title: Association of white matter hyperintensities and gray matter volume with cognition in older individuals without cognitive impairment.
abstract: Both presence of white matter hyperintensities (WMH) and smaller total gray matter volume on brain magnetic resonance imaging (MRI) are common findings in old age, and contribute to impaired cognition. We tested whether total WMH volume and gray matter volume had independent associations with cognition in community-dwelling individuals without dementia or mild cognitive impairment (MCI). We used data from participants of the Rush Memory and Aging Project. Brain MRI was available in 209 subjects without dementia or MCI (mean age 80; education = 15 years; 74 % women). WMH and gray matter were automatically segmented, and the total WMH and gray matter volumes were measured. Both MRI-derived measures were normalized by the intracranial volume. Cognitive data included composite measures of five different cognitive domains, based on 19 individual tests. Linear regression analyses, adjusted for age, sex, and education, were used to examine the relationship of logarithmically-transformed total WMH volume and of total gray matter volume to cognition. Larger total WMH volumes were associated with lower levels of perceptual speed (p < 0.001), but not with episodic memory, semantic memory, working memory, or visuospatial abilities (all p > 0.10). Smaller total gray matter volumes were associated with lower levels of perceptual speed (p = 0.013) and episodic memory (p = 0.001), but not with the other three cognitive domains (all p > 0.14). Larger total WMH volume was correlated with smaller total gray matter volume (p < 0.001). In a model with both MRI-derived measures included, the relation of WMH to perceptual speed remained significant (p < 0.001), while gray matter volumes were no longer related (p = 0.14). This study of older community-dwelling individuals without overt cognitive impairment suggests that the association of larger total WMH volume with lower perceptual speed is independent of total gray matter volume. These results help elucidate the pathological processes leading to lower cognitive function in aging.
authors.affiliation: Rush Alzheimer's Disease Center, Rush University Medical Center, 600 S. Paulina Ave, Suite 1020, Chicago, IL, 60612, USA. zarvanit@rush.edu.|Department of Neurological Sciences, Rush University Medical Center, Chicago, USA. zarvanit@rush.edu.
authors.forename: Zoe
authors.initials: Z
authors.lastname: Arvanitakis
authors.affiliation: Rush Alzheimer's Disease Center, Rush University Medical Center, 600 S. Paulina Ave, Suite 1020, Chicago, IL, 60612, USA.|Department of Neurological Sciences, Rush University Medical Center, Chicago, USA.|Department of Behavioral Sciences, Rush University Medical Center, Chicago, USA.
authors.forename: Debra A
authors.initials: DA
authors.lastname: Fleischman
authors.affiliation: Rush Alzheimer's Disease Center, Rush University Medical Center, 600 S. Paulina Ave, Suite 1020, Chicago, IL, 60612, USA.|Department of Diagnostic Radiology and Nuclear Medicine, Rush University Medical Center, Chicago, USA.|Department of Biomedical Engineering, Illinois Institute of Technology, Rush University Medical Center, Chicago, USA.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Arfanakis
authors.affiliation: Rush Alzheimer's Disease Center, Rush University Medical Center, 600 S. Paulina Ave, Suite 1020, Chicago, IL, 60612, USA.|Department of Neurological Sciences, Rush University Medical Center, Chicago, USA.
authors.forename: Sue E
authors.initials: SE
authors.lastname: Leurgans
authors.affiliation: Rush Alzheimer's Disease Center, Rush University Medical Center, 600 S. Paulina Ave, Suite 1020, Chicago, IL, 60612, USA.|Department of Neurological Sciences, Rush University Medical Center, Chicago, USA.|Department of Behavioral Sciences, Rush University Medical Center, Chicago, USA.
authors.forename: Lisa L
authors.initials: LL
authors.lastname: Barnes
authors.affiliation: Rush Alzheimer's Disease Center, Rush University Medical Center, 600 S. Paulina Ave, Suite 1020, Chicago, IL, 60612, USA.|Department of Neurological Sciences, Rush University Medical Center, Chicago, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Bennett
mesh_terms: D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology*; D001921:Brain / Q000473:pathology*; D003071:Cognition / Q000502:physiology*; D005260:Female; D066128:Gray Matter / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009483:Neuropsychological Tests; D066127:White Matter / Q000473:pathology*
keywords: Aging; Brain; Cognition; Gray matter; MRI; Volume; Voxel-wise analyses; White matter hyperintensities
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