: M
authors: Mijajlovic
authors: Dragan
authors: D
authors: Pavlović
authors: Gordana
authors: G
authors: Tomić
authors: Nadežda
authors: N
authors: Sternić
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000473:pathology; D001921:Brain / Q000473:pathology; D059345:Cerebral Small Vessel Diseases / Q000150:complications / Q000175:diagnosis / Q000473:pathology*; D003071:Cognition / Q000502:physiology; D003072:Cognition Disorders / Q000209:etiology / Q000473:pathology; D003430:Cross-Sectional Studies; D015140:Dementia, Vascular / Q000175:diagnosis / Q000523:psychology; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D002546:Ischemic Attack, Transient / Q000209:etiology / Q000473:pathology; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D009483:Neuropsychological Tests; D012307:Risk Factors; D014652:Vascular Diseases / Q000503:physiopathology