Predictors of White Matter Hyperintensities (WMH) in the elderly Congolese population Restricted; Files Only
Omba Yohe, Emile (Fall 2023)
Published
Abstract
Objectives: White matter disease is a general term for changes and damage to the brain’s white matter, which can be seen as a bright spot on magnetic resonance imaging (MRI) of the brain, called white matter hyperintensities (WMH). WMHs are strongly linked to cardiovascular risk factors and other health conditions like Alzheimer’s disease in high-income countries and populations of European ancestry. However, there is no evidence of these associations in the Congolese population. This study evaluates factors associated with WMH in the elderly Congolese population. Methods: In a cross-sectional study of 77 people from the Democratic Republic of Congo (DRC), participants were categorized as having dementia or being a healthy control group based on their cognitive tests. Then, participants' brain MRIs were performed to analyze their WMH volume. A simple linear regression model was conducted to test the association between WMH and each considered predictor (neurological status, age, sex, hypertension, diabetes, tobacco abuse, stroke, high cholesterol, cardiovascular medication, and alcohol abuse). Then, stepwise selection and backward elimination were performed to obtain the final model. Finally, a multiple linear regression model was conducted to assess the association of WMH and variables retained in the final model (neurological status, sex, and age). Results: Of the 77 sample population, 47 (61%) had dementia, 40 (52.6%) were males, and the mean age was 73 years (± 8.0 years standard deviation). In simple linear regression models, WMH was significantly associated with dementia (expβ1 =1.75, 95% CI =1.14 – 2.71, p-value =0.01) and had a weak association with age (expβ1 =1.03, 95% CI =1.00 – 1.05, p-value =0.05) and sex (male) (expβ1 =0.66, 95% CI =0.43 – 1.01, p-value =0.05). In multiple linear regression models, WMH was statistically significantly associated with dementia (expβ1 =1.97, 95% CI =1.31 – 2.95, p-value =0.001), sex (male) (expβ2 =0.54, 95% CI =0.36 – 0.80, p-value =0.003), and age (expβ3 =1.03, 95% CI =1.00 – 1.06, p-value =0.03). However, WMH was not significantly associated with common cardiovascular risk factors, such as high blood pressure, diabetes, tobacco use, obesity, and high cholesterol levels. Conclusion: WMH is significantly associated with neurological status, sex, and age in the Congolese population. Understanding these predictors of WMH may be a helpful prevention tool for white matter disease in Sub-Saharan African countries, especially in DRC, where brain MRI diagnosis is difficult to obtain.
Table of Contents
BACKGROUND……………………...…………………………………….………………......1 METHODS………………………………………………………………………….…......……6 STATISTICAL ANALYSIS……………………………………………………………………10 RESULTS………………………………………………………………….……………………11 DISCUSSION………………………………………………………………………………...…14 CONCLUSION…………………………………………………………………………….…....17 REFERENCES……………………………………………………………………….…….........19 TABLES…………………………………………………………………………………...…….22 FIGURES…………………………………………………………………………………......…26
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File download under embargo until 08 January 2026 | 2023-11-17 20:34:21 -0500 | File download under embargo until 08 January 2026 |
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