Objective: To determine the impact of white matter hyperintensities (WMHs) on physical health and cognitive function in 60-64 year old individuals residing in the community. Methods: A subsample of 478 persons aged 60-64 from a larger community sample underwent brain magnetic resonance imaging (MRI) scans. WMHs on T2 weighted FLAIR (fluid attenuated inversion recovery) MRI scans were assessed using an automated procedure. Subjects were assessed for global cognitive function, episodic memory, working memory (digit span), information processing speed (Symbol Digit Modalities Test; SDMT), fine motor dexterity (Purdue Pegboard), and grip strength, and completed the Physical Component Summary of the Short Form Health Survey (SF-12). Regression analyses were used to examine the effect of WMHs on physical and cognitive function. Results: Deep and periventricular WMHs were present in all subjects, with women having slightly more lesions than men. WMHs were significantly associated with poorer reported physical health on the SF-12 scale, after adjusting for depression, cognitive function, and brain atrophy. WMHs were also related to lower scores on the Purdue Pegboard test, grip strength, choice reaction time, and SDMT, but not on tests of episodic memory, working memory, general intellectual function, and global cognitive function. On regression analyses, the Purdue Pegboard test and grip strength were related to physical disability. Conclusion: WMHs are common, albeit mild, in middle adult life. They are associated with physical disability, possibly through reduced speed, fine motor coordination, and muscular strength. They are also related to slowed information processing speed but not other cognitive functions. There is accumulating evidence that these incidental findings are not benign, but are associated with several impairments, such as cognitive deficits, 2 gait and balance problems, 3 urinary dysfunction, 4 and depression. 5 Although WMHs do not have a specific pathology, the lesions seen incidentally in elderly individuals with no history of neurological disorder are considered to be generally ischaemic in origin. 6 Most research into WMHs has involved subjects who are elderly; that is, older than 65 years. However, these lesions are also seen commonly in individuals in their 50s and 60s, especially those with risk factors for small vessel disease, such as hypertension and diabetes. 7 The question of whether they produce impairment in mid-adult life has not been adequately investigated. It is possible that at an earlier age, because the load of white matter lesions is small, the brain has sufficient reserve capacity to overcome any dysfunction. The findings in older individuals suggest that the relation between WMHs and impairment increases with age, 2 so that the examination of a population in mid-adult life is of interest.In our study, we examined physical and cognitive associations of WMHs in a community sample of 60-64 year old individuals. The younger age of our population sample made it unlikely that cli...
