Analysis of Risk Factors for White Matter Hyperintensity in Older Adults without Stroke

Brain Sci. 2023 May 22;13(5):835. doi: 10.3390/brainsci13050835.

Abstract

Background: White matter hyperintensity (WMH) is prevalent in older adults aged 60 and above. A large proportion of people with WMH have not experienced stroke and little has been reported in the literature.

Methods: The case data of patients aged ≥60 years without stroke in Wuhan Tongji Hospital from January 2015 to December 2019 were retrospectively analyzed. It was a cross-sectional study. Univariate analysis and logistic regression were used to analyze independent risk factors for WMH. The severity of WMH was assessed using the Fazekas scores. The participants with WMH were divided into periventricular white matter hyperintensity (PWMH) group and deep white matter hyperintensity (DWMH) group, then the risk factors of WMH severity were explored separately.

Results: Eventually, 655 patients were included; among the patients, 574 (87.6%) were diagnosed with WMH. Binary logistic regression showed that age and hypertension were associated with the prevalence of WMH. Ordinal logistic regression showed that age, homocysteine, and proteinuria were associated with the severity of WMH. Age and proteinuria were associated with the severity of PWMH. Age and proteinuria were associated with the severity of DWMH.

Conclusions: The present study showed that in patients aged ≥60 years without stroke, age and hypertension were independent risk factors for the prevalence of WMH; while the increasing of age, homocysteine, and proteinuria were associated with greater WMH burden.

Keywords: age; homocysteine; hypertension; magnetic resonance imaging; nonstroke patient; proteinuria; white matter hyperintensity.

Grants and funding

This work was supported by the Fundamental Research Funds for the Central Universities (item number: 2019kfyXKJC055), the National Key Research and Development Program of China (Project No.2019YFC2004805 and 2020YFC2004800) and the Tongji Hospital Scientific Research Fund (2022A19).