Abstract 102: Predictors of the Development of White Matter Hyperintensities Over a 20-Year Period: A Secondary Analysis of the ARIC Study

Abstract

Introduction: White matter hyperintensities on MRI (WMH) are associated with cognitive impairment and disability. Prior reports have shown associations between various risk factors and WMH. Hypothesis: Composite risk stratification will accurately predict WMH burden on MRI performed over 20 years later in the Atherosclerosis Risk in the Community (ARIC) study. Methods: We included demographic data from Study Visit 1 (1987-1989) and brain MRI volumetric data (cm^3) from Visit 5 (2011-2013). The primary outcome is quartiles of WMH as a percentage of intrapatient total brain volume. Using Student’s t-test and the chi-squared test we compared demographics between WMH quartile 4 and quartiles 1-3. We also fit a multivariate logistic regression model to WMH quartile 4 versus 1-3. Results: Inclusion criteria were met by 1,748 patients, aged 52.7±5.2 years and 41% male. Patient age, black race, cigarette smoking, diabetes mellitus, and family history of stroke were all associated with a larger WMH burden. This association persisted in the multivariate model (Table 2), and is an accurate predictor of WMH development (Figure 3, AUC 0.67). Conclusion: These historical and demographic data could be used to develop a clinical score to predict patients at risk for a larger WMH burden, more than 20 years later. This unique cohort provides important data for the study of WMH, which can take decades to develop.