Severe Perivascular Space Pathology Predictive of Dementia in Older Adults

A study published in Neurology found severe perivascular space (PVS) dilation pathology to be predictive of higher risk of cognitive decline among adults 72 to 92 years old, reports Neurology Advisor . The researchers looked at 414 community-dwelling older adults in that age range participating in the Sydney Memory and Aging study. Subjects received cognitive assessments and 3T magnetic resonance imaging, and were evaluated for consensus dementia diagnoses at baseline and once every two years for up to eight years. Investigators tallied up the number of PVS in two representative segments in the basal ganglia (BG) and centrum semiovale (CSO), and described severe PVS pathology as the top quartile. Roughly 38 percent of participants exhibited severe PVS pathology in either region, while 7 percent had severe pathology in both regions; 22 percent had severe BG PVS pathology and 24 percent had severe CSO PVS pathology. Those with severe BG PVS had much more white matter hyperintensities volume and were substantially more likely to have lacunes and multiple cerebral microbleeds, versus participants with absent/mild BG PVS. Subjects with severe PVS pathology in both regions suffered faster declines in global cognition compared to those with less severe pathology. The researchers determined that "further research is needed into the etiology and sequelae of PVS pathology since PVS may be an important potential biomarker to help with early dementia diagnosis, prognosis and subtyping."