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BACKGROUND AND PURPOSE: Cerebral white matter hyperintensities (WMHs) are believed to be the consequence of small vessel disease, and it is uncertain whether their extent predicts the risk of dementia in patients with vascular disease history. Method- Brain MRI was performed in 226 participants of the PROGRESS study. WMH severity was assessed using a visual rating scale. During follow-up, patients were classified for incident severe cognitive deterioration (including dementia) using standard criteria. RESULTS: Over 4-year follow-up, the incidence of severe cognitive deterioration ranged from 1.1 to 9.1 per 100 person-years in patients with respectively no or severe WMHs at baseline. In multivariable analysis, incident severe cognitive deterioration was associated with baseline severe WMHs (odds ratio=7.7, P<0.005). CONCLUSIONS: Higher WMH load is a strong predictor of dementia and cognitive decline in patients with cerebrovascular disease history.

Original publication




Journal article



Publication Date





2219 - 2221


Aged Angiotensin-Converting Enzyme Inhibitors/therapeutic use Brain/*pathology Cerebrovascular Disorders/*pathology/*psychology Cognition Disorders/*pathology/*psychology Dementia/pathology/psychology Disease Progression Female Follow-Up Studies Humans Ischemic Attack, Transient/pathology/psychology Magnetic Resonance Imaging Male Middle Aged Neuropsychological Tests Perindopril/therapeutic use Predictive Value of Tests Recurrence Stroke/pathology/psychology