White matter hyperintensity shape is associated with long-term dementia risk.

Abstract

We aimed to investigate the association between white matter hyperintensity (WMH) shape and volume and the long-term dementia risk in community-dwelling older adults. Three thousand seventy-seven participants (mean age: 75.6±5.2 years) of the Age Gene/Environment Susceptibility (AGES)-Reykjavik study underwent baseline 1.5T brain magnetic resonance imaging and were followed up for dementia (mean follow-up: 9.9±2.6 years). More irregular shape of periventricular/confluent WMH (lower solidity (hazard ratio (95% confidence interval) 1.34 (1.17 to 1.52), p<.001) and convexity 1.38 (1.28 to 1.49), p<.001); higher concavity index 1.43 (1.32 to 1.54), p<.001) and fractal dimension 1.45 (1.32 to 1.58), p<.001)), higher total WMH volume (1.68 (1.54 to 1.87), p<.001), higher periventricular/confluent WMH volume (1.71 (1.55 to 1.89), p<.001), and higher deep WMH volume (1.17 (1.08 to 1.27), p<.001) were associated with an increased long-term dementia risk. WMH shape markers may in the future be useful in determining patient prognosis and may aid in patient selection for future preventive treatments in community-dwelling older adults.