White Matter Lesions: Prevalence and Clinical Phenotype in Asymptomatic Individuals Aged ≥50 Years

Dement Geriatr Cogn Disord. 2016;42(3-4):159-168. doi: 10.1159/000448991. Epub 2016 Sep 21.


Background: To assess the prevalence of early confluent/confluent white matter lesions (ec/cWMLs) in asymptomatic individuals aged ≥50 years and to identify associated clinical phenotypes.

Methods: Cross-sectional analysis of 141 asymptomatic individuals aged ≥50 years assessed at an outpatient department in France. Brain magnetic resonance imaging was rated using the Fazekas scale. Age-adjusted odds ratios (ORs) and 95% confidence intervals were estimated using logistic models to investigate factors associated with ec/cWMLs; independent risk factors were identified by multivariate analysis.

Results: Median age was 63 years; 53.9% were women, 32.6% had hypertension, and 76.6% had ≥1 cardiovascular risk factors. The prevalence of ec/cWMLs was 26.2%. Apart from age, independent risk factors were family history of cardiovascular event (OR = 5.55; 1.13-27.32) and hypertension (2.47; 1.05-5.81). Patients with ec/cWMLs had lower cognitive dual-task walking speed (1.15; 0.98-1.40), MMSE (1.41; 1.06-1.89), and FAB scores (5.21; 1.49-19.84). The Scheltens score was independently associated with the WML severity score.

Conclusion: ec/cWMLs are common in asymptomatic community-dwelling individuals aged ≥50 years. They are associated with cardiovascular risk factors, impairments in global and executive cognitive function, and Scheltens score elevation.

MeSH terms

  • Aged
  • Asymptomatic Diseases*
  • Brain / diagnostic imaging*
  • Cardiovascular Diseases / epidemiology
  • Cognition
  • Cross-Sectional Studies
  • Female
  • France
  • Humans
  • Hypertension / epidemiology
  • Leukoencephalopathies / diagnostic imaging
  • Leukoencephalopathies / epidemiology*
  • Logistic Models
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Odds Ratio
  • Phenotype
  • Prevalence
  • Risk Factors
  • Task Performance and Analysis
  • Walking Speed
  • White Matter / diagnostic imaging*