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This study identified diffusion tensor imaging (DTI) and cortical thickness as sensitive markers for predicting cognitive decline. Sex-specific brain changes were observed, highlighting the importance of stratified analyses for early detection of impairment.

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Area of Science:

  • Neuroimaging
  • Biomarkers
  • Cognitive Neuroscience

Background:

  • Neuroimaging biomarkers are crucial for understanding MCI and dementia development.
  • Longitudinal changes in structural and functional brain metrics can indicate progression, especially in subsequently impaired (SI) individuals.
  • Identifying sensitive preclinical markers for SI is essential.

Purpose of the Study:

  • To investigate MRI-based macro- and micro-structural predictors differentiating SI from cognitively normal (CN) older adults.
  • To identify sensitive markers for early detection of cognitive impairment.

Main Methods:

  • Utilized data from 509 CN BLSA participants (age 50+) with longitudinal cognitive assessments and 3T MRI scans.
  • Assessed DTI parameters (FA, MD, RD, AD) for white matter integrity, cortical thickness, regional volumes, and machine learning-derived atrophy scores.
  • Employed linear mixed-effects models to analyze associations between cognitive status and MRI biomarkers, adjusting for covariates and performing sex-stratified analyses.

Main Results:

  • Significantly faster declines in DTI white matter tract measures and cortical thickness were observed in SI compared to CN individuals.
  • SI males showed greater white matter changes in commissural and association tracts.
  • SI females exhibited more pronounced atrophy in occipital cortical regions.

Conclusions:

  • Selected DTI and cortical thickness measures serve as sensitive indicators of early brain integrity changes.
  • Sex-specific patterns in brain changes predict cognitive status, with females showing more macrostructural cortical changes and males more microstructural white matter changes.
  • Sex-stratified analyses are vital for detecting early brain changes indicative of future cognitive impairment.