121 Distinct brain MRI phenotypes and their association with long-term dementia risk 6 significant hazard ratios (HRs) across the subgroups varied between 1.01 and 6.18. The subgroup with relatively severe WMH and atrophy (subgroup 12) showed the largest long-term risk for dementia (HR 6.18, 95% CI 3.37–11.32) compared with the reference subgroup (subgroup 10). The multi-burden subgroups (subgroup 2: HR 3.68, 2.06–6.61; subgroup 14: HR 3.48, 1.96–6.16), the subgroup with mostly irregularly shaped WMH and cerebral atrophy (subgroup 3: HR 3.33, 1.94–5.73), the subgroup with mostly irregularly shaped WMH and microbleeds (subgroup 9: HR 2.99, 1.60–5.56), and the subgroup with mostly cortical infarcts and atrophy (subgroup 15: HR 3.16, 1.70–5.86) also showed a relatively high long-term risk for dementia. Figure 6.3. Symbolic illustration of the brain MRI markers per subgroup. Small circles indicate low WMH volumes or low amount of cerebral atrophy. Big circles indicate high WMH volumes or cerebral atrophy. WMH shape is illustrated with symbols with three varying degrees of shape irregularity (regular, moderate, and irregular). Pie charts indicate percentages of participants with infarcts, enlarged PVS or microbleeds. S: subgroup; WMH: white matter hyperintensities; enlarged PVS: enlarged perivascular spaces in and around the basal ganglia.
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