Progression of neuroimaging markers of cerebral small vessel disease in older adults: A 6-year follow-up study

We investigated progression and interrelationships of cerebral small vessel disease (cSVD) markers. This population-based cohort study included 325 participants (age >= 60 years) who had repeated measures of cSVD markers over 6 years: white-matter hyperintensity (WMH), perivascular spaces (PVS), lacunes, and grey-matter (GM) and ventricular volumes. We found that all cSVD markers, except PVS, progressed faster with increasing age. Regional WMH progressed faster in males and less-educated people ( p < 0.05). Each 10-point increment in global WMH score was associated with multi-adjusted hazard ratio of 1.78 (95% CI = 1.50-2.10) for incident lacunes and multi-adjusted beta-coefficients of 0.15 (0.08-0.22), -0.37 (-0.58- 0.16), and 0.11 (0.03-0.18) for annual changes of global WMH score, GM volume, and ventricular volume, respectively. The corresponding figures associated with per 10-PVS increment were 1.14 (1.01-1.28), 0.07 (0.03-0.11), -0.18 (-0.32-0.04), and 0.02 (-0.03-0.07). Prevalent lacunes were related to multi-adjusted beta-coefficients of 0.29 (0.0 0-0.58), 0.22 (0.05-0.38), 0.10 (0.01-0.18), and -0.93 (-1.83-0.03) for annual changes of global, deep, and periventricular WMH scores and GM volume, respectively. These results suggest that cSVD progresses faster in older, male, and less-educated people, and that greater loads of WMH, PVS, and lacunes anticipate faster cSVD progression. (C) 2022 The Author(s). Published by Elsevier Inc.