Life Extension Magazine March 2014
Leukoaraiosis: A Hidden Cause Of Brain Aging
By Clyde Eberley
Finally, leukoaraiosis has been associated with a greater risk of dementia, and even of death.6 In one study, leukoaraiosis was independently associated with a 46% increase in the risk of dying early; another study found that the risk of dying early was nearly 3-fold higher in those with severe leukoaraiosis than in those without.46,47
Gait and balance disturbances are another hallmark of leukoaraiosis, again the result of white matter damage that prevents quick and reliable communication between various brain centers.6,44 Studies show an association between the amount of leukoaraiosis and deficiencies in gait, balance, and walking speed.48,49 These disturbances more than double the risk of falling, which is itself a leading cause of disability and premature death in older people.49 People with larger areas of leukoaraiosis perform more poorly in daily activities than matched, same-aged controls with no damage to their white matter pathways.6,50
Depression is increasingly common as people age; now there is solid evidence to suggest that growing areas of leukoaraiosis may be involved.6,44 Studies show that people with more progression of leukoaraiosis over a 3-year period have higher rates of depression than those with slower or no progression.51,52
Stroke risk is clearly affected by the presence of leukoaraiosis, at least for certain stroke types, particularly those that also affect smaller brain blood vessels in white matter areas of the brain.53-56 In people who have had a “minor” warning, such as a transient ischemic attack (TIA) or a non-disabling stroke, the presence of leukoaraiosis significantly increases their chances of having a stroke—one study found that 37% of people with widespread leukoaraiosis had a stroke within 3 years, compared with just 20% of those without leukoaraiosis.57 Another study found the risk of stroke to increase nearly five-fold for people with higher-level leukoaraiosis, compared with those having low-grade leukoaraiosis.58
Leukoaraiosis is also associated with an increased risk of a type of “silent stroke” called cerebral microbleeds by more than five-fold in patients with a prior stroke history.59 And in people who have just had a serious stroke and have been treated with modern “clot busting” drugs, having leukoaraiosis raised the risk of having dangerous bleeding into the brain (intra cerebral hemorrhage) by nearly three-fold, and doubled the risk of any bad outcome within 90 days of the treatment.11,60
Other consequences of leukoaraiosis are rapidly becoming evident, as shown in Table 2, driving home the point that we all need to do everything we can to prevent this insidious form of brain damage.
How Can I Prevent Leukoaraiosis?
Currently there is no reliable treatment for leukoaraiosis, partly because its fundamental causes remain unknown.5,6 But our knowledge of its risk factors can be used to our advantage in preventing leukoaraiosis, and at the very least in slowing its progression.
Not surprisingly, lifestyle and dietary interventions have proven the most effective approaches, especially those that help lower blood pressure, lower blood sugar, reduce obesity, and contribute to improvement in endothelial function.
A few specific interventions have already been shown to directly address leukoaraiosis and its related cognitive deficits:
Physical activity reduces leukoaraiosis-related limitations in mobility.48 In one study of people with leukoaraiosis, greater physical activity was associated with a 36% reduction in the risk of cognitive impairment, a 39% reduction in risk of dementia, and a 58% reduction in risk of vascular dementia.61
Homocysteine-lowering therapy using B vitamins has been shown to improve executive function, which is so strongly affected by leukoaraiosis.62
Correcting platelet function, specifically, the tendency of platelets to be too “sticky,” slows the progression of leukoaraiosis.63
Table 3 provides a partial listing of some nutraceutical supplements that can be helpful in reducing risk factors, thereby potentially slowing the progression of leukoaraiosis. Those with blood pressure readings above 115/75 that do not respond to nutraceuticals may consider pharmaceutical intervention, though those with severe leukoaraiosis sometimes require higher blood pressure to squeeze blood into deformed cerebral arterial and capillary beds.
Unidentified bright objects, formally known as leukoaraiosis, or white matter hyperintensities, are early warning signs of ongoing chronic brain damage.5 It’s almost like having a stroke in ultra-slow motion.
No one even knew of the existence of leukoaraiosis until modern scanning technology detected it. Now we recognize that leukoaraiosis is both widespread and dangerous, signaling the presence of insidious disease in the brain’s smallest blood vessels. Small vessel disease deprives local areas of the brain of sufficient blood supply to carry out normal activities, and eventually leads to formation of leukoaraiosis that can be seen on scans.
The causes of leukoaraiosis are not entirely understood, but evidence points to hypertension, endothelial dysfunction, platelet aggregation problems, and homocysteine elevations as major risk factors. And the consequences of leukoaraiosis are increasingly apparent: the larger the volume of brain involved in leukoaraiosis, the worse a person’s cognitive function is—even before they become aware of it.
Leukoaraiosis also increases risk for stroke, cognitive decline, and dementia, while interfering with normal gait and balance, eventually leading to greater risks of falling. Indeed, leukoaraiosis seems to correlate with most of the changes we’ve always associated with brain aging—except that it appears to be preventable and even reversible. Perhaps that’s the message those “unidentified bright objects” are trying to send us.
Life Extension members should find comfort that their nutrients and healthy lifestyle choices confer significant protection against leukoaraiosis.
If you have any questions on the scientific content of this article, please call a Life Extension® Health Advisor at 1-866-864-3027.