High burden of cerebral white matter lesion in 9 Asian cities

Lam B.Y.K., Yiu B., Ampil E., Chen C.L.-H., Dikot Y., Dominguez J.C., Ganeshbhai P.V., Hilal S., Kandiah N., Kim S.Y., Lee J.-Y., Ong A.P., Senanarong V., Leung K.T., Wang H., Yang Y.-H., Yong T., Arshad F., Alladi S., Wong S., Ko H., Lau A.Y.L., Mok V.C.T.

Division of Neurology, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong; Therese Pei Fong Chow Research Centre for Prevention of Dementia and Margaret Kam Ling Cheung Research Centre for Management of Parkinsonism, Gerald Choa Neuroscience Centre, The Chinese University of Hong Kong, Hong Kong; Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China; Department of Neuroscience and Behavioural Medicine, Faculty of Medicine and Surgery, University of Santo Tomas, Manila, Philippines; Institute for Neurosciences, St. Luke’s Medical Centre, Quezon City, Philippines; Memory Aging and Cognition Center, National University Health System, Singapore, Singapore; Department of Pharmacology, National University of Singapore, Singapore, Singapore; Department of Neurology, Achmad Yani University, Cimahi, Indonesia; Department of Neurology, National Institute of Mental Health and Neuro Sciences, Bengaluru, India; Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore; Department of Neurology, National Neuroscience Institute, Singapore, Singapore; Department of Neurology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seoul, South Korea; Department of Psychiatry, SMG-SNU Boramae Medical Centre, Seoul National University College of Medicine, Seoul, South Korea; Department of Neurology, Hasan Sadikin Hospital, Bandung, Indonesia; Department of Medicine At, Mahidol University, Bangkok, Thailand; Dementia Care and Research Centre, Peking University Institute of Mental Health, Beijing, China; Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital and Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong; Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong


Age-related white matter lesion (WML) is considered a manifestation of sporadic cerebral small vessel disease and an important pathological substrate for dementia. Asia is notable for its large population with a looming dementia epidemic. Yet, the burden of WML and its associated risk factors across different Asian societies are unknown. Subjects from 9 Asian cities (Bangkok, Bandung, Beijing, Bengaluru, Hong Kong, Kaohsiung, Manila, Seoul, and Singapore) were recruited (n = 5701) and classified into (i) stroke/transient ischemic attack (TIA), (ii) Alzheimer’s disease (AD)/mild cognitive impairment (MCI), or (iii) control groups. Data on vascular risk factors and cognitive performance were collected. The severity of WML was visually rated on MRI or CT. The prevalence of moderate-to-severe WML was the highest in subjects with stroke/TIA (43.3%). Bandung Indonesia showed the highest prevalence of WML, adjusted for age, sex, education, disease groups, and imaging modality. Hypertension and hyperlipidemia were significant risk factors for WML, and WML was negatively associated with MMSE in all groups. WML is highly prevalent in Asia and is associated with increasing age, hypertension, hyperlipidemia, and worse cognitive performance. Concerted efforts to prevent WML will alleviate the huge dementia burden in the rapidly aging Asian societies. © 2021, The Author(s).


Scientific Reports

Publisher: Nature Research

Volume 11, Issue 1, Art No 11587, Page – , Page Count

Journal Link: https://www.scopus.com/inward/record.uri?eid=2-s2.0-85107213249&doi=10.1038%2fs41598-021-90746-x&partnerID=40&md5=a1fac18be2a4daf41f2b3ce3f93c6923

doi: 10.1038/s41598-021-90746-x

Issn: 20452322

Type: All Open Access, Gold, Green


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