A recent study led by researchers at UT Health San Antonio has found that white matter hyperintensity (WMH) burden, a common feature seen in brain magnetic resonance imaging, is a primary vascular factor associated with the risk of developing dementia. Published in JAMA Network Open, the study underscores the importance of WMH burden in preventive strategies for dementia and suggests it could serve as a surrogate marker in clinical trials aimed at preventing dementia by controlling vascular risk. With dementia expected to affect 75 million people globally by 2030, finding ways to prevent or delay its onset is a critical public health priority, as most cases of dementia, including Alzheimer’s disease, are attributed to a combination of vascular and neurodegenerative factors.
Cerebral small-vessel disease is believed to be a major underlying cause of cognitive decline and dementia, with nearly half of dementia cases showing characteristics of both Alzheimer’s and cerebral small-vessel disease. Previous observational studies had suggested a link between WMH burden and an increased risk of stroke and dementia, but causal evidence was lacking. In the new study, researchers used Mendelian randomization, a genetic instrumental variable analysis, to demonstrate a causal association between larger WMH burden and an increased risk of Alzheimer’s disease, while considering the effects of pulse pressure. This approach allowed the researchers to establish a clearer link between vascular traits and dementia risk.
The study also emphasized the importance of using multiple epidemiological approaches and various types of data analysis to explore the impact of vascular traits on late-onset diseases like dementia. The findings suggest that as vascular disease is a modifiable contributor to dementia risk, strategies aimed at preventing Alzheimer’s and dementia should focus on addressing vascular risk factors. The researchers hope that future studies will further investigate whether these findings can be applied to non-European populations, expanding the implications of their research on a global scale.
In addition to UT Health San Antonio, the study involved collaboration with several institutions and entities worldwide, including the University of Bordeaux, University of Washington, University of Michigan, and others. These partnerships allowed for a comprehensive investigation of the relationship between vascular traits and dementia risk, highlighting the need for collective efforts in addressing this growing public health concern. UT Health San Antonio’s role as a leading research institution in South Texas underscores its commitment to advancing scientific knowledge and developing innovative strategies for preventing and treating dementia.
Overall, the study’s findings provide valuable insights into the role of WMH burden as a vascular factor associated with dementia risk and highlight the importance of incorporating vascular risk management in dementia prevention strategies. By leveraging genetic analyses and collaborative research efforts, the study contributes to a better understanding of the complex relationship between vascular health and cognitive decline. This research lays the foundation for future studies to build upon, ultimately leading to more effective interventions and treatments for dementia on a global scale.