This study will examine possible relationships among motoric dysfunction, presence of periventricular white matter lesions (PWML), and cognitive function in the elderly. The presence of PWML on CT/MRI has been recently associated with subclinical motor deficits in cognitively normal elderly subjects and with an increased prevalence of motor dysfunction and gait abnormalities in patients with Alzheimer's disease (AD). These PWML have also been linked to the appearance of small blood vessel disease in the brain. In this project, we propose to test the motor function of 60 cognitively normal and 60 mildly cognitively impaired elderly subjects by employing a variety of neuropsychological and computerized tests of motor/psychomotor performance. Each of these two subject groups will be equally divided between subjects with an without PWML on MRI. The PWML will be carefully classified by regional location(s) and the magnitude of the lesion(s) will be quantified. In order to evaluate the predictive power of the motor test measures and the MRI findings for detecting subsequent motor/gait and cognitive status, each subject will be reevaluated for motor function and given a second MRI scan two years after the initial evaluation. It is expected that results obtained from this investigation will contribute to basic knowledge concerning brain- behavior relationships in aging and dementia, and provide useful information for the identification of elderly patients who are at risk for the subsequent development of clinically significant motor/gait problems (which are associated with falling in the elderly) and cognitive dysfunction.
