Cerebral white matter lesions and subjective cognitive dysfunction - The Rotterdam Scan Study

Objective: To determine the relationship between cerebral white matter lesi ons (WML) and subjective cognitive dysfunction. Background: Subjective cogn itive dysfunction is present when a person perceives failures of cognitive function. When annoying enough, these failures will be expressed as complai nts. Subjective cognitive dysfunction may be a prelude to or coincide with objective cognitive impairment. WML have been related to objective cognitiv e impairment and dementia, but their relationship with subjective cognitive dysfunction is not clear. Previous population-based studies on the latter relationship have been limited in sample size, recording of subjective cogn itive function, and assessment of WML severity. Methods: We randomly sample d 1,049 elderly nondemented participants from the general population. Data on subjective cognitive dysfunction and its progression were derived from a 15-item questionnaire. Objective cognitive performance was assessed using a series of neuropsychological tests. WML were scored on MRI for periventri cular and subcortical regions separately. Results: WML were associated with more subjective cognitive failures. WML were more severe for participants reporting progression of these failures compared with participants without these failures, especially within participants with better than average cog nitive performance (p = 0.008, for periventricular WML). Participants with severe WML reported progression of cognitive failures more than twice as of ten than did those with little or no WML. The relationship between the seve rity of WML and subjective cognitive failures was present for periventricul ar and subcortical WML. Conclusions: WML are associated with subjective cog nitive failures and in particular with reporting progression of these failu res, even in the absence of objective cognitive impairment.