Clinical significance of cerebral white matter lesions in older Asians with suspected dementia.

BACKGROUND: cerebral white matter lesions are commonly seen on neuroimaging in older people and have been associated with clinical features such as gait abnormalities, urinary incontinence and depression. The significance of cerebral white matter lesions in older people with dementia remains uncertain.
OBJECTIVES: to study the association between cerebral white matter lesions and the presence or absence of dementia in a group of elderly Asian patients; and to determine the clinical significance of cerebral white matter lesions in patients who are diagnosed to have dementia in terms of associated clinical features and the impact of cerebral white matter lesions on cognitive status.
METHODS: for the first objective, the records of 141 older people of Asian ethnicity presenting to a memory clinic for the evaluation of suspected dementia were reviewed to compare the prevalence of cerebral white matter lesions in patients who did not fulfil the criteria for dementia, patients diagnosed to have Alzheimer's disease and patients diagnosed to have vascular dementia. For the second objective, 115 of these patients who were diagnosed to have dementia were studied to determine if demented patients with cerebral white matter lesions were more likely to have urinary incontinence, Parkinsonism, depression and greater severity of dementia. In addition, a comparison was made between demented patients with cerebral white matter lesions and those without cerebral white matter lesions in terms of psychometric assessment scores.
RESULTS: cerebral white matter lesions were more common in Asian patients with vascular dementia. Demented patients with cerebral white matter lesions were also found to have more severe dementia and greater functional disability.
CONCLUSION: cerebral white matter lesions are common, and are associated with greater functional disability in elderly Asian patients with dementia.