The Association of White Matter Hyperintensities with Frailty in Patients with Very Mild to Moderate Alzheimer’s Disease

Background: Frailty, one of serious global health problems in the elderly, is a growing concern in patients with Alzheimer’s disease (AD) because of its high prevalence in AD and its impact on the prognosis. Objective: To investigate the quantitative association between white matter hyperintensities (WMH) and frailty in AD. Methods: A total of 144 outpatients were included. All subjects were evaluated by using Korean version of the CERAD assessment battery and diagnosed very mild to moderate AD. WMH volume was calculated using automated segmentation analysis from the 3D MRI image and further partitioned according to the distance from the ventricular surface. Using the Korean Frailty Index, prefrailty was defined by the scores of 3 and 4 and frailty by the score of 5 and higher. Results: In total, 23.6%were frailty, 32.6%were pre-frailty, and 43.8%were classified as a robust group. The frailty group had higher WMH volume compared to the robust group (p = 0.02), and these trends remained significant after linear regression analyses. According to the subclassification of WMH, using the robust group as a reference, total WMH (OR = 6.297, p = 0.013, 95%CI = 1.463–27.114), juxtaventricular WMH (OR = 12.955, p = 0.014, 95%CI = 1.687–99.509), and periventricular WMH (OR = 3.382, p = 0.025, 95%CI = 1.163–9.8531) volumes were associated with frailty, but deep WMH volume was not. Conclusions: A quarter of patients with very mild to moderate AD is suffering from frailty. Our study provides the evidence of a cross-sectional relationship between WMH volume and frailty, and there is a difference in the association between the subclassification of WMH volume and frailty.

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White-Matter Hyperintensities and Lacunar Infarcts Are Associated with an Increased Risk of Alzheimer's Disease in the Elderly in China

Journal of Clinical Neurology ◽

10.3988/jcn.2019.15.1.46 ◽

2019 ◽

Vol 15 (1) ◽

pp. 46 ◽

Cited By ~ 2

Author(s):

Shuai Ye ◽

Shuyang Dong ◽

Jun Tan ◽

Le Chen ◽

Hai Yang ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

White Matter ◽

White Matter Hyperintensities ◽

The Elderly ◽

Lacunar Infarcts ◽

Increased Risk

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Cross‐sectional and longitudinal associations of white matter hyperintensities and cortical thickness in the biomarkers of Alzheimer’s Disease in Down Syndrome (ADDS) study

Alzheimer s & Dementia ◽

10.1002/alz.045344 ◽

2020 ◽

Vol 16 (S4) ◽

Author(s):

Patrick J Lao ◽

Linggang Luo ◽

Kay C Igwe ◽

Batool Rizvi ◽

Mithra Sathishkumar ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Down Syndrome ◽

White Matter ◽

Cortical Thickness ◽

White Matter Hyperintensities ◽

Cross Sectional ◽

Longitudinal Associations

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P3-130: Effects of white matter hyperintensities on the volumes of right and left hippocampus in patients with Alzheimer's disease

Alzheimer s & Dementia ◽

10.1016/j.jalz.2012.05.1350 ◽

2012 ◽

Vol 8 (4S_Part_14) ◽

pp. P497-P498

Author(s):

Jae-Won Jang ◽

Young Chul Youn ◽

Ko-woon Kim

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

White Matter ◽

White Matter Hyperintensities ◽

Left Hippocampus

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Topographic patterns of white matter hyperintensities are associated with multimodal neuroimaging biomarkers of Alzheimer’s disease

Alzheimer s Research & Therapy ◽

10.1186/s13195-020-00759-3 ◽

2021 ◽

Vol 13 (1) ◽

Author(s):

