High burden of cerebral white matter lesion in 9 Asian cities

• Main Authors: Bonnie Yin Ka Lam, Brian Yiu, Encarnita Ampil, Christopher Li-Hsian Chen, Yustiani Dikot, Jacqueline C. Dominguez, Patel Vishal Ganeshbhai, Saima Hilal, Nagaendran Kandiah, SangYun Kim, Jun-Young Lee, Anam Paulus Ong, Vorapun Senanarong, Kam Tat Leung, Huali Wang, Yuan-Han Yang, Tingting Yong, Faheem Arshad, Suvarna Alladi, Samuel Wong, Ho Ko, Alexander Yuk Lun Lau, Vincent Chung Tong Mok
• Format: Article
• Language: English
• Published: Nature Publishing Group 2021-06-01
• Series: Scientific Reports
• Online Access: https://doi.org/10.1038/s41598-021-90746-x

Abstract 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.