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Whole-brain atrophy rate in Alzheimer disease: identifying fast progressors

J D Sluimer1, H Vrenken, M A Blankenstein

  • 1Department of Radiology and Alzheimer Centre, Vrije Universiteit Medical Centre, PO Box 7057, 1007 MB Amsterdam, The Netherlands. jd.sluimer@vumc.nl

Neurology
|May 7, 2008
PubMed
Abstract

Insights

Younger Alzheimer

Area of Science:

  • Neurology
  • Radiology
  • Gerontology

Background:

  • Alzheimer disease (AD) is characterized by progressive brain atrophy.
  • Identifying predictors of whole-brain atrophy is crucial for understanding AD progression.

Purpose of the Study:

  • To determine which baseline clinical and MRI measures predict whole-brain atrophy rates in Alzheimer disease patients.
  • To characterize subgroups of AD patients at risk for accelerated brain volume loss.

Main Methods:

  • Recruited 65 AD patients (mean age 70 years).
  • Assessed whole-brain atrophy rates using serial MRI over an average of 1.7 years.
  • Utilized linear regression to analyze the influence of age, sex, APOE genotype, MMSE, hippocampal volume, and normalized brain volume on atrophy rates.

Main Results:

  • Mean whole-brain atrophy rate was -1.9% per year.
  • Younger age, absence of APOE epsilon 4, and lower Mini-Mental State Examination (MMSE) scores were associated with higher atrophy rates.
  • A spared hippocampus predicted faster decline in patients with lower baseline brain volume and lower MMSE.

Conclusions:

  • Subgroups of AD patients at risk for faster brain volume loss can be identified.
  • Patients with generalized atrophy, onset before 65, and APOE epsilon 4 negative status may experience faster whole-brain atrophy compared to typical AD patients.

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