title: White Matter Changes and Cognitive Decline in a Ten-Year Follow-Up Period: A Pilot Study on a Single-Center Cohort from the Leukoaraiosis and Disability Study.
abstract: To describe the contribution of white matter lesions to the long-term neuropsychological profiles of different groups of clinical diagnoses, and to identify neuropsychological predictors of cognitive impairment in a 10-year follow-up.
  
  
  
  The Lisbon subcohort of the Leukoaraiosis and Disability (LADIS) study was re-evaluated performing a clinical, functional and cognitive evaluation [including Mini-Mental State Examination (MMSE), Alzheimer's Disease Assessment Scale - Cognition (ADAS-Cog) and ADAS-Cog with the extension for vascular impairment (VADAS-Cog), the 9-word version of the California Verbal Learning Test (CVLT-9), the Trail-Making test and the Stroop test] as well as an MRI scan. Using clinical diagnostic criteria, participants were identified as having no cognitive impairment (NI), cognitive impairment but no dementia (CIND) or dementia (DEM), and the effect of time on clinical diagnosis and neuropsychological profiles was analyzed.
  
  
  
  From the initial group of 66 participants, 37 out of 41 survivors (90%) were re-evaluated (mean age 81.40 years, 57% women). Fifteen patients (41%) had DEM, 12 (32%) CIND and 10 (27%) NI. Over time, the three groups presented distinct profiles in the MMSE [F2, 62 = 15.85, p = 0.000], ADAS [F2, 62 = 15.85, p = 0.000] and VADAS [F2, 48 = 5.87, p = 0.008]. Logistic regression analysis identified higher scores on MMSE (β = 1.14, p = 0.03, OR = 3.13, 95% CI 1.09-8.97) as predictors of NI after 10 years of follow-up.
  
  
  
  Higher scores on baseline MMSE were the only neuropsychological predictors of NI after 10 years.
authors.affiliation: Department of Neurosciences, Santa Maria Hospital, University of Lisbon, Lisbon, Portugal.
authors.forename: Sofia
authors.initials: S
authors.lastname: Madureira
authors.forename: Ana
authors.initials: A
authors.lastname: Verdelho
authors.forename: Carla
authors.initials: C
authors.lastname: Moleiro
authors.forename: Catarina
authors.initials: C
authors.lastname: Santos
authors.forename: Philip
authors.initials: P
authors.lastname: Scheltens
authors.forename: Alida
authors.initials: A
authors.lastname: Gouw
authors.forename: José
authors.initials: J
authors.lastname: Ferro
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D060825:Cognitive Dysfunction / Q000175:diagnosis / Q000523:psychology; D003704:Dementia / Q000175:diagnosis / Q000523:psychology; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D049292:Leukoaraiosis / Q000175:diagnosis / Q000523:psychology; D016015:Logistic Models; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D000073216:Mental Status and Dementia Tests; D009483:Neuropsychological Tests; D010865:Pilot Projects; D066127:White Matter / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology