Leukoaraiosis Severity and List-Learning in Dementia

Abstract

In patients with dementia, leukoaraiosis (LA) was hypothesized to result in differential patterns of impairment on a verbal serial list-learning test. Using a visual rating scale, 144 dementia patients with ischemic scores <4 were re-categorized as having mild (n = 73), moderate (n = 44), or severe LA (n = 27). Mild LA was predicted to be associated with an amnestic list-learning profile, while severe LA was predicted to be associated with a dysexecutive profile. List-learning performances were standardized to a group of healthy older adults (n = 24). Analyses were conducted on a set of four factors derived from the list-learning paradigm, as well as error scores. Data indicate that LA severity is an important marker for understanding list learning in dementia.

Keywords:

• Alzheimer's disease
• Vascular dementia
• Binswanger's disease
• Subcortical dementia
• Episodic memory
• The Philadelphia (repeatable) Verbal Learning Test (PrVLT)

Acknowledgments

We wish to thank the editor (JS) and reviewers for their insightful and constructive comments/suggestions. This research was supported in part by the following NIH grants: K23NS060660_01 (CCP) and F32-AG021362 (CCP); R03-AG026610 (ALJ), R03-AG027480 (ALJ), K23-AG030962 (Paul B. Beeson Career Development Award in Aging; ALJ), and P30-AG013846 (Boston University Alzheimer's Disease Core Center; ALJ). Portions of this research were presented at the 3rd Biannual Meeting of the International Society for Vascular Behavioural and Cognitive Disorders, San Antonio, TX. No authors have conflicts of interest to report.

Notes

¹ Please contact the authors for more information on P(r)VLT test construction.

² Some readers may question whether lacune presence altered the PrVLT factor structure or results. We re-examined these data after excluding patients with lacunes (new sample: mild LA n = 57, moderate LA n = 26, severe LA n = 2). The PrVLT factor structure remained the same with the exception of a slightly lower percent variance (new cumulative percentage = 74.13). Result findings were unchanged.