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Focal atrophy and cerebrovascular disease increase dementia risk among cognitively normal older adults

Caterina Rosano1, Howard J Aizenstein, Minjie Wu

  • 1School of Public Health, Department of Epidemiology, University of Pittsburgh, Pennysylvania, USA. RosanoC@edc.pitt.edu

Journal of Neuroimaging : Official Journal of the American Society of Neuroimaging
|April 20, 2007
PubMed
Abstract

Insights

Medial temporal lobe atrophy and brain infarcts, indicators of neurodegeneration and cerebrovascular disease, significantly increase Alzheimer's disease risk in cognitively normal older adults.

Area of Science:

  • Neurology
  • Neuroimaging
  • Geriatrics

Background:

  • Alzheimer's disease (AD) risk factors in cognitively normal individuals are crucial for early detection.
  • Medial temporal lobe (MTL) atrophy and cerebrovascular disease are potential early AD indicators.

Purpose of the Study:

  • To investigate the association between MTL atrophy, cerebrovascular disease markers (white matter hyperintensities [WMH], subclinical infarcts), and Alzheimer's disease (AD) risk.
  • To assess these associations in a cohort of cognitively normal older adults.

Main Methods:

  • 155 cognitively normal older adults underwent brain MRI to assess MTL volumes and detect WMH and subclinical infarcts.
  • Participants were followed for an average of 4.3 years with cognitive evaluations to identify AD development.
  • Statistical analysis examined the independent and combined risks associated with MTL atrophy and infarcts.

Main Results:

  • MTL atrophy and subclinical infarcts were independently associated with a significantly higher risk of developing AD.
  • Individuals with both MTL atrophy and at least one brain infarct showed a 7-fold increased risk of AD.
  • White matter hyperintensities (WMH) were also assessed but their specific association with AD risk was not detailed in the provided results.

Conclusions:

  • Both neurodegenerative markers (MTL atrophy) and cerebrovascular disease markers (infarcts) independently contribute to AD risk in cognitively normal older adults.
  • The combined presence of MTL atrophy and infarcts substantially elevates AD risk.
  • These findings highlight the importance of considering both neurodegeneration and cerebrovascular health in predicting AD development.

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