84 Chapter 5 5.1 ABSTRACT We aimed to investigate the association between white matter hyperintensity (WMH) shape and volume and the long-term dementia risk in community-dwelling older adults. Three thousand seventy-seven participants (mean age: 75.6 ± 5.2 years) of the Age Gene/Environment Susceptibility (AGES)-Reykjavik study underwent baseline 1.5T brain magnetic resonance imaging and were followed up for dementia (mean followup: 9.9 ± 2.6 years). More irregular shape of periventricular/confluent WMH (lower solidity (hazard ratio (95% confidence interval) 1.34 (1.17 to 1.52), p <0.001) and convexity 1.38 (1.28 to 1.49), p <0.001); higher concavity index 1.43 (1.32 to 1.54), p <0.001) and fractal dimension 1.45 (1.32 to 1.58), p <0.001)), higher total WMH volume (1.68 (1.54 to 1.87), p <0.001), higher periventricular/confluent WMH volume (1.71 (1.55 to 1.89), p <0.001), and higher deep WMH volume (1.17 (1.08 to 1.27), p <0.001) were associated with an increased long-term dementia risk. WMH shape markers may in the future be useful in determining patient prognosis and may aid in patient selection for future preventive treatments in community-dwelling older adults.
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