Age of Onset and Risk Factors for MRI-Detected White Matter Hyperintensities in a Lahore Population: A Cross-Sectional Study

Background White matter hyperintensities (WMHs) detected on MRI are established neuroimaging markers of cerebrovascular disease, vascular dementia, and cognitive decline. The age of onset and associated vascular risk factors for WMHs remain underexplored in South Asian populations. Identifying these associations may help guide early prevention and risk management strategies. Methods This cross-sectional study was conducted over seven months at Shalamar Hospital, Lahore. A total of 145 participants aged 30–86 years were included; individuals with a history of stroke or intracranial hemorrhage were excluded. Brain MRI scans were acquired using a 1.5T scanner. Demographic and clinical data were collected, and analysis of covariance (ANCOVA) was performed to assess the relationship between WMHs and vascular risk factors, including diabetes, hypertension, and smoking. Results The study cohort included both male and female participants with a mean age of 46 years. WMHs were observed as early as age 30. Increasing age, diabetes, hypertension, and the interaction between diabetes and hypertension were significantly associated with WMH burden. Participants with either diabetes or hypertension had a greater burden of WMHs compared to those without these conditions, and individuals with both risk factors demonstrated the highest burden. Smoking, however, did not show a statistically significant association with WMHs. Conclusion This study demonstrates that WMHs can occur in relatively young adults and are strongly associated with diabetes and hypertension in a South Asian population. These findings emphasize the importance of early screening, vascular risk factor management, and consideration of neuroimaging in at-risk individuals to mitigate future cerebrovascular and cognitive complications.