title: White matter hyperintensities and geriatric syndrome: An important role of arterial stiffness.
abstract: White matter hyperintensities (WMH) are defined as cerebral white matter changes presumed to be of vascular origin, bilateral and mostly symmetrical. They can appear as hyperintense on T2-weighted and fluid-attenuated inversion recovery sequences, and as isointense or hypointense on T1-weighted magnetic resonance imaging of the brain. WMH have been focused on because of their clinical importance as a risk factor for cerebrovascular diseases and cognitive impairment. WMH are associated with geriatric syndrome, which is defined by clinical symptoms characteristic of older adults, including cognitive and functional impairment and falls. Cerebral small vessel diseases, such as WMH, might play an important role as risk factors for cerebrovascular diseases, cognitive impairment and geriatric syndrome through the mechanism of arterial stiffness. However, the vascular, physiological and metabolic roles of arterial stiffness remain unclear. Basically, arterial stiffness indicates microvessel arteriosclerosis presenting with vascular endothelial dysfunction. These changes might arise from hemodynamic stress as a result of a "tsunami effect" on cerebral parenchyma. In the present article, we review the clinical characteristics of WMH, focusing particularly on two associations: (i) those between cerebral small vessel diseases including WMH and arterial stiffness; and (ii) those between WMH and geriatric syndrome.
authors.affiliation: Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Obu, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Saji
authors.affiliation: Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Obu, Japan.|Biobank, National Center for Geriatrics and Gerontology, Obu, Japan.|Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
authors.forename: Noriko
authors.initials: N
authors.lastname: Ogama
authors.affiliation: Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Obu, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Toba
authors.affiliation: Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Obu, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Sakurai
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D002545:Brain Ischemia / Q000473:pathology* / Q000503:physiopathology; D003072:Cognition Disorders / Q000453:epidemiology / Q000503:physiopathology*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D018450:Disease Progression; D005260:Female; D015577:Geriatric Assessment / Q000379:methods; D005853:Geriatrics; D006801:Humans; D049292:Leukoaraiosis / Q000453:epidemiology / Q000473:pathology; D008297:Male; D011379:Prognosis; D018570:Risk Assessment; D013577:Syndrome; D059289:Vascular Stiffness; D066127:White Matter / Q000473:pathology* / Q000503:physiopathology
keywords: arterial stiffness; cerebral small vessel disease; cognitive impairment; geriatric syndrome; white matter hyperintensities