title: Cerebral white matter disease is associated with Alzheimer pathology in a prospective cohort.
abstract: BACKGROUND
  Although magnetic resonance imaging (MRI)-detected white matter disease has been correlated with cognitive decline in the elderly individuals, it is unclear whether white matter disease is primarily responsible for the cognitive deterioration or whether another process is common to both white matter disease and dementia.
  
  
  METHODS
  We examined the relationship between Alzheimer-type brain pathology at autopsy and MRI-detected cerebral white matter disease in 50 participants from the Baltimore Longitudinal Study of Aging Autopsy Program, a prospective study of aging that includes detailed cognitive assessments.
  
  
  RESULTS
  White matter disease was quantitated in pre- and postmortem MRI scans using the Cardiovascular Health Study (CHS) criteria in a blinded manner. We found that several measures of Alzheimer's disease (AD) pathology, including the Consortium to Establish a Registry for Alzheimer's Disease score, Braak score, and a composite AD pathology score, along with hypertension, were significantly associated with CHS white matter score using univariate and multivariate ordinal regression. In contrast, amyloid angiopathy was not independently associated with CHS score. Although a clinical diagnosis of dementia was associated with CHS score in univariate analysis, the association disappeared after accounting for AD pathology.
  
  
  CONCLUSIONS
  AD pathology at autopsy is associated with MRI-detected cerebral white matter disease. This relationship may explain, in part, the association between cerebral white matter disease and cognitive decline in the elderly individuals.
authors.affiliation: Department of Neurology, Johns Hopkins Bayview Medical Center, Baltimore, MD, USA.
authors.forename: Abhay
authors.initials: A
authors.lastname: Moghekar
authors.forename: Michael
authors.initials: M
authors.lastname: Kraut
authors.forename: Wendy
authors.initials: W
authors.lastname: Elkins
authors.forename: Juan
authors.initials: J
authors.lastname: Troncoso
authors.forename: Alan B
authors.initials: AB
authors.lastname: Zonderman
authors.forename: Susan M
authors.initials: SM
authors.lastname: Resnick
authors.forename: Richard J
authors.initials: RJ
authors.lastname: O'Brien
mesh_terms: D000368:Aged; D000375:Aging / Q000473:pathology; D000544:Alzheimer Disease / Q000473:pathology*; D001921:Brain / Q000473:pathology*; D003072:Cognition Disorders / Q000473:pathology*; D015331:Cohort Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D009413:Nerve Fibers, Myelinated / Q000473:pathology*