Dataset Information

Relationship between orthostatic hypotension and white matter hyperintensity load in older patients with mild dementia.

ABSTRACT:

Background/objectives

White matter hyperintensities (WMH) in magnetic resonance imaging (MRI) scans of the brain, and orthostatic hypotension (OH) are both common in older people. We tested the hypothesis that OH is associated with WMH.

Design

Cross-sectional study.

Setting

Secondary care outpatient clinics in geriatric medicine and old age psychiatry in western Norway.

Participants

160 older patients with mild dementia, diagnosed according to standardised criteria.

Measurements

OH was diagnosed according to the consensus definition, measuring blood pressure (BP) in the supine position and within 3 minutes in the standing position. MRI scans were performed according to a common protocol at three centres, and the volumes of WMH were quantified using an automated method (n=82), followed by manual editing. WMH were also quantified using the visual Scheltens scale (n=139). Multiple logistic regression analyses were applied, with highest vs. lowest WMH quartile as response.

Results

There were no significant correlations between WMH volumes and systolic or diastolic orthostatic BP drops, and no significant correlations between Scheltens scores of WMH and systolic or diastolic BP drops. In the multivariate analyses, only APOE?4 status remained a significant predictor for WMH using the automated method (p=0.037, OR 0.075 (0.007-0.851)), whereas only age remained a significant predictor for WMH scores (p=0.019, OR 1.119 (1.018-1.230)).

Conclusion

We found no association between OH and WMH load in a sample of older patients with mild dementia.

SUBMITTER: Soennesyn H

PROVIDER: S-EPMC3526570 | biostudies-literature | 2012

REPOSITORIES: biostudies-literature

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Publications

Relationship between orthostatic hypotension and white matter hyperintensity load in older patients with mild dementia.

Soennesyn Hogne H Nilsen Dennis W DW Oppedal Ketil K Greve Ole Jacob OJ Beyer Mona K MK Aarsland Dag D

PloS one 20121219 12

<h4>Background/objectives</h4>White matter hyperintensities (WMH) in magnetic resonance imaging (MRI) scans of the brain, and orthostatic hypotension (OH) are both common in older people. We tested the hypothesis that OH is associated with WMH.<h4>Design</h4>Cross-sectional study.<h4>Setting</h4>Secondary care outpatient clinics in geriatric medicine and old age psychiatry in western Norway.<h4>Participants</h4>160 older patients with mild dementia, diagnosed according to standardised criteria.< ...[more]

PMID: 23284932

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Project description:Abstract White matter hyperintensities are areas of hyperintense signal on MRI that typically represent cerebrovascular pathology. While focal white matter hyperintensities are common among older individuals, extensive white matter hyperintensities have been found to accelerate the progression of dementia. However, little is currently known about how various socioeconomic, health, lifestyle and environmental factors affect the severity of these lesions, particularly in low- and middle-income countries such as India. We investigated this question using cross-sectional MRI data (n = 126) from a pilot neuroimaging sub-study of an ongoing, nationally representative epidemiological study of late-life cognition in India. As a screening step, we estimated white matter hyperintensity load from fluid-attenuated inversion recovery MRI using a fully automated technique and tested for associations with each factor separately, controlling for age, sex and estimated total intracranial volume in each case. A combined model of white matter hyperintensity load included five factors which were significant after multiple comparisons correction: systolic blood pressure, body mass index, urbanicity status (urban versus rural living), daily chore hours and the frequency of store trips. This model explained an additional 27% of the variance in white matter hyperintensity load (54 versus 27% for the baseline model with only age, sex and estimated total intracranial volume). We accounted for the possibility of reverse causality by additionally controlling for concurrent markers of neurodegeneration and cognitive impairment, with no substantial change in our findings. Overall, our findings suggest that controlling high blood pressure and maintaining both a healthy body mass index and high levels of physical activity may reduce white matter hyperintensity load in older Indian adults, helping to prevent or delay dementia. Aksman et al. investigated which socioeconomic, health and lifestyle factors affect the white matter hyperintensity (WMH) load in older Indians, finding that high blood pressure, high body mass index and low levels of physical activity contribute to WMH load in this population. Graphical Abstract Graphical abstract

Dataset Information

Relationship between orthostatic hypotension and white matter hyperintensity load in older patients with mild dementia.

Background/objectives

Design

Setting

Participants

Measurements

Results

Conclusion

Publications

Relationship between orthostatic hypotension and white matter hyperintensity load in older patients with mild dementia.

Similar Datasets

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