The Journals of Gerontology Series A: Biological Sciences and Medical Sciences Advance Access first published online on January 20, 2009
This version published online on January 27, 2009
The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, doi:10.1093/gerona/gln004
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Single and Combined Effects of Cerebral White Matter Lesions and Lacunar Infarctions on Cognitive Function in an Elderly Population
1 Department of Psychiatry, School of Medicine, James Cook University, Australia
2 Department of Psychiatry, University of Münster, Germany
3 Department of Radiology, Zentralklinikum Augsburg, Germany
4 Department of Neurology
5 Institute of Epidemiology and Social Medicine, University of Münster, Germany
Address correspondence to Bernhard Baune, MD, PhD, MPH, Department of Psychiatry, School of Medicine, James Cook University, QLD 4811, Australia. Email: bernhard.baune{at}jcu.edu.au
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Abstract |
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Background.: This study is to investigate the association between single and combined vascular brain changes (white matter lesions [WMLs], lacunar infarctions) and the cognitive domains of memory, processing speed, and motor function in the elderly adults.
Methods.: In a sample of 268 participants aged 65–83 years of the MEMO (Memory and Morbidity in Augsburg Elderly) population-based study in Augsburg, Germany, cerebral magnetic resonance imaging (MRI) was performed and a detailed neuropsychological test battery applied. Analysis of covariance determined the effects of vascular brain changes on domains of cognitive functioning.
Results.: Strong associations of large WMLs and of MRI-defined lacunar infarction with three different domains of cognitive function even after adjustment for age, gender, and education were found. The combined occurrence of both lesions affected about one in 10 participants and was associated with a strong decrease in cognitive function in all domains. The difference between the groups with only one lesion type (either large WMLs or MRI-defined infarction) and participants affected by both was significant in the domains of processing speed and memory, even after adjustment for important confounders such as age, gender, education, and comorbidities. The effects of both lesion types on cognitive function were not more than additive.
Conclusions.: Our study shows that both large WMLs and MRI-defined lacunar infarction contribute to impairments in different cognitive domains. The results suggest that their combined occurrence is associated with stronger reductions in cognitive function than each of the two brain lesion types alone.
Keywords White matter lesions; Brain infarcts; Cognitive function; Elderly
Received: July 15, 2007; Accepted: April 28, 2008