172 Chapter 9 term (10 years) risk for dementia. In total 3056 participants were included and we identified 15 subgroups with distinct brain MRI phenotypes. The phenotypes ranged from limited burden, mostly irregular WMH shape and cerebral atrophy, mostly irregularly WMHs and microbleeds, mostly cortical infarcts and atrophy, mostly irregularly shaped WMHs and cerebral atrophy to multi-burden subgroups. Each subgroup showed different long-term risks for dementia, with especially the brain MRI phenotype with mainly WMHs and atrophy showing an increased risk for dementia. Our results indicate that distinct brain MRI phenotypes can be identified in community-dwelling older adults and that these subgroups have a varying long-term risk for development of dementia. Brain MRI phenotypes may in the future assist in an improved understanding of the structural correlates of dementia predisposition. In Chapter 7 a novel prospective cross-sectional study was presented applying high spatial resolution WMH shape markers and other cutting-edge MRI techniques to further understand processes involved in SVD. The WHIte MAtter hyperintensity Shape and glymphatics (WHIMAS) study is including memory and geriatric clinic outpatients with MRI scanning performed both at 3 Tesla as well as at 7 Tesla MRI. The aim of the WHIMAS study is to understand variations in WMH shape and find their relation to cerebral SVD and markers of brain clearance and cognitive functioning. Such early markers of SVD are extremely important as they may represent a basis for future patient selection for lifestyle interventions or for treatment trials aimed at prevention of dementia.
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