Leukoaraiosis and mobility decline: a high resolution magnetic resonance imaging study in older people with mild cognitive impairment.

Patterns of leukoaraiosis were analyzed on both T2-weighted fast fluid-attenuated inversion-recovery and 3D T1-weighted sequences in 23 community-dwelling older subjects with mild cognitive impairment. Mobility assessment had allowed their classification into higher and lower mobility groups (P<0.0001). Lower mobility appeared correlated with frontal subependymal lesions (P=0.0005). The absence of marked ventriculomegaly, any thick caps, deep white matter lesions curved along the ventricles bodies, large deep white matter lesions, deep grey matter leukoaraiosis was an hallmark of the higher mobility group (P<0.0001). High resolution MRI demonstrated regular patterns of the subependymal lesions and detected perivascular distribution in other forms of leukoaraiosis. It suggests that the underlying mechanism of mobility decline in the elderly may be impairment of cerebrospinal fluid dynamics with cerebral small vessel disease.