Risk factors and cognitive correlates of white matter hyperintensities in ethnically diverse populations without dementia: The COSMIC consortium.

Introduction: White matter hyperintensities (WMHs) are an important imaging marker for cerebral small vessel diseases, but their risk factors and cognitive associations have not been well documented in populations of different ethnicities and/or from different geographical regions.
Methods: We investigated how WMHs were associated with vascular risk factors and cognition in both Whites and Asians, using data from five population-based cohorts of non-demented older individuals from Australia, Singapore, South Korea, and Sweden ( N  = 1946). WMH volumes (whole brain, periventricular, and deep) were quantified with UBO Detector and harmonized using the ComBat model. We also harmonized various vascular risk factors and scores for global cognition and individual cognitive domains.
Results: Factors associated with larger whole brain WMH volumes included diabetes, hypertension, stroke, current smoking, body mass index, higher alcohol intake, and insufficient physical activity. Hypertension and stroke had stronger associations with WMH volumes in Whites than in Asians. No associations between WMH volumes and cognitive performance were found after correction for multiple testing.
Conclusion: The current study highlights ethnic differences in the contributions of vascular risk factors to WMHs.
Competing Interests: Tze Pin Ng has received research grants from National Medical Research Council (Grant Numbers: NMRC/1108/2007, NMRC/CIRG/1409/2014) and Agency for Science, Technology and Research (A*STAR) Biomedical Research Council (Grant Number: BMRC/08/1/21/19/567). Darren M. Lipnicki has received support for the present manuscript from the National Institute on Aging of the National Institutes of Health (Award number: RF1AG057531) for the COSMIC study. He has also held leadership roles as an associate and review editor for Frontiers journals. Henry Brodaty has received research grants from NHMRC Program Grant. Henry Brodaty has received consulting fees from Eisai, Eli Lilly, Roche, Biogen, Skin2Neuron, and Cranbrook Care. Additionally, he holds unpaid leadership roles in the Montefiore Homes Clinical Advisory Committee and the Dementia Australia Research Foundation. Kaarin J. Anstey has received support from National Health and Medical Research Council for institution. Perminder S. Sachdev has received grants or contracts paid to his institution from the National Health and Medical Research Council of Australia and the National Institutes of Health, USA. He has received personal payments for a lecture given at the Frontiers of Psychiatry 2023 seminar by Alkem Labs in Mumbai, India, in June 2023. Furthermore, he has been compensated for his participation in the Medical Advisory Committees for Biogen Australia in 2020 and 2021 and Roche Australia in 2022. He also holds unpaid executive committee roles in the VASCOG Society and planning committee roles in the World Psychiatric Association. Rory Chen has received NIH grant (3RF1AG057531‐01S1) for institution. Keshuo Lin, Wei Wen, Louise Mewton, Jing Du, Dadong Wang, Ingmar Skoog, Therese Rydberg Sterner, Jenna Najar, Ki Woong Kim, Ji Won Han, Jun Sung Kim, Roger Ho, Denise Qian Ling Chua, Nicolas Cherbuin, Moyra E. Mortby, Nicole Kochan, Jiyang Jiang have no conflicts of interest. Author disclosures are available in the supporting information.
(© 2024 The Authors. Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring published by Wiley Periodicals LLC on behalf of Alzheimer's Association.)