The age-related white matter changes scale correlates with cognitive impairment

Background and purpose: Age-related white matter changes (ARWMC) are closely associated with cognitive impairment. Although the ARWMC scale has been widely used to grade white matter changes (WMC) severity, the correlation between this scale and cognitive impairment has not been studied. We aimed to validate the ARWMC scale against cognition in patients with stroke.

Methods: We determined the severity of WMC for 172 patients with stroke on MRI by volumetric quantification and the ARWMC scale. Two scores (total score and global score) were derived from the ARWMC scale. We assessed executive function and global cognition using the Mattis dementia rating scale-initiation/perseveration subset (MDRS I/P) and mini-mental state examination (MMSE), respectively. We investigated the association between the three WMC measures (volume, total score, and global score) and clinical variables with cognitive impairment using multivariate regression analysis.

Results: Even after adjusting for other clinical variables, total score and global score of ARWMC scale were independently associated with MDRS I/P (beta = -0.248, P = 0.001 and beta = -0.218, P = 0.005, respectively) and MMSE (adjusted odds ratio 1.181, 95%CI [1.038-1.343] and adjusted odds ratio 1.740, 95%CI [1.063-2.847], respectively).

Conclusion: The ARWMC scale correlates well with cognitive impairment in patients with stroke.