WHITE-MATTER CHANGES - NEUROBEHAVIORAL MANIFESTATIONS OF BINSWANGERS-DISEASE AND CLINICAL CORRELATES IN ALZHEIMERS-DISEASE

Although white matter lesions (WMLs) are among the most common structu ral neuroimaging changes found on computed tomography and magnetic res onance imaging of older persons with dementia, their presence should n ot be misconstrued as proof that vascular disease is causing or contri buting to the dementia. We report the results of several studies exami ning the neurobehavioral manifestations of persons meeting explicit op erational criteria for Binswanger's disease (BD) and the clinical corr elates of white matter changes in persons with autopsy-proven Alzheime r's disease (AD). The findings suggest that relative to persons with A D of comparable dementia severity, persons with BD have less profound impairments in episodic memory, more depressive symptomatology and a m ore variable rate of cognitive decline; among persons with AD, some WM Ls are associated with incontinence and gait disturbance, but they do not appear to contribute to dementia severity.