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Computed tomography in the elderly: changes over time in a normal population.

J M Bird, R Levy, R J Jacoby

    The British Journal of Psychiatry : the Journal of Mental Science
    |January 1, 1986
    PubMed
    Summary
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    A single brain scan (CT) is insufficient for diagnosing early dementia in older adults. However, cognitive decline over time linked to CT changes, particularly ventricular enlargement, may indicate underlying disease.

    Area of Science:

    • Gerontology
    • Neurology
    • Radiology

    Background:

    • Assessing cognitive decline and brain changes in the elderly is crucial for early disease detection.
    • Previous research has explored the relationship between cognitive function and structural brain imaging.

    Purpose of the Study:

    • To evaluate the clinical, psychometric, and computed tomographic (CT) status of fit elderly volunteers over time.
    • To determine if a single CT scan can identify early dementia or if changes over time are more indicative.

    Main Methods:

    • Longitudinal follow-up of previously fit elderly volunteers for up to four years.
    • Clinical assessments, psychometric testing, and computed tomographic (CT) brain scans were performed.
    • Analysis of relationships between cognitive scores and CT findings, including ventricular size.

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    Main Results:

    • No dementing group could be identified from a single CT scan.
    • Subtle cognitive decline over time, observed in 10% of participants, was significantly related to CT changes.
    • A subgroup with larger ventricles developed late-onset depressive disorders, linked to recent bereavement.

    Conclusions:

    • A single CT scan is not a reliable discriminatory test for early dementia.
    • Repeat CT scans showing ventricular enlargement are likely significant indicators of disease.
    • Cognitive impairment or late-onset depression in the elderly may signal an underlying pathological process.