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White matter hyperintensities are related to physical disability and poor motor function

¹ School of Psychiatry, University of New South Wales, Sydney, NSW 2052, Australia
² Centre for Mental Health Research, Australian National University, Canberra, 0200, Australia

Correspondence to:
Correspondence to:
Professor P Sachdev
NPI, Prince of Wales Hospital, Barker Street, Randwick NSW 2031, Australia; p.sachdev{at}unsw.edu.au

Objective: To determine the impact of white matter hyperintensities (WMHs) on physical health and cognitive function in 60–64 year old individuals residing in the community.

Methods: A subsample of 478 persons aged 60–64 from a larger community sample underwent brain magnetic resonance imaging (MRI) scans. WMHs on T2 weighted FLAIR (fluid attenuated inversion recovery) MRI scans were assessed using an automated procedure. Subjects were assessed for global cognitive function, episodic memory, working memory (digit span), information processing speed (Symbol Digit Modalities Test; SDMT), fine motor dexterity (Purdue Pegboard), and grip strength, and completed the Physical Component Summary of the Short Form Health Survey (SF-12). Regression analyses were used to examine the effect of WMHs on physical and cognitive function.

Results: Deep and periventricular WMHs were present in all subjects, with women having slightly more lesions than men. WMHs were significantly associated with poorer reported physical health on the SF-12 scale, after adjusting for depression, cognitive function, and brain atrophy. WMHs were also related to lower scores on the Purdue Pegboard test, grip strength, choice reaction time, and SDMT, but not on tests of episodic memory, working memory, general intellectual function, and global cognitive function. On regression analyses, the Purdue Pegboard test and grip strength were related to physical disability.

Conclusion: WMHs are common, albeit mild, in middle adult life. They are associated with physical disability, possibly through reduced speed, fine motor coordination, and muscular strength. They are also related to slowed information processing speed but not other cognitive functions.

Abbreviations: CSF, cerebrospinal fluid; CVLT, California Verbal Learning Test; df, degrees of freedom; DWMH, deep white matter region; FLAIR, fluid attenuated inversion recovery; FOV, field of view; ICC, intraclass correlation; ICV, intracranial volume; MMSE, Mini Mental State Examination; MRI, magnetic resonance imaging; PVH, periventricular region; SDMT, Symbol Digits Modalities Test; SF-12, Physical Component Summary of the 12 Item Short Form Health Survey; TE, echo time; TR, repetition time; WMH, white matter hyperintensity

Keywords: white matter hyperintensities; physical health; motor speed; cognitive function; grip strength; magnetic resonance imaging

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