Abstract
Background
Information on the association between disability and severity of white matter hyperintensities (WMH) among stroke-free individuals is limited. We aimed to assess this association in apparently healthy older adults.
Methods
Following a population-based cross-sectional design, community-dwelling older adults received a brain MRI to grade WMH severity and the Functional Activities Questionnaire to assess the ability to perform activities of daily living. Demographics, clinical risk factors and other markers of cerebral small vessel disease were taken into consideration for analysis.
Results
Unadjusted analysis showed a significant association between moderate-to-severe WMH and disability (p = 0.003) that was tempered by the effect of age. Causal mediation analysis showed that age took away 65.9% of the effect of WMH severity on disability. An interaction model showed that disability was higher only among subjects with moderate-to-severe WMH above the median age.
Conclusions
Increasing age mediates the probability of WMH-related disability in stroke-free individuals.
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Data availability
Aggregated data from this study are available from the corresponding author upon written request.
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Funding
The study supported by Universidad Espíritu Santo—Ecuador. The sponsor had no role in the design of the study, nor in data collection or analyses, or in the decision to submit this work for publication.
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Contributions
OHD: study design, imaging readings, manuscript drafting; DAR: data collection and interpretation; BYR: study coordinator; RMM: statistical analysis of data, significant intellectual contribution to manuscript content. All authors read and approved the final version of the submitted manuscript.
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The authors declared no potential conflicts of interest concerning the research, authorship, and/or publication of this article.
Ethical approval
The Ethics Committee of Hospital-Clínica Kennedy, Guayaquil, Ecuador (FWA 00030727) approved the study. The study followed ethical principles stated in the Declaration of Helsinki.
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All human studies have been approved by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.
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Study participants signed comprehensive informed consents at enrollment, as well as before the practice of follow-up MRIs.
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Del Brutto, O.H., Rumbea, D.A., Recalde, B.Y. et al. The association between white matter hyperintensities of presumed vascular origin and disability is mediated by age: a population-based study in stroke-free older adults. Aging Clin Exp Res 35, 887–892 (2023). https://doi.org/10.1007/s40520-023-02355-5
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DOI: https://doi.org/10.1007/s40520-023-02355-5