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Open Access

White matter hyperintensity progression is associated with incident probable dementia or mild cognitive impairment

Adam de Havenon, Kevin N Sheth, Sharon D Yeatts, Tanya N Turan, Shyam Prabhakaran
DOI: 10.1136/svn-2021-001357 Published 2 September 2022
Adam de Havenon
1 Neurology, Yale University, New Haven, Connecticut, USA
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Kevin N Sheth
1 Neurology, Yale University, New Haven, Connecticut, USA
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Sharon D Yeatts
2 Public Health Sciences, MUSC, Charleston, South Carolina, USA
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Tanya N Turan
3 Neurology, MUSC, Charleston, South Carolina, USA
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Shyam Prabhakaran
4 Neurology, University of Chicago Pritzker School of Medicine, Chicago, Illinois, USA
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    Figure 1

    (A) An example of the pathway between WMH progression on MRI and dementia/MCI, (B) predicted probability* of incident dementia/MCI for ±2 Z scores of WMH progression. *Adjusted for baseline WMH volume, total intracranial volume, patient race, retirement status and randomisation arm. MCI, mild cognitive impairment; WMH, white matter hyperintensity.

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    Baseline demographics and MRI volumes, stratified by the WMH progression threshold of ≥1.4 mL vs <1.4 mL

    VariableFull cohort
    (N=433)
    WMH progression ≥1.4 mL
    (n=156)
    WMH progression <1.4 mL
    (n=277)
    P value*
    Age67.3±7.869.7±8.065.9±7.3<0.001
    Male sex272 (62.8%)90 (57.7%)182 (65.7%)0.098
    Race/ethnicity0.730
     White277 (64.0%)97 (62.2%)180 (65.0%)
     Black132 (30.5%)52 (33.3%)80 (28.9%)
     Hispanic20 (4.6%)6 (3.9%)14 (5.1%)
     Other4 (0.9%)1 (0.6%)3 (1.1)
    History of cardiovascular disease50 (11.6%)25 (16.0%)25 (9.0%)0.029
    History of diabetes9 (2.1%)5 (3.2%)4 (1.4%)0.294
    History of peripheral vascular disease24 (5.5%)7 (4.5%)17 (6.1%)0.471
    History of atrial fibrillation29 (6.7%)10 (6.4%)19 (6.9%)0.858
    Smoking (n=432)0.050
     Never197 (45.6%)59 (37.8%)138 (50.0%)
     Past180 (41.7%)75 (48.1%)105 (38.0%)
     Current55 (12.7%)22 (14.1%)33 (12.0%)
    Alcoholism10 (2.3%)3 (1.9%)7 (2.5%)1.000
    Vigorous phsycial activities0.817
     ≤1 /week219 (50.6%)82 (52.6%)137 (49.5%)
     1–4/week152 (35.1%)53 (34.0%)99 (35.7%)
     ≥5 /week62 (14.3%)21 (13.4%)41 (14.8%)
    Aspirin use217 (50.1%)85 (54.5%)132 (47.7%)0.172
    Retired250 (57.7%)100 (64.1%)150 (54.2%)0.044
    Education0.042
     <College or other250 (57.7%)101 (64.7%)149 (53.8%)
     College69 (16.0%)17 (10.9%)52 (18.9%)
     Graduate school114 (26.3%)38 (24.4%)76 (27.4%)
    Randomised to intensive blood pressure reduction241 (55.7%)73 (46.8%)168 (60.7%)0.005
    Baseline WMH volume (mL)5.8±7.49.7±9.33.6±4.9<0.001
    Baseline total intracranial volume (mL)1391±1441397±1461388±1430.558
    • *P value shown for comparison between WMH progression stratification and calculated with Student’s t-test for interval variables and the χ2 or Fisher’s exact test for binary variables, depending on frequency; interval variables shown as mean±SD and binary variables as n (%).

    • WMH, white matter hyperintensity.

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White matter hyperintensity progression is associated with incident probable dementia or mild cognitive impairment
Adam de Havenon, Kevin N Sheth, Sharon D Yeatts, Tanya N Turan, Shyam Prabhakaran
Stroke and Vascular Neurology Aug 2022, 7 (4) 364-366; DOI: 10.1136/svn-2021-001357

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White matter hyperintensity progression is associated with incident probable dementia or mild cognitive impairment
Adam de Havenon, Kevin N Sheth, Sharon D Yeatts, Tanya N Turan, Shyam Prabhakaran
Stroke and Vascular Neurology Aug 2022, 7 (4) 364-366; DOI: 10.1136/svn-2021-001357
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White matter hyperintensity progression is associated with incident probable dementia or mild cognitive impairment
Adam de Havenon, Kevin N Sheth, Sharon D Yeatts, Tanya N Turan, Shyam Prabhakaran
Stroke and Vascular Neurology Aug 2022, 7 (4) 364-366; DOI: 10.1136/svn-2021-001357
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