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Niels D. Prins, MD, PhD; Ewoud J. van Dijk, MD; Tom den Heijer, MD; Sarah E. Vermeer, MD, PhD; Peter J. Koudstaal, MD, PhD; Matthijs Oudkerk, MD, PhD; Albert Hofman, MD, PhD; Monique M. B. Breteler, MD, PhD

Arch Neurol. 2004;61:1531-1534.

Objective  To study the association between white matter lesions (WML) in specific locations and the risk of dementia.

Design  The Rotterdam Scan Study, a prospective population-based cohort study. We scored periventricular and subcortical WML on magnetic resonance imaging and observed participants until January 2002 for incident dementia.

Setting  General population.

Participants  We included 1077 people aged 60 to 90 years who did not have dementia at baseline.

Main Outcome Measure  Incident dementia by Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM III-R) criteria.

Results  During a mean follow-up of 5.2 years, 45 participants developed dementia. Higher severity of periventricular WML increased the risk of dementia, whereas the association between subcortical WML and dementia was less prominent. The adjusted hazard ratio of dementia for each standard deviation increase in periventricular WML severity was 1.67 (95% confidence interval, 1.25-2.24). This increased risk was independent of other risk factors for dementia and partly independent of other structural brain changes on magnetic resonance imaging.

Conclusion  White matter lesions, especially in the periventricular region, increase the risk of dementia in elderly people.

Author Affiliations: Departments of Epidemiology and Biostatistics (Drs Prins, van Dijk, den Heijer, Vermeer, Hofman, and Breteler) and Neurology (Drs Prins, van Dijk, den Heijer, Vermeer, and Koudstaal), Erasmus Medical Center, Rotterdam, the Netherlands; and the Department of Radiology, University Hospital Groningen, Groningen, the Netherlands (Dr Oudkerk).

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