Cerebral “Dirty-Appearing” White Matter in Relation to Cognitive Decline and Dementia Risk in Community-Dwelling Older Adults

BACKGROUND AND OBJECTIVES: Cerebral "dirty-appearing" or "diffusely abnormal" white matter (DAWM) represents subtle white matter abnormalities that are associated with progression of cerebral small vessel disease (cSVD), but the association with cognitive function and dementia is unclear. Our aim was to study the association between DAWM and cognitive function, long-term cognitive decline, and long-term dementia risk in community-dwelling older adults with limited baseline cSVD burden. METHODS: -scores at baseline and their change at follow-up (after 5.2 ± 0.2 years) and with dementia status assessed at long-term follow-up (after 10.3 ± 2.2 years). This was performed by statistical models adjusted for age, sex, vascular risk factors, and education (for the cognition analyses). RESULTS: = 0.025). DISCUSSION: In contrast to WMH, DAWM was not associated with baseline cognition, long-term cognitive decline, nor long-term dementia risk in community-dwelling older adults with limited cSVD burden. Although DAWM is associated with progression of cSVD, its role in the development of cognitive impairment and dementia remains unclear.