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Centre for Policy on Ageing | |
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Changes in white matter as determinant of global functional decline in older independent outpatients
— three year follow-up of LADIS (leukoaraiosis and disability) study cohort | | Author(s) | Domenico Inzitari, Giovanni Pracucci, Anna Poggesi |
| Journal title | British Medical Journal, vol 339, no 7715, 1 August 2009 |
| Pages | pp 279-282 |
| Source | www.bmj.com |
| Keywords | Cognitive impairment ; Tissues ; Screening ; Out-patients ; Physical disabilities ; Longitudinal surveys ; Europe. |
| Annotation | The impairment in daily living activities in older people with age-related changes in white matter was assessed according to the severity of these changes. Participants were 639 non-disabled older patients (45.1% men, mean age 74.1) in 11 European countries in whom brain magnetic resonance imaging (MRI) showed mild, moderate or severe age-related changes in white matter (Fazekas scale). MRI assessment also included cerebral infarcts and atrophy. Over a mean follow-up of 2.42 years (median 2.84 years), information on the main outcome was available for 633 patients. The annual rate of transition or death was 10.5%, 15.1% and 29.5%, respectively, for patients with mild, moderate or severe age-related changes in white matter (Kaplan-Meier log rank test p (0.001). In a Cox model comparing factors of functional decline, the risk of transition to disability or death was more than twofold higher. The other predictors were age group, history of atrial fibrilation, and complaint of gait disturbance. The effect of severe changes remained significant independently of baseline degree of atrophy and number of infarcts, incident stroke and dementia only slightly modified this effect. The 3-year results of the LADIS study suggest that in older adults who seek medical attention for non-disabling complaints, severe age-related changes in white matter independently and strongly predicted rapid global functioning decline. (RH). |
| Accession Number | CPA-090902210 A |
| Classmark | E4: BKT: 3V: LFB: BN: 3J: 74 * |
Data © Centre for Policy on Ageing |
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| ...from the Ageinfo database published by Centre for Policy on Ageing. |
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