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Hairu R, Close JCT, Lord SR, Delbaere K, Wen W, Jiang J, Taylor ME. The association between white matter hyperintensity volume and cognitive/physical decline in older people with dementia: A one-year longitudinal study. Aging Ment Health 2022; 26:2503-2510. [PMID: 34569854 DOI: 10.1080/13607863.2021.1980859] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVES Understanding the relationship between white matter hyperintensities (WMHs) and cognitive and physical decline in people with dementia will assist in determining potential treatment strategies. Currently there is conflicting evidence describing the association between WMHs and cognitive decline and, WMHs association with declines in objective measures of physical function have not been examined. We examined the relationship between baseline WMH volume and physical/cognitive decline over one-year in older people with dementia. METHODS Twenty-six community-dwelling older people with dementia (mean age = 81 ± 8 years; 35% female) were assessed at baseline and follow-up (one-year) using the Addenbrooke's Cognitive Examination-Revised (including verbal fluency), Trail Making Test A, the Physiological Profile Assessment (PPA), timed-up-and-go (TUG) and gait speed. WMH volumes were quantified using a fully automated segmentation toolbox, UBO Detector. RESULTS In analyses adjusted for baseline performance, higher baseline WMH volume was associated with decline in executive function (verbal fluency), sensorimotor function (PPA) and mobility (TUG). Executive function (semantic/category fluency) was the only domain association that withstood adjustment for age, and additionally hippocampal volume. CONCLUSIONS In unadjusted analyses, WMH volume was associated with one-year declines in cognitive and physical function in older people with dementia. The association with executive function decline withstood adjustment for age. More research is needed to confirm these findings and explore whether vascular risk reduction strategies can reduce WMH volume and associated cognitive and physical impairments in this group.
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Affiliation(s)
- Rismah Hairu
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, UNSW, Sydney, NSW, Australia.,Prince of Wales Clinical School, Medicine, UNSW, Sydney, NSW, Australia
| | - Jacqueline C T Close
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, UNSW, Sydney, NSW, Australia.,Prince of Wales Clinical School, Medicine, UNSW, Sydney, NSW, Australia
| | - Stephen R Lord
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, UNSW, Sydney, NSW, Australia.,School of Public Health and Community Medicine, Medicine, UNSW, Sydney, NSW, Australia
| | - Kim Delbaere
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, UNSW, Sydney, NSW, Australia.,School of Public Health and Community Medicine, Medicine, UNSW, Sydney, NSW, Australia
| | - Wei Wen
- Neuropsychiatric Institute, Prince of Wales Hospital, Randwick, NSW, Australia.,Centre for Healthy Brain Ageing, School of Psychiatry, Medicine, UNSW, Sydney, NSW, Australia
| | - Jiyang Jiang
- Neuropsychiatric Institute, Prince of Wales Hospital, Randwick, NSW, Australia.,Centre for Healthy Brain Ageing, School of Psychiatry, Medicine, UNSW, Sydney, NSW, Australia
| | - Morag E Taylor
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, UNSW, Sydney, NSW, Australia.,Prince of Wales Clinical School, Medicine, UNSW, Sydney, NSW, Australia
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Hairu R, Close JCT, Lord SR, Delbaere K, Wen W, Jiang J, Taylor ME. The association between white matter hyperintensity volume and gait performance under single and dual task conditions in older people with dementia: A cross-sectional study. Arch Gerontol Geriatr 2021; 95:104427. [PMID: 34015687 DOI: 10.1016/j.archger.2021.104427] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 04/26/2021] [Accepted: 04/28/2021] [Indexed: 01/29/2023]
Abstract
BACKGROUND Understanding the relationship between white matter hyperintensities (WMHs) and gait may assist in understanding the central control of gait and determining treatment modalities. These relationships are yet to be realized in older people with dementia. OBJECTIVE To examine the association between WMH volume and gait under single-task and dual task (DT) conditions in people with dementia. METHODS Twenty-eight community-dwelling older people with dementia (median age=83 years; [IQR=77-86]; 36% female) had timed gait speed assessed at usual pace. Gait (speed, stride length, cadence) was assessed using the GAITRite® mat under three conditions (n = 18/28): a) single-task, b) functional DT: carrying a glass of water and c) cognitive DT: counting backwards from 30. WMH volumes were quantified using a fully automated segmentation toolbox. RESULTS Total, temporal and parietal WMH volumes were negatively correlated with timed and functional DT gait speed, and with stride length under single-task, functional DT and cognitive DT conditions. Frontal WMH volumes were negatively correlated with timed gait speed and stride length under single-task and functional DT conditions. Participants with higher total WMH burden had significantly slower timed and functional DT gait speed and reduced stride length under single-task, functional DT and cognitive DT conditions compared to participants with lower WMH burden. CONCLUSIONS WMH volume was associated with slower gait speed and reduced stride length, but not cadence, under single-task and DT conditions in people with dementia. Further research is needed to confirm these findings and determine whether vascular risk management can improve gait in older people with dementia.
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Affiliation(s)
- Rismah Hairu
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, UNSW, Sydney, NSW, Australia; Prince of Wales Clinical School, Medicine, UNSW, Sydney, NSW, Australia
| | - Jacqueline C T Close
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, UNSW, Sydney, NSW, Australia; Prince of Wales Clinical School, Medicine, UNSW, Sydney, NSW, Australia
| | - Stephen R Lord
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, UNSW, Sydney, NSW, Australia; School of Public Health and Community Medicine, Medicine, UNSW, Sydney, NSW, Australia
| | - Kim Delbaere
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, UNSW, Sydney, NSW, Australia; School of Public Health and Community Medicine, Medicine, UNSW, Sydney, NSW, Australia
| | - Wei Wen
- Neuropsychiatric Institute, Prince of Wales Hospital, Randwick, NSW, Australia; Centre for Healthy Brain Ageing, School of Psychiatry, Medicine, University of New South Wales, Sydney, Australia
| | - Jiyang Jiang
- Neuropsychiatric Institute, Prince of Wales Hospital, Randwick, NSW, Australia; Centre for Healthy Brain Ageing, School of Psychiatry, Medicine, University of New South Wales, Sydney, Australia
| | - Morag E Taylor
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, UNSW, Sydney, NSW, Australia; Prince of Wales Clinical School, Medicine, UNSW, Sydney, NSW, Australia.
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