title: The cross-sectional and longitudinal relationships between white matter hyperintensities and dementia in patients with Parkinson's disease: A retrospective analysis of 132 patients in a single center.
abstract: OBJECTIVE
  To clarify the cross-sectional and longitudinal relationships between white matter hyperintensities (WMH) and dementia in Parkinson's disease (PD) patients.
  
  
  METHODS
  One hundred thirty-two PD patients were included. Using medical records, the patient data including Hoehn and Yahr stage, postural instability, neuropsychological tests and magnetic resonance imaging were analyzed. The degree of WMH was rated according to a modified Fazekas scale. The relationship between the variables and dementia was analyzed using the independent t-test, the chi-square test, logistic regression analysis and the Cox proportional hazard model.
  
  
  RESULTS
  The mean age of the study patients (35 males and 97 females) was 71.6 years (range, 45-93 years). The baseline WMH was associated not only cross-sectionally with the contemporary prevalence of dementia but also longitudinally with subsequent occurrence of dementia in the univariate analysis. These relationships became attenuated and statistically insignificant in the multivariate analysis after adjusting for confounders. It was postural instability that consistently predicted dementia in both the cross-sectional and the longitudinal data.
  
  
  CONCLUSIONS
  Our study showed that baseline WMH was not independently associated with dementia, and instead postural instability revealed at first examination can be a more reliable predictor of dementia in PD patients.
authors.affiliation: Department of Neurology, Sejong General Hospital, Bucheon, South Korea. Electronic address: neurosj@catholic.ac.kr.
authors.forename: Seung-Jae
authors.initials: SJ
authors.lastname: Lee
authors.affiliation: Department of Neurology, Sejong General Hospital, Bucheon, South Korea. Electronic address: lee0324@gmail.com.
authors.forename: Dong-Geun
authors.initials: DG
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003704:Dementia / Q000150:complications / Q000473:pathology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000150:complications / Q000473:pathology*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D066127:White Matter / Q000473:pathology*
keywords: Dementia; Parkinson’s disease; Postural instability; White matter hyperintensities