Brain White Matter Hyperintensities: Relative Importance of Vascular Risk Factors in Nondemented Elderly People
Abstract
PURPOSE: To prospectively determine whether there is an association between brain white matter signal hyperintensities on magnetic resonance (MR) images and potential risk factors for cerebral ischemia in a well-characterized narrow age cohort of nondemented community-dwelling elderly people. MATERIALS AND METHODS: The study population consisted of surviving members of the Aberdeen 1921 Birth Cohort, a subsample of participants in the 1932 Scottish Mental Survey who were born in 1921. With the permission of the local ethics committee and with informed written consent, 106 nondemented subjects (62 men, 44 women) aged 78-79 years underwent T2-weighted brain MR imaging. Brain MR images were scored semiquantitatively for deep white matter hyperintensities and periventricular hyperintensities. Vascular risk factors and clinical measures potentially associated with cerebral ischemia included hypertension, diabetes, cerebrovascular disease, smoking, body mass index grade, respiratory function levels (forced expiratory volume in 1 second [FEV1], forced vital capacity [FVC], and peak expiratory flow rate [PEFR]) normalized for subject's height, plasma lipid levels (cholesterol, triglycerides, high-density lipoprotein, and low-density lipoprotein), glycated hemoglobin level, and mean fasting blood glucose level. Pearson correlation coefficients were calculated for correlations between potential vascular risk factors and scores for deep white matter and periventricular hyperintensities, and stepwise multiple linear regression analysis was performed for factors with a statistically significant correlation. RESULTS: Significant Pearson correlations with deep white matter hyperintensities were found for glycated hemoglobin level (r = 0.31), hypertension (r = 0.27), normalized FEV1 (r = -0.27), normalized FVC (r = -0.22), normalized PEFR (r = -0.27), low-density lipoprotein (r = 0.24), and cholesterol (r = 0.20), and with periventricular hyperintensities for glycated hemoglobin level (r = 0.28) and normalized PEFR (r = -0.23). Multiple linear regression analysis showed that glycated hemoglobin level and hypertension were predictive of 16.2% of the variance in deep white matter hyperintensities. When subjects with non-insulin-dependent (type 2) diabetes mellitus (n = 11) were excluded, hypertension and decreased normalized PEFR were predictive of 11.7% of the variance. CONCLUSION: White matter hyperintensities are associated with elevated levels of glycated hemoglobin in nondemented community-dwelling elderly subjects. Hypertension and decreased normalized PEFR are the principal predictors of deep white matter hyperintensities in nondiabetic subjects.
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WMH are directly related to vascular risk factors such as hypertension, diabetes, and obesity, which impair cerebral blood flow and lead to ischemic injury to small vessels.
“WMH are directly related to vascular risk factors such as hypertension, diabetes, and obesity, which impair cerebral blood flow and lead to ischemic injury to small vessels. 7 , 8”
From White matter hyperintensity modulates the amyloid‐tau‐cognition association and anti‐amyloid treatment efficacy in asymptomatic older adults (2025) · cites this paper as [7]
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- Authors
- Murray, A. D., Staff, R. T., Shenkin, S. D., Deary, I. J., Starr, J. M., & Whalley, L. J.
- Affiliations
- University of Aberdeen (GB)
- University of Edinburgh (GB)
- Venue
- Radiology
- Published
- 2005-10
- Volume
- 237
- Issue
- 1
- Pages
- 251-257
- ISSN
- 0033-8419 (ISSN-L)
- 1527-1315
- OpenAlex
- W2113144027
- Cited by
- 206
- References
- 42
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 5 · 2023: 7 · 2022: 4 · 2021: 11 · 2020: 7 · 2019: 9 · 2018: 7 · 2017: 14 · 2016: 12 · 2015: 13 · 2014: 18 · 2013: 10 · 2012: 11
- FWCI
- 4.53
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Radiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Wellcome Trust
- Topics
- Health Sciences › Medicine › Neurology › Cerebrovascular and genetic disorders
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advanced MRI Techniques and Applications
- Keywords
- white matter hyperintensities, deep white matter hyperintensities, periventricular white matter hyperintensities, vascular risk factors, cerebral ischemia, non-demented elderly, hypertension, HbA1c, type 2 diabetes, respiratory function, low-density lipoprotein, plasma lipids, T2-weighted MRI
- MeSH terms
- Aged, Brain, Brain Ischemia, Cholesterol, Female, Glycated Hemoglobin, Humans, Hypertension, Magnetic Resonance Imaging, Male, Prospective Studies, Respiratory Function Tests, Risk Factors
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