Sara Kaffashian1, Aïcha Soumaré1, Yi-Cheng Zhu1, Bernard Mazoyer1, Stéphanie Debette2, Christophe Tzourio2. 1. From the INSERM U1219 and University of Bordeaux, France (S.K., A.S., C.T., S.D.); Department of Neurology, Peking Union Medical College Hospital, Beijing, China (Y-C.Z.); CNRS-CEA UMR 5293 and University of Bordeaux, France (B.M.); Department of Neurology, Bordeaux University Hospital, France (S.D.); and Department of Neurology, Boston University School of Medicine, Framingham Heart Study, MA (S.D.). 2. From the INSERM U1219 and University of Bordeaux, France (S.K., A.S., C.T., S.D.); Department of Neurology, Peking Union Medical College Hospital, Beijing, China (Y-C.Z.); CNRS-CEA UMR 5293 and University of Bordeaux, France (B.M.); Department of Neurology, Bordeaux University Hospital, France (S.D.); and Department of Neurology, Boston University School of Medicine, Framingham Heart Study, MA (S.D.). Christophe.tzourio@u-bordeaux.fr Stephanie.debette@u-bordeaux.fr.
Abstract
BACKGROUND AND PURPOSE: White matter hyperintensity (WMH) volume and covert brain infarcts are highly prevalent in older adults and are often asymptomatic. We compared the impact of WMH volume and brain infarcts on risk of clinical stroke and dementia in older adults in the population. METHODS: Participants were 1677 individuals aged ≥65 years from the 3-City Dijon study, who were free of stroke and dementia at baseline, followed-up for ≤12 years. RESULTS: Both lesion types were comparably associated with an increased risk of stroke (adjusted hazard ratio, 1.72; 95% confidence interval, 1.24-2.40 for WMH volume and hazard ratio, 2.15; 95% confidence interval, 1.18-3.93 for brain infarcts), but only WMH volume was associated with an increased risk of dementia (hazard ratio, 1.41; 95% confidence interval, 1.09-1.83). CONCLUSIONS: The differential impact of WMH and brain infarcts on clinical stroke and dementia suggests relatively different prognostic value of the 2 lesions. WMHs may represent a particularly pertinent magnetic resonance imaging intermediate marker that can be utilized in optimizing prevention strategies for both stroke and dementia in primary care and in trials.
BACKGROUND AND PURPOSE: White matter hyperintensity (WMH) volume and covert brain infarcts are highly prevalent in older adults and are often asymptomatic. We compared the impact of WMH volume and brain infarcts on risk of clinical stroke and dementia in older adults in the population. METHODS:Participants were 1677 individuals aged ≥65 years from the 3-City Dijon study, who were free of stroke and dementia at baseline, followed-up for ≤12 years. RESULTS: Both lesion types were comparably associated with an increased risk of stroke (adjusted hazard ratio, 1.72; 95% confidence interval, 1.24-2.40 for WMH volume and hazard ratio, 2.15; 95% confidence interval, 1.18-3.93 for brain infarcts), but only WMH volume was associated with an increased risk of dementia (hazard ratio, 1.41; 95% confidence interval, 1.09-1.83). CONCLUSIONS: The differential impact of WMH and brain infarcts on clinical stroke and dementia suggests relatively different prognostic value of the 2 lesions. WMHs may represent a particularly pertinent magnetic resonance imaging intermediate marker that can be utilized in optimizing prevention strategies for both stroke and dementia in primary care and in trials.
Authors: Brittany S Passiak; Dandan Liu; Hailey A Kresge; Francis E Cambronero; Kimberly R Pechman; Katie E Osborn; Katherine A Gifford; Timothy J Hohman; Matthew S Schrag; L Taylor Davis; Angela L Jefferson Journal: Neurology Date: 2019-02-27 Impact factor: 11.800