The Relation of White Matter Hyperintensities to Cognitive Performance in the Normal Old: Education Matters

  title={The Relation of White Matter Hyperintensities to Cognitive Performance in the Normal Old: Education Matters},
  author={Robert D. Nebes and Carolyn C. Meltzer and Ellen M. Whyte and Joelle M. Scanlon and Edythe M. Halligan and Judith A. Saxton and Patricia R. Houck and Fernando E. Boada and Steven T. DeKosky},
  journal={Aging, Neuropsychology, and Cognition},
  pages={326 - 340}
ABSTRACT This study examined whether the severity of cerebral white matter abnormalities (evident on MR images as white matter hyperintensities (WMH)) was related to the cognitive performance of 141 high-functioning older adults. The elderly showed the typical age decrement on measures of processing speed, working memory, and inhibition; however WMH severity was significantly related only to processing speed. The strength of this relationship was, however, influenced by the educational level of… 
Specific anatomic associations between white matter integrity and cognitive reserve in normal and cognitively impaired elders.
Correlations between CR and WM integrity in regions showing WM age-related effects or pathologic changes and differences of slopes between groups are studied to suggest a putative link between reduced WM integrity (maximal in patients with high CR) and risk of progression to AD.
Cerebral white matter hyperintensities in the prediction of cognitive decline and incident dementia
Cerebral white matter hyperintensities appear to be early predictors of the risk of dementia, but this association appears to be modulated by cognitive reserve, age and the spatial distribution of lesions.
Differential age-related gray and white matter impact mediates educational influence on elders’ cognition
This study suggests that the cognitive advantage associated to high education among healthy aging is related to the coexistence of both neuroprotective and compensatory mechanisms, and high educated elders seem to have greater capacity to counteract a more abrupt age impact on WM integrity.
Cognitive Reserve Moderates Effects of White Matter Hyperintensity on Depressive Symptoms and Cognitive Function in Late-Life Depression
In patients with LLD, high education attenuates the deleterious effect of WMH on mood and cognition, and CR appears to exert a protective effect on neurocognitive functioning in people with L LD.
Education modulates the impact of white matter lesions on the risk of mild cognitive impairment and dementia.
  • M. Mortamais, F. Portet, S. Artero
  • Psychology, Medicine
    The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry
  • 2014
Neuroanatomical correlates of aging, cardiopulmonary fitness level, and education.
Fitness and education may protect against cognitive impairments in aging. They may also counteract age-related structural changes within the brain. Here we analyzed volumetric differences in
Influence of Education on Subcortical Hyperintensities and Global Cognitive Status in Vascular Dementia
Education moderated the relationship between SH volume and MMSE score, demonstrating that individuals with higher education had higher scores on the MMSE despite similar degrees of SH burden, suggesting that educational attainment buffers the deleterious effects ofSH burden on cognitive status among VaD patients.
Cognitive reserve moderates the association between hippocampal volume and episodic memory in middle age


The cognitive correlates of white matter abnormalities in normal aging: a quantitative review.
Results indicate that white matter abnormalities observed on MR images are associated with attenuated performance on tasks of processing speed, immediate and delayed memory, executive functions, and indices of global cognitive functioning, and there was no significant link between the white matter hyperintensities and psychometric indices of intelligence or fine motor performance.
Influence of education on the relationship between white matter lesions and cognition
Education modulates the consequences of WMH on cognition and participants with a high level of education were protected against the cognitive deterioration related to vascular insults of the brain.
Cerebral white matter abnormalities and lifetime cognitive change: a 67-year follow-up of the Scottish Mental Survey of 1932.
This work retested 83 participants of the Scottish Mental Survey of 1932 on a battery of mental tests and showed that, irrespective of brain location, white matter abnormalities contributed about 14% of cognitive function variance in old age.
Neuropsychological correlates of white-matter lesions in healthy elderly subjects. A threshold effect.
It is suggested that a "threshold" of WML area must be present before cognitive deficits are observed in healthy elderly individuals, and factors other than vascular disturbances are involved in the origin of at least some WMLs.
White matter changes in healthy elderly persons correlate with attention and speed of mental processing.
Mild LA in normal aged subjects could explain some of the intellectual impairment in the elderly, especially that of slowing of distinct motor and attentional functions, as well as slowing of mental processing.
Neuropsychological importance of subcortical white matter hyperintensity.
It is concluded that subcortical hyperintensity in healthy adults does not relate to cognitive functioning, at least with these two instruments.
Cognitive Correlates of Ventricular Enlargement and Cerebral White Matter Lesions on Magnetic Resonance Imaging: The Rotterdam Study
This study suggests that white matter lesions are primarily related to impairment of subcorticofrontal functions, whereas enlargement of the lateral ventricles is associated with disturbances of cortical functions as well.
Cerebral white matter lesions and cognitive function: The Rotterdam scan study
Tasks that involve speed of cognitive processes appear to be more affected by WMLs than memory tasks, and subjects with most severe periventricular W MLs performed nearly 1 SD below average on tasks involving psychomotor speed, and more than 0.5SD below average for global cognitive function.
Incidental white-matter foci on MRI in “healthy” subjects: evidence of subtle cognitive dysfunction
White-matter foci not adjacent to the lateral ventricles were found to be related to performance on immediate visual memory/visuoperceptual skills, visuomotor tracking/psychomotor speed and, to a lesser degree, learning capacity and abstract and conceptual reasoning skills.