Regional Variability in the Prevalence of Cerebral White Matter Lesions: An MRI Study in 9 European Countries (CASCADE)Launer L.J.a, b · Berger K.c · Breteler M.M.B.b · Dufouil C.d · Fuhrer R.e · Giampaoli S.f · Nilsson L.-G.g · Pajak A.h · de Ridder M.b · van Dijk E.J.b · Sans S.i · Schmidt R.j · Hofman A.b
aLaboratory of Epidemiology, Demography, Biometry, National Institute on Aging, Bethesda, Md., USA; bDepartment of Epidemiology and Biometry, Erasmus Medical Center, Rotterdam, The Netherlands; cInstitute of Epidemiology and Social Medicine, University of Münster, Münster, Germany; dINSERM Unit 360, Epidemiological Research in Neurology and Psychopathology, Hôpital La Salpêtrière, Paris, France; eDepartment of Epidemiology, Biostatistics and Occupational Health, McGill University Faculty of Medicine, Montreal, Canada; fIstituto Superiore di Sanità, National Center of Epidemiology, Surveillance and Health Promotion, Rome, Italy; gDepartment of Psychology, Stockholm University, Stockholm, Sweden; hDepartment of Epidemiology and Population Studies, Institute of Public Health Jagiellonian University Medical School, Kraków, Poland; iInstitute of Health Studies, Barcelona, Spain; jDepartment of Neurology, Karl-Franzens University, Graz, Austria
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White matter lesions (WML) on MRI of the brain are common in both demented and nondemented older persons. They may be due to ischemic events and are associated with cognitive and physical impairments. It is not known whether the prevalence of these WML in the general population differs across European countries in a pattern similar to that seen for coronary heart disease. Here we report the prevalence of WML in 1,805 men and women drawn from population-based samples of 65- to 75-year-olds in ten European cohorts. Data were collected using standardized methods as a part of the multicenter study CASCADE (Cardiovascular Determinants of Dementia). Centers were grouped by region: south (Italy, Spain, France), north (Netherlands, UK, Sweden), and central (Austria, Germany, Poland). In this 10-year age stratum, 92% of the sample had some lesions, and the prevalence increased with age. The prevalence of WML was highest in the southern region, even after adjusting for differences in demographic and selected cardiovascular risk factors. Brain aging leading to disabilities will increase in the future. As a means of hypothesis generation and for health planning, further research on the geographic distribution of WML may lead to the identification of new risk factors for these lesions.
© 2006 S. Karger AG, Basel
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