title: Silent infarcts and cerebral microbleeds modify the associations of white matter lesions with gait and postural stability: population-based study.
abstract: OBJECTIVE
  Although cerebral white matter lesions (WMLs), silent infarcts (SIs), and microbleeds (MBs) are individually associated with poorer gait and balance, it is unknown if they interact. We studied the interactions of WML volume with SI and MB on gait and postural stability.
  
  
  METHODS
  Participants in a population-based study aged 60 to 86 years underwent brain MRI, computerized gait measurement, and a physiological profile assessment of postural stability. Segmentation procedures and standard rating methods were used to measure WML, SI, and MB. Linear regression was used to test interactions between lesions on gait and postural stability, adjusting for age, sex, and total intracranial volume.
  
  
  RESULTS
  There were 395 participants (mean age, 72 years; SD, 7.0). SIs were predominantly located in subcortical frontal white matter and in deep gray structures, and MBs were largely lobar. Participants with SI or MB had higher WML volumes than those without (P<0.001 and P=0.05, respectively). The presence of SI (P for interaction=0.01) or MB (P for interaction <0.01) magnified the adverse association of WML volume with gait. SI (P for interaction=0.02), but not MB, magnified the adverse association of WML volume with postural stability.
  
  
  CONCLUSIONS
  Subclinical cerebrovascular lesions are adversely associated with gait and postural stability in older people in a cumulative fashion.
authors.affiliation: Stroke and Ageing Research Group, Department of Medicine, Southern Clinical School, Monash University, Melbourne, Australia.
authors.forename: Philip
authors.initials: P
authors.lastname: Choi
authors.forename: Mandy
authors.initials: M
authors.lastname: Ren
authors.forename: Thanh G
authors.initials: TG
authors.lastname: Phan
authors.forename: Michele
authors.initials: M
authors.lastname: Callisaya
authors.forename: John V
authors.initials: JV
authors.lastname: Ly
authors.forename: Richard
authors.initials: R
authors.lastname: Beare
authors.forename: Winston
authors.initials: W
authors.lastname: Chong
authors.forename: Velandai
authors.initials: V
authors.lastname: Srikanth
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020520:Brain Infarction / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D005684:Gait; D006801:Humans; D020300:Intracranial Hemorrhages / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011187:Posture; D011859:Radiography; D012189:Retrospective Studies; D013648:Tasmania