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Decline in intelligence is associated with progression in white matter hyperintensity volume

¹ Danish Research Centre for Magnetic Resonance, Copenhagen University Hospital, Hvidovre, Denmark
² Department of Health Psychology, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark
³ Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, Denmark

Correspondence to:
Correspondence to:
Dr Ellen Garde
National Hospital for Neurology and Neurosurgery, Dementia Research Centre, Box 16, 8–11 Queen Square, London WC1N 3BG, UK; elleng{at}magnet.drcmr.dk

ABSTRACT
Objectives: To quantify the time course of white matter hyperintensities (WMH) and assess the association between progression and cognitive decline in non-demented octogenarians.

Methods: From a Danish cohort of 698 people born in 1914, 26 participated in neuropsychological assessment (Wechsler adult intelligence scale) initiated at age 50, including cognitive testing and cerebral magnetic resonance imaging at the 80 and 85 year studies. WMH volumes were quantified and partial correlations were calculated between WMH volume change and decline in WAIS scores from 80 to 85.

Results: Progression in WMH volume ranged from 0 ml to 20.7 ml, providing a median increase of 2.6 ml (range 0.1 to 20.7, p<0.001) and, with a mean time interval between scans of 3.8 years, a rate of progression of 0.63 (0 to 6.8) ml/year. WMH volume measures for the two hemispheres were highly correlated (r = 0.95) and did not differ significantly. Increase in WMH volume was correlated with a simultaneous decline in verbal IQ (r = –0.65, p = 0.001), while baseline WMH was associated with subsequent decline in performance subtests (digit symbol, r = –0.57, p = 0.02).

Conclusions: The association between WMH and decline in essential cognitive abilities even in well preserved elderly people suggests that WMH should be regarded as a risk factor for cognitive impairment and dementia.

Abbreviations: ICC, intraclass correlation coefficient; MMSE, mini-mental state examination; WAIS, Wechsler adult intelligence scale; WMH, white matter hyperintensity

Keywords: white matter hyperintensities; cognitive decline; aging

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