Objective: This study examined whether computed tomography evidence of cerebrovascular disease in the form of white matter changes was associated with decreased implicit performance of frontal tests and with a loss of motivation in a group of 10 elderly volunteers with mild cognitive impairment and in a group of 29 demented patients.
Design: Since the recognition of white matter changes on computed tomography, research was done to investigate a possible relation with aging and cognition.
Materials and Methods: 39 old patients (28 females: 82.4 years ± 7.1 ; 10 males: 75.5 years ± 11.3 ) cared for in a psycho-geriatric day care hospital were enrolled for this essay. Motivation was evaluated with a specific scale: EAD. Patients were tested during the same period with MMS for cognition, Cornell’s scale for depression, and Marin’s scale for apathy. They were also assessed with a battery of frontal tests: BREF test. A brain scan was used to determine the presence of leukoaraïosis.
Results: The population was composed of 10 patients with a mild cognitive impairment (mean age: 78.1 ± 5.5) and 29 demented patients (mean age: 81.3 ± 9.8). Cognitive disorder but also apathy and loss motivation, frontal evaluation significantly differ in the two studied groups. The presence of a leucoaraïosis is associated with older people, and a weaker cognitive status, more important than apathy or loss of motivation, and weaker results with frontal evaluation. Similar results were obtained considering only the frontal lesions of the leucoaraïosis.
Conclusion: Age related changes of the white matter observed on computed tomography were associated with a decreased cognitive status. Leukoaraïosis is associated with loss of motivation and related with poor results on frontal assessment. Loss of motivation is associated with certain frontal dysfunctions and with brain abnormal scan anomalies.
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