Malo Gaubert ◽

Catharina Lange ◽

Antoine Garnier-Crussard ◽

Theresa Köbe ◽

Salma Bougacha ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

White Matter ◽

Glucose Metabolism ◽

Corpus Callosum ◽

Gray Matter ◽

Fdg Pet ◽

White Matter Hyperintensities ◽

Gray Matter Volume ◽

Matter Volume

Abstract Background White matter hyperintensities (WMH) are frequently found in Alzheimer’s disease (AD). Commonly considered as a marker of cerebrovascular disease, regional WMH may be related to pathological hallmarks of AD, including beta-amyloid (Aβ) plaques and neurodegeneration. The aim of this study was to examine the regional distribution of WMH associated with Aβ burden, glucose hypometabolism, and gray matter volume reduction. Methods In a total of 155 participants (IMAP+ cohort) across the cognitive continuum from normal cognition to AD dementia, FLAIR MRI, AV45-PET, FDG-PET, and T1 MRI were acquired. WMH were automatically segmented from FLAIR images. Mean levels of neocortical Aβ deposition (AV45-PET), temporo-parietal glucose metabolism (FDG-PET), and medial-temporal gray matter volume (GMV) were extracted from processed images using established AD meta-signature templates. Associations between AD brain biomarkers and WMH, as assessed in region-of-interest and voxel-wise, were examined, adjusting for age, sex, education, and systolic blood pressure. Results There were no significant associations between global Aβ burden and region-specific WMH. Voxel-wise WMH in the splenium of the corpus callosum correlated with greater Aβ deposition at a more liberal threshold. Region- and voxel-based WMH in the posterior corpus callosum, along with parietal, occipital, and frontal areas, were associated with lower temporo-parietal glucose metabolism. Similarly, lower medial-temporal GMV correlated with WMH in the posterior corpus callosum in addition to parietal, occipital, and fontal areas. Conclusions This study demonstrates that local white matter damage is correlated with multimodal brain biomarkers of AD. Our results highlight modality-specific topographic patterns of WMH, which converged in the posterior white matter. Overall, these cross-sectional findings corroborate associations of regional WMH with AD-typical Aß deposition and neurodegeneration.

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Influence of White Matter Hyperintensities on Baseline and Longitudinal Amyloid-β in Cognitively Normal Individuals

Journal of Alzheimer s Disease ◽

10.3233/jad-210333 ◽

2021 ◽

pp. 1-11

Author(s):

Fennie Choy Chin Wong ◽

Seyed Ehsan Saffari ◽

Chathuri Yatawara ◽

Kok Pin Ng ◽

Nagaendran Kandiah ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Executive Function ◽

White Matter ◽

White Matter Hyperintensities ◽

Small Vessel Disease ◽

Amyloid Β ◽

Intracranial Volume ◽

Linear Regression Models ◽

Cognitively Normal

Background: The associations between small vessel disease (SVD) and cerebrospinal amyloid-β1-42 (Aβ1-42) pathology have not been well-elucidated. Objective: Baseline (BL) white matter hyperintensities (WMH) were examined for associations with month-24 (M24) and longitudinal Aβ1-42 change in cognitively normal (CN) subjects. The interaction of WMH and Aβ1-42 on memory and executive function were also examined. Methods: This study included 72 subjects from the Alzheimer’s Disease Neuroimaging Initiative. Multivariable linear regression models evaluated associations between baseline WMH/intracranial volume ratio, M24 and change in Aβ1-42 over two years. Linear mixed effects models evaluated interactions between BL WMH/ICV and Aβ1-42 on memory and executive function. Results: Mean age of the subjects (Nmales = 36) = 73.80 years, SD = 6.73; mean education years = 17.1, SD = 2.4. BL WMH was significantly associated with M24 Aβ1-42 (p = 0.008) and two-year change in Aβ1-42 (p = 0.006). Interaction between higher WMH and lower Aβ1-42 at baseline was significantly associated with worse memory at baseline and M24 (p = 0.003). Conclusion: BL WMH was associated with M24 and longitudinal Aβ1-42 change in CN. The interaction between higher WMH and lower Aβ1-42 was associated with poorer memory. Since SVD is associated with longitudinal Aβ1-42 pathology, and the interaction of both factors is linked to poorer cognitive outcomes, the mitigation of SVD may be correlated with reduced amyloid pathology and milder cognitive deterioration in Alzheimer’s disease.

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Prevalência, desempenho cognitivo e funcionalidade de idosos com Doença de Alzheimer em instituições de longa permanência de Bento Gonçalves

PAJAR - Pan-American Journal of Aging Research ◽

10.15448/2357-9641.2017.1.26051 ◽

2017 ◽

Vol 5 (1) ◽

pp. 23 ◽

Cited By ~ 2

Author(s):

Daniela Fernandes Tonholi ◽

Gisele Oltramari

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cognitive Performance ◽

Junior High School ◽

Functional Independence Measure ◽

The Elderly ◽

Functional Independence ◽

Cross Sectional Study ◽

Functional Evaluation ◽

Cross Sectional

Aims: To determine the prevalence, cognitive performance and functionality of elderly people with Alzheimer's disease in long-stay institutions for the elderlyin the city of Bento Gonçalves. Methods: Cross-sectional study including 24 elderly residents in long-stay institutions for the elderly, sociodemographic datawere obtained, and the elderly were subjected to functional evaluation by the Functional Independence Measure and evaluation of cognitive performancethrough the mental state the Mini (MMSE). Results: Most of the residents were female (83%), as 54.2% schooling had completed junior high school, mostof the elderly (70.8%) was admitted by the will of the family, 100% of the elderly showed cognitive performance bad, and the smaller the more dependentcognitive performance was the individual. Conclusion: institutionalized elderly with Alzheimer's disease had negative results on cognitive performance,as well as deficits in their ability to perform activities of daily living, thus altering their functionality.Keywords: aging; functionality; cognition; Alzheimer Disease; long-stay institutions.

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