Prevalence of cerebral white matter lesions in elderly people: a population based magnetic resonance imaging study. The Rotterdam Scan Study
- F-E de Leeuwa,d,
- J C de Groota,
- E Achtenb,
- M Oudkerkb,
- L M P Ramosc,
- R Heijboerb,
- A Hofmana,
- J Jollese,
- J van Gijnd,
- M M B Bretelera
- aDepartment of Epidemiology and Biostatistics, Erasmus Medical Centre, PO Box 1738, 3000 DR Rotterdam, The Netherlands, bDepartment of Radiology, Daniel den Hoed Cancer Clinic, Erasmus Medical Centre Rotterdam, The Netherlands, cDepartment of Radiology, University Medical Centre Utrecht, The Netherlands, dDepartment of Neurology, University Medical Center Utrecht, The Netherlands, eDepartment of Psychiatry and Neuropsychology, University of Maastricht, The Netherlands
- Dr M M B Bretelerbreteler{at}epib.fgg.eur.nl
- Received 19 November 1999
- Revised 21 May 2000
- Accepted 27 June 2000
Abstract
OBJECTIVE White matter lesions are often seen on MR scans of elderly non-demented and demented people. They are attributed to degenerative changes of small vessels and are implicated in the pathogenesis of cognitive decline and dementia. There is evidence that especially periventricular white matter lesions are related to cognitive decline, whereas subcortical white matter lesions may be related to late onset depression. The frequency distribution of subcortical and periventricular white matter lesions according to age and sex reported.
METHODS A total of 1077 subjects aged between 60–90 years were randomly sampled from the general population. All subjects underwent 1.5T MR scanning; white matter lesions were rated separately for the subcortical region and the periventricular region.
RESULTS Of all subjects 8% were completely free of subcortical white matter lesions, 20% had no periventricular white matter lesions, and 5% had no white matter lesions in either of these locations. The proportion with white matter lesions increased with age, similarly for men and women. Women tended to have more subcortical white matter lesions than men (total volume 1.45 ml v 1.29 ml; p=0.33), mainly caused by marked differences in the frontal white matter lesion volume (0.89 ml v 0.70 ml; p=0.08). Periventricular white matter lesions were also more frequent among women than men (mean grade 2.5 v 2.3; p=0.07). Also severe degrees of subcortical white matter lesions were more common in women than in men (OR 1.1; 95% confidence interval (95% CI) 0.8–1.5) and periventricular white matter lesions (OR 1.2; 95% CI 0.9–1.7), albeit that none of these findings were statistically significant.
CONCLUSIONS The prevalence and the degree of cerebral white matter lesions increased with age. Women tended to have a higher degree of white matter lesions than men. This may underlie the finding of a higher incidence of dementia in women than in men, particularly at later age.
