Urinary Complaints in Nondisabled Elderly People with Age-Related White Matter Changes: The Leukoaraiosis And DISability (LADIS) Study Anna Poggesi, MD, a Giovanni Pracucci, MD, a Hugues Chabriat, MD, PhD, b Timo Erkinjuntti, MD, PhD, c Franz Fazekas, MD, d Ana Verdelho, MD, e Michael Hennerici, MD, f Peter Langhorne, MD, BSC, PhD, g John O’Brien, DM, h Philip Scheltens, MD, PhD, i Marieke C. Visser, MD, PhD, i Milita Crisby, MD, PhD, j Gunhild Waldemar, MD, DMSc, k Anders Wallin, MD, PhD, l Domenico Inzitari, MD, a and Leonardo Pantoni, MD, PhD, a on behalf of the LADIS Study Group OBJECTIVES: To investigate, in a cohort of nondisabled elderly people, the association between urinary complaints and severity of age-related white matter changes (AR- WMC). DESIGN: Cross-sectional data analysis from a longitudinal multinational study. SETTING: The Leukoaraiosis And DISability Study, as- sessing ARWMC as an independent predictor of the tran- sition from functional autonomy to disability in elderly subjects. PARTICIPANTS: Six hundred thirty-nine subjects (288 men, 351 women, mean age 74.1  5.0) with magnetic resonance imaging (MRI)-detected ARWMC of different severity. MEASUREMENTS: ARWMC severity was graded on MRI as mild, moderate, and severe (Fazekas scale). MRI assessment also included ARWMC volumetric analysis and the count of infarcts. Urinary complaints (nocturia, urinary frequency, urgency, incontinence) were recorded based on subjects’ answers to four questions. RESULTS: In comparing the three ARWMC severity groups, there was a significant difference only in preva- lence of urgency, with 16% of subjects in the mild severity group, 17% in the moderate severity group, and 25% in the severe group (P 5.03). Adjusting for age, sex, lacunar and nonlacunar infarcts, diabetes mellitus, and use of diuretics, severe ARWMC retained an independent effect in the as- sociation with urinary urgency (odds ratio 5 1.74, 95% confidence interval 5 1.04–2.90, severe vs mild group). Subjects with urinary urgency also had higher ARWMC volumes (25.2, vs 20.4 mm 3 in those without urinary ur- gency; Po.001). Urgency was confirmed to be associated with the severe degree of ARWMC, irrespective of com- plaints of memory, gait disturbances, or history of depres- sion. CONCLUSION: In a cohort of nondisabled elderly people, severe ARWMC were associated with urinary urgency, independent of other potential confounders and vascular lesions of the brain. J Am Geriatr Soc 56:1638–1643, 2008. Key words: white matter changes; urinary complaints; disability; MRI E lderly subjects commonly report urinary disturbances, which are associated with disability at older age. 1 Mic- turition dysfunctions are often seen with brain diseases, especially vascular pathology. 2 Urinary disturbances are a common sequel of stroke 3 and are considered to be a strong predictor of stroke outcome, particularly incontinence. 4 Cerebral age-related white matter changes (ARWMC), also called leukoaraiosis, probably consequent to cerebral small- Address correspondence to Leonardo Pantoni, MD, PhD, Department of Neurological and Psychiatric Sciences, University of Florence, Viale Mor- gagni 85, 50134 Florence, Italy. E-mail: pantoni@unifi.it DOI: 10.1111/j.1532-5415.2008.01832.x From the a Department of Neurological and Psychiatric Sciences, University of Florence, Florence, Italy; b Department of Neurology, Ho ˆ pital Lariboisie `re, Paris, France; c Memory Research Unit, Department of Clinical Neuro- sciences, Helsinki University, Helsinki, Finland; d Department of Neurology and MRI Institute, Medical University Graz, Graz, Austria; e Servic ¸o de Neurologia, Centro de Estudos Egas Moniz, Hospital de Santa Maria, Lisbon, Portugal; f Department of Neurology, University of Heidelberg, Klinikum Mannheim, Mannheim, Germany; g Academic Department for Geriatric Medicine, Glasgow Royal Infirmary, Glasgow, Scotland; h Institute for Ageing and Health, Newcastle University, Newcastle-upon-Tyne, United Kingdom; i Department of Radiology and Neurology, VU Medical Center, Amsterdam, the Netherlands; j Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Karolinska University Hospital Huddinge, Huddinge, Sweden; k Memory Disorders Research Unit, Department of Neurology, Copenhagen University Hospital, Copenhagen, Denmark; and l Institute of Clinical Neuroscience, Go ¨teborg University, Go ¨ teborg, Sweden. JAGS 56:1638–1643, 2008 r 2008, Copyright the Authors Journal compilation r 2008, The American Geriatrics Society 0002-8614/08/$15.00