Risk of Rapid Global Functional Decline in Elderly Patients With Severe Cerebral Age-Related White Matter Changes

Results: The rate of transition was 9%, 15%, and 26%, in the mild, moderate, and severe ARWMC group, re- spectively.ComparingtheseverewiththemildARWMC groups and adjusting for age and for other predictors of decline, the risk was more than 2-fold higher (odds ra- tio; 2.38; 95% confidence interval, 1.29-4.38) in pa- tientswith0or1activitylimited,and3-foldhigher(odds ratio, 3.02; 95% confidence interval, 1.34-6.78) among patients fully independent at baseline. Both motor and cognitive deterioration predominantly explained the ef- fect of ARWMCs on global functional decline. Conclusion: Elderly patients who are functionally in- dependent and who have severe ARWMCs are at con- siderableriskofbecomingmoredependentinashortpe- riod, mostly owing to motor and cognitive deterioration. Arch Intern Med. 2007;167:81-88