title: Accelerated progression of white matter hyperintensities and subsequent risk of mortality: a 12-year follow-up study.
abstract: We examined the association of accelerated progression of white matter hyperintensities (WMH) with mortality outcomes in 534 older subjects at risk for cardiovascular disease. Using brain magnetic resonance imaging, volume of WMH was measured 2 times in an average of 33 months apart. After the second magnetic resonance imaging, occurrence of death was recorded during 12 years of follow-up. In multivariable analyses, each mL/y increase in global WMH was associated with 1.22-fold (95% confidence interval [CI], 1.09-1.37) higher risk of all-cause mortality, 1.29-fold (95% CI, 1.06-1.56) higher risk of cardiovascular mortality, and 1.20-fold (95% CI, 1.02-1.40) higher risk of noncardiovascular mortality. Each mL/y increase in periventricular WMH was associated with 1.22-fold (95% CI, 1.08-37) higher risk of all-cause mortality and 1.24-fold (95% CI, 1.06-1.44) higher risk of noncardiovascular mortality. Conversely, deep cortical WMH was only associated with cardiovascular mortality (1.92-fold, 95% CI, 1.12-3.30). Accelerated progression of WMH is linked with mortality risk in old age. Progression of periventricular WMH associates with noncardiovascular mortality, whereas progression of deep cortical WMH associates with cardiovascular mortality.
authors.affiliation: Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands; Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: b.sabayan@lumc.nl.
authors.forename: Behnam
authors.initials: B
authors.lastname: Sabayan
authors.affiliation: Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Jeroen
authors.initials: J
authors.lastname: van der Grond
authors.affiliation: Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands; Department of Public Health, Copenhagen University, Denmark.
authors.forename: Rudi G
authors.initials: RG
authors.lastname: Westendorp
authors.affiliation: Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Mark A
authors.initials: MA
authors.lastname: van Buchem
authors.affiliation: Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands; Netherlands Consortium for Healthy Ageing, Leiden, The Netherlands.
authors.forename: Anton J M
authors.initials: AJ
authors.lastname: de Craen
mesh_terms: D000368:Aged; D000375:Aging / Q000473:pathology*; D002318:Cardiovascular Diseases / Q000401:mortality*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D015999:Multivariate Analysis; D009929:Organ Size; D012306:Risk; D013997:Time Factors; D066127:White Matter / Q000473:pathology*
keywords: Brain MRI; Mortality; Older subjects; White matter hyperintensities