Regional brain atrophy rate predicts future cognitive decline: 6-year longitudinal MR imaging study of normal aging.
OBJECTIVE
To determine if medial temporal lobe (MTL) atrophy rate, assessed by using an automated procedure over the initial time interval of a 6-year, three-time-point longitudinal study, is predictive of future memory decline.


METHODS
Healthy elderly subjects (age, >60 years) were administered a comprehensive battery of neuropsychometric tests and underwent magnetic resonance (MR) imaging at baseline and two or more follow-up examinations. The rate of brain atrophy between the baseline and first follow-up examinations was assessed by using an automated procedure that included spatial coregistration of the two images and regional brain boundary shift analysis. At final observation, the 45 subjects were separated into a group of those who did and a group of those who did not show objective evidence of cognitive decline. A forward stepwise logistic regression model was used to identify variables that predicted decline.


RESULTS
Thirty-two subjects remained healthy, and 13 showed cognitive decline. Among subjects who showed cognitive decline, six declined after the second observation. MTL atrophy rate, through its interactions with sex and age, was the most significant predictor of decline. The overall accuracy of prediction was 89% (in 40 of 45 subjects), with 91% specificity (in 29 of 32 subjects) and 85% sensitivity (in 11 of 13 subjects).


CONCLUSIONS
Among healthy elderly individuals, increased MTL atrophy rate appears to be predictive of future memory decline.
Rusinek
Henry
H
Department of Radiology, New York University School of Medicine, Bellevue C&D Bldg, Room D120, 550 First Ave, New York, NY 10016, USA. hr18@nyu.edu
De Santi
Susan
S
Frid
Dina
D
Tsui
Wai-Hon
WH
Tarshish
Chaim Y
CY
Convit
Antonio
A
de Leon
Mony J
MJ
D000368:Aged; D001284:Atrophy; D003072:Cognition Disorders / Q000175:diagnosis*; D005260:Female; D005544:Forecasting; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008569:Memory Disorders / Q000175:diagnosis*; D009483:Neuropsychological Tests; D012680:Sensitivity and Specificity; D013702:Temporal Lobe / Q000473:pathology*