Effect of normal aging versus hypertension, abnormal body mass index, and diabetes mellitus on white matter hyperintensity volume

Document Type

Article

Abstract

BACKGROUND AND PURPOSE: The natural history of white matter hyperintensity (WMH) progression resulting from normal aging versus comorbid vascular insults remains unclear. Therefore we investigated age-related differences in WMH volumes among a group with comorbid hypertension, abnormal body mass index, and diabetes mellitus to a normal aging group drawn from the same population lacking any of these comorbidities. METHODS: WMH volumes were acquired using 3T MRI for 2011 Dallas Heart Study participants. The slope of the WMH versus age regression was compared between normal and comorbidity groups<50 and ≥50 years of age where a change in slope was demonstrated. RESULTS: Aging was linearly associated with greater log WMH volume for both normal (P=0.02) and comorbidity (P<0.0001) groups. Beyond 50 years of age, more rapid increases in WMH volumes for age were seen in the group with comorbidities (P<0.0001) but not in the normal group (P=0.173). The between-group difference in slope of expected WMH for age was significantly greater in the comorbidity groups≥50 years of age (P=0.0008) but not <50 years of age (P=0.752). CONCLUSIONS: After 50 years of age, but not before, comorbid hypertension, obesity, and diabetes mellitus were associated with significantly larger WMH volumes for age compared with a normal aging group lacking these conditions. These results support the assertion that age-related differences in WMH volumes are significantly increased in the presence of comorbidities, but the effect is only detectable after 50 years of age.

Medical Subject Headings

Adult; Age Factors; Aged; Aged, 80 and over; Aging (pathology, physiology); Body Mass Index; Brain (pathology); Comorbidity; Diabetes Mellitus (pathology); Ethnicity; Female; Humans; Hypertension (pathology); Image Processing, Computer-Assisted; Magnetic Resonance Imaging; Male; Middle Aged; Obesity (complications, pathology); Regression Analysis; Risk Factors; Sex Factors; Socioeconomic Factors

Publication Date

1-1-2014

Publication Title

Stroke

E-ISSN

1524-4628

Volume

45

Issue

1

First Page

255

Last Page

7

PubMed ID

24203844

Digital Object Identifier (DOI)

10.1161/STROKEAHA.113.003602

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