Relationships Between White Matter Hyperintensities, Cerebral Amyloid Angiopathy and Dementia in a Population-based Sample of the Oldest Old
2013
Previous reports suggest that brain white matter changes, a surrogate for small vessel disease, are related to
cerebral amyloid angiopathy (CAA). However, this relationship has not been explored in population-based studies or in
the oldest old (>85 years of age). We studied the relationships between white matter hyperintensities (WMH) determined
by post-mortem magnetic resonance imaging (MRI) and neuropathologically assessed CAA in demented and nondemented
subjects enrolled in the prospective community-based Finnish Vantaa 85+ Study. In this analysis, we evaluated
scans and brain samples from 123 subjects (86% women) with a mean age of 90.6 years. We found CAA to be present in
63 % of the 123 subjects, whereas WMH was present in 74%, and dementia in 59 %. The presence of WMH of any severity
did not relate to the presence or the degree of CAA severity, irrespective of the dementia status of the subjects. Furthermore,
multivariate regression analysis showed a clear association between CAA and dementia but WMH was not related
to dementia in this very old sample. We conclude that severe WMH may not be determined by CAA in this very elderly
population.
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