Neuropsychological correlates of MRI measures in the continuum of cognitive decline at old age.
OBJECTIVE
To investigate the independent associations between medial temporal lobe atrophy and white matter hyperintensities (WMH) and cognitive functions in the elderly.


METHODS
Cognitive functions of 41 Alzheimer's disease patients, 20 patients with mild cognitive impairment and 28 elderly subjects without memory complaints were assessed using a neuropsychological test battery. Quantitative MRI measures of medial temporal lobe volume and WMH were obtained. Multiple regression analyses were performed to assess the independent contribution of MRI measures to impairment in several cognitive functions.


RESULTS
Scores on the Wechsler Memory Scale and Trails B depended selectively on medial temporal lobe volume, whereas WMH selectively contributed to performance on Trails A. Medial temporal lobe volume and WMH both contributed to scores on the Cambridge Cognitive Examination and the Boston naming task.


CONCLUSIONS
MRI measures suggestive of Alzheimer-type pathology and microvascular pathology independently contribute to cognitive decline at old age. Memory impairment as measured using the Wechsler Memory Scale and performance on Trails B primarily depended on medial temporal lobe atrophy. Psychomotor slowness, as measured using Trails A, mainly depended on WMH. These results suggest that vascular pathology and Alzheimer-type pathology each have specific cognitive correlates.
van der Flier
Wiesje M
WM
Department of Neurology and Alzheimer Center, VU Medical Center, Leiden, The Netherlands. wm.vdflier@vumc.nl
Middelkoop
Huub A M
HA
Weverling-Rijnsburger
Annelies W E
AW
Admiraal-Behloul
Faiza
F
Bollen
Eduard L E M
EL
Westendorp
Rudi G J
RG
van Buchem
Mark A
MA
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000473:pathology / Q000523:psychology; D001284:Atrophy; D001921:Brain / Q000473:pathology*; D003072:Cognition Disorders / Q000473:pathology* / Q000523:psychology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D007802:Language; D008279:Magnetic Resonance Imaging; D008297:Male; D008568:Memory / Q000502:physiology; D009483:Neuropsychological Tests; D011597:Psychomotor Performance; D012044:Regression Analysis; D013702:Temporal Lobe / Q000473:pathology