MRI in older patients-A focused review

Area of Science:

• Neurology
• Radiology
• Gerontology

Background:

• Magnetic Resonance Imaging (MRI) significantly enhances understanding of age-related brain abnormalities.
• Common MRI findings in older adults include atrophy and small vessel disease (SVD)-related changes such as white matter hyperintensities (WMH), lacunes, microbleeds, microinfarcts, and enlarged perivascular spaces.

Purpose of the Study:

• To provide an overview of common MRI findings in older adults.
• To discuss the pathology, risk factors, and cognitive relationships of these findings.
• To highlight recent advancements, including remote lesion effects and brain network alterations.

Main Methods:

• Literature review of MRI findings in aging brains.
• Discussion of pathophysiological mechanisms and vascular risk factors.
• Exploration of cognitive correlations and network effects.

Main Results:

• Atrophy, WMH, and lacunes are linked to cognitive decline; the role of microbleeds, microinfarcts, and perivascular spaces is less clear.
• Vascular risk factors, particularly hypertension, are critical in the development of these brain changes.
• Complex relationships exist between visible brain abnormalities, remote lesion effects, network changes, and cognitive trajectories.

Conclusions:

• Early management of vascular risks is vital for mitigating age-related brain abnormalities and cognitive consequences.
• Standard MRI increasingly detects signs of brain aging, necessitating clear patient communication.
• Further research into remote effects and network changes is needed to fully understand cognitive aging.