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The Prevalence of White-Matter Lesions on Computed Tomography of the Brain in Demented and Nondemented 85-Year-Olds

Department of Psychiatry (Dr. Skoog), University of Gothenburg, Sahlgren's Hospital, and the Department of Radiology (Drs. Palmertz and Andreasson), Östra sjukhuset, Gothenburg, Sweden.

Bo Palmertz, MD

Department of Psychiatry (Dr. Skoog), University of Gothenburg, Sahlgren's Hospital, and the Department of Radiology (Drs. Palmertz and Andreasson), Östra sjukhuset, Gothenburg, Sweden.

Lars-Arne Andreasson, MD

Department of Psychiatry (Dr. Skoog), University of Gothenburg, Sahlgren's Hospital, and the Department of Radiology (Drs. Palmertz and Andreasson), Östra sjukhuset, Gothenburg, Sweden.

The prevalence of white-matter lesions on computed tomography was studied in a representative sample of 85-year-olds living in Gothenburg, Sweden. The study included a psychiatric examination, interview of a close informant, neuropsychological examination, physical examination, comprehensive laboratory tests, electrocardiogram, chest x-ray, computed tomography scan of the head, and cerebrospinal fluid analysis. The diagnoses of dementia and other mental disorders were made according to DSM-III-R criteria. The prevalence of white-matter lesions in demented subjects was 68.9%, and in nondemented, 33.8%. Their prevalence was not increased in any mental disorder other than dementia. All severities of dementia and the subtypes, Alzheimer's disease, vascular dementia, and other types of dementia, had a significantly higher prevalence of white-matter lesions than did nondemented subjects. The risk for dementia, but not its severity, increased with the severity of these lesions. A stepwise logistic regression analysis showed that both white-matter lesions and infarcts on computed tomography contributed independently to dementia.

White-matter changes may be a contributing cause of dementia in the oldest old, or may represent a disease entity of its own. They are important to recognize since they may be potentially preventable, or even treatable.

Journal of Geriatric Psychiatry and Neurology, Vol. 7, No. 3, 169-175 (1994)
DOI: 10.1177/089198879400700308


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