Predictors of white matter hyperintensities in the elderly Congolese population.

Autor:	Yohe EO; Emory University, Department of Epidemiology, Rollins School of Public Health, Atlanta, GA, 30322, USA., Alonso A; Emory University, Department of Epidemiology, Rollins School of Public Health, Atlanta, GA, 30322, USA., Drane DL; Emory University School of Medicine, Departments of Neurology and Pediatrics, Atlanta, Georgia 30322, USA., Patel SS; Emory University School of Medicine, Department of Rehabilitation Medicine, Atlanta, Georgia, 30322, USA.; OneRehab, Dallas, Texas, USA., Schwinne M; Emory University, Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Atlanta, GA, USA., Epenge E; University of Kinshasa, Department of Neurology, Kinshasa, B.P. 7463 Kinshasa I, Democratic Republic of Congo., Gikelekele G; University of Kinshasa and Catholic University of Congo, School of Medicine, Kinshasa, Department of Psychiatry, B.P. 7463 Kinshasa I, Democratic Republic of Congo., Herve E; University of Kinshasa, Department of Neurology, Kinshasa, B.P. 7463 Kinshasa I, Democratic Republic of Congo., Kavugho I; Memory clinic of Kinshasa, Kinshasa, B.P. 7463 Kinshasa I, Democratic Republic of Congo., Tshengele N; University of Kinshasa and Catholic University of Congo, School of Medicine, Kinshasa, Department of Psychiatry, B.P. 7463 Kinshasa I, Democratic Republic of Congo., Mampunza S; University of Kinshasa and Catholic University of Congo, School of Medicine, Kinshasa, Department of Psychiatry, B.P. 7463 Kinshasa I, Democratic Republic of Congo., Mananga L; University of Kinshasa, Department of Neurology, Kinshasa, B.P. 7463 Kinshasa I, Democratic Republic of Congo., Zhao L; Emory University, Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Atlanta, GA, USA., Qiu D; Emory University, School of Medicine, Department of Radiology and Imaging Sciences & Department of Biomedical Engineering, Atlanta, GA, USA., Stringer A; Emory University School of Medicine, Department of Rehabilitation Medicine, Atlanta, Georgia, 30322, USA., Saindane AM; Emory University School of Medicine, Departments of Radiology and Imaging Sciences and Neurosurgery, Atlanta, GA, USA., Ikanga J; Emory University School of Medicine, Department of Rehabilitation Medicine, Atlanta, Georgia, 30322, USA.; University of Kinshasa and Catholic University of Congo, School of Medicine, Kinshasa, Department of Psychiatry, B.P. 7463 Kinshasa I, Democratic Republic of Congo.; University of Kinshasa and Catholic University of Congo, School of Medicine, Kinshasa, Department of Psychiatry, B.P. 7463 Kinshasa I, Democratic Republic of Congo.
Jazyk:	angličtina
Zdroj:	MedRxiv : the preprint server for health sciences [medRxiv] 2024 Sep 04. Date of Electronic Publication: 2024 Sep 04.
DOI:	10.1101/2024.09.03.24313022
Abstrakt:	Background: White matter hyperintensities (WMHs) are strongly linked to cardiovascular risk factors and other health conditions such as Alzheimer's disease. However, there is a dearth of research on this topic in low-income countries and underserved populations, especially in the Democratic Republic of Congo (DRC) where the population is aging rapidly with increasing cardiovascular risk factors and dementia-related diseases. This study evaluates health factors associated with WMH in the elderly Sub-Saharan Africa (SSA), specifically Congolese adults. Methods: In a cross-sectional study of 77 people from the DRC, participants underwent neuroimaging to analyze WMH volume and completed clinical evaluation, laboratory-based blood exams, self-reported questionnaires, and interviews. A simple linear regression model was conducted to test the association between WMH and potential predictors (neurological status, age, sex, hypertension, diabetes, tobacco abuse, stroke, high cholesterol, cardiovascular medication, and alcohol abuse). Stepwise selection and backward elimination analyses were performed to obtain the final model. Finally, a multiple linear regression model was conducted to assess the association between WMH and variables retained in the final model (neurological status, sex, and age). Results: Of the 77 individuals, 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) though it 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), male sex (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 may improve our ability to diagnose, assess, and develop preventative treatments for white matter disease in SSA/DRC populations, where neuroimaging is difficult to obtain. Competing Interests: CONFLICT OF INTEREST The authors have no conflict of interest to report.
Databáze:	MEDLINE
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