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Whole-brain atrophy rate and cognitive decline: longitudinal MR study of memory clinic patients

Jasper D Sluimer1, Wiesje M van der Flier, Giorgos B Karas

  • 1Department of Diagnostic Radiology, Alzheimer Centre, Vrije Universiteit Medical Centre, Amsterdam, the Netherlands. jd.sluimer@vumc.nl

Radiology
|June 25, 2008
PubMed
Abstract

Insights

Whole-brain atrophy rate, a measure of brain shrinkage, is strongly linked to cognitive decline in Alzheimer's disease and mild cognitive impairment. Higher atrophy rates predict an increased risk of developing dementia.

Area of Science:

  • Neurology
  • Neuroimaging
  • Geriatrics

Background:

  • Mild cognitive impairment (MCI) and Alzheimer's disease (AD) are associated with brain volume changes.
  • Quantifying whole-brain atrophy rates can help understand disease progression and predict dementia risk.

Purpose of the Study:

  • To prospectively determine whole-brain atrophy rates in MCI and AD patients.
  • To assess the association between atrophy rates and cognitive decline.
  • To investigate the risk of dementia progression in non-demented individuals based on baseline brain volume and atrophy rate.

Main Methods:

  • Prospective study including 65 AD patients, 45 MCI patients, 27 with subjective complaints, and 10 controls.
  • Two MRI scans were acquired approximately 1.8 years apart to measure baseline brain volume and whole-brain atrophy rates.
  • Partial correlations and Cox proportional hazards models were used to analyze associations with cognitive decline and dementia risk.

Main Results:

  • Whole-brain atrophy rates were significantly higher in AD patients (-1.9%/year) compared to MCI patients (-1.2%/year), subjective complaints (-0.7%/year), and controls (-0.5%/year).
  • Higher whole-brain atrophy rates correlated with greater annualized cognitive decline (r = 0.48, P < .001).
  • A higher whole-brain atrophy rate was associated with an increased risk of progression to dementia (HR, 3.6; 95% CI: 1.2, 11.4) after adjusting for baseline factors.

Conclusions:

  • Whole-brain atrophy rate is a significant indicator of cognitive decline in neurodegenerative diseases.
  • In non-demented individuals, a rapid rate of whole-brain atrophy is a predictor of future dementia development.

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