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October 1991

Improved Recognition of Leukoaraiosis and Cognitive Impairment in Alzheimer's Disease

Author Affiliations

From the Departments of Psychiatry (Drs Diaz, Merskey, and Fox and Ms Boniferro), Clinical Neurological Sciences (Dr Hachinski), and Diagnostic Radiology (Dr Lee), University of Western Ontario, London; the Stroke and Aging Research Group, The John P. Robarts Research Institute, London, Ontario (Dr Hachinski); the Clinical Trials Resources Group, London, Ontario (Dr Wong); and Cooper Hospital, University Medical Center, University of Medicine and Dentistry of New Jersey, Camden (Dr Mirsen). Dr Hachinski is a career investigator with the Heart and Stroke Foundation of Ontario.

Arch Neurol. 1991;48(10):1022-1025. doi:10.1001/archneur.1991.00530220038016

• We identified 85 patients in a longitudinal study of dementia who had uncomplicated Alzheimer's disease and in whom computed tomography of the head and psychometric testing were conducted within a 6-month period following their entry into the study. Thirty-four patients (40%) had leukoaraiosis, which was disproportionately common in female patients (62% vs 15% in male patients). Analysis of covariance demonstrated a relative reduction of scores on the Extended Scale for Dementia in those patients who had leukoaraiosis, after adjusting for the confounding effects of age, sex, educational level, and duration of illness. Leukoaraiosis was also much more common in women, even after adjusting for the possible confounding effects of age, duration of illness, Extended Scale for Dementia score, and hypertension. Multiple regression analysis showed that leukoaraiosis accounted for 11.6% of the variance of the Extended Scale for Dementia scores. Leukoaraiosis, together with duration of illness, accounted for 18.2% of the variance. Leukoaraiosis is associated with a greater degree of cognitive impairment in patients with Alzheimer's disease.

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