title: White matter hyperintensities are an independent predictor of physical decline in community-dwelling older people.
abstract: BACKGROUND
  Ageing is associated with physical disability, but little is known about the influence of white matter hyperintensities (WMHs) on physical function decline in older people.
  
  
  OBJECTIVE
  To investigate the role of WMHs as a predictor of decline in physical function in cognitively intact older people.
  
  
  METHODS
  287 community-dwelling people aged 70-90 years underwent the Physiological Profile Assessment (PPA) and assessments of total and regional WMH volumes, cognitive function and comorbidities. Participants underwent reassessment of the PPA 12 months later, and those in the top quartile for increases in PPA scores over the year were regarded as having declined physically.
  
  
  RESULTS
  Multivariate logistic regression analyses revealed that people with WMH volumes in the 4th quartile showed greater physical decline (odds ratio 3.02, 95% confidence interval 1.02-8.95) while controlling for age, baseline physical function, general health, physical activity and cognitive function. Subsequent univariate analyses indicated that WMHs in the deep fronto-parietal and periventricular parieto-occipital regions had the strongest associations with physical decline.
  
  
  CONCLUSIONS
  These findings indicate that WMHs are an independent predictor of decline in physical function and suggest that interventions that focus on preventing the development or progression of white matter lesions may help preserve physical function in older people.
authors.affiliation: Falls and Balance Research Group, Neuroscience Research Australia, University of New South Wales, Sydney, NSW, Australia.
authors.forename: Jacqueline J J
authors.initials: JJ
authors.lastname: Zheng
authors.forename: Kim
authors.initials: K
authors.lastname: Delbaere
authors.forename: Jacqueline C T
authors.initials: JC
authors.lastname: Close
authors.forename: Perminder
authors.initials: P
authors.lastname: Sachdev
authors.forename: Wei
authors.initials: W
authors.lastname: Wen
authors.forename: Henry
authors.initials: H
authors.lastname: Brodaty
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Lord
mesh_terms: D000058:Accidental Falls; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000473:pathology* / Q000502:physiology* / Q000523:psychology; D001921:Brain / Q000473:pathology*; D015331:Cohort Studies; D056344:Executive Function; D005260:Female; D006801:Humans; D056784:Leukoencephalopathies / Q000473:pathology / Q000503:physiopathology / Q000523:psychology; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D009043:Motor Activity; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012111:Residence Characteristics