CLINICAL CORRELATES OF WHITE-MATTER FINDINGS ON CRANIAL MAGNETIC-RESONANCE-IMAGING OF 3301 ELDERLY PEOPLE - THE CARDIOVASCULAR HEALTH STUDY

Background and Purpose Our aim was to identify potential risk factors for and clinical manifestations of white matter findings on cranial MR I in elderly people. Methods Medicare eligibility lists were used to o btain a representative sample of 5888 community-dwelling people aged 6 5 years or older. Correlates of white matter findings were sought amon g 3301 participants who underwent MRI scanning and denied a history of stroke or transient ischemic attack. Participants underwent extensive standardized evaluations at baseline and on follow-up, including stan dard questionnaires, physical examination, multiple blood tests, elect rocardiogram, pulmonary function tests, carotid sonography, and M-mode echocardiography. Neuroradiologists graded white matter findings from 0 (none) to 9 (maximal) without clinical information. Results Many po tential risk factors were related to the white matter grade, but in th e multivariate model the factors significantly (all P < .01) and indep endently associated with increased grade were greater age, clinically silent stroke on MRI, higher systolic blood pressure, lower forced exp iratory volume in 1 second (FEV(1)), and income less than $50 000 per year. If excluded, FEV(1) was replaced in the model by female sex, his tory of smoking, and history of physician-diagnosed hypertension at th e baseline examination, Many clinical features were correlated with th e white matter grade, especially those indicating impaired cognitive a nd lower extremity function. Conclusions White matter findings were si gnificantly associated with age, silent stroke, hypertension, FEV(1), and income. The white matter findings may not be considered benign bec ause they are associated with impaired cognitive and lower extremity f unction.