MRI measures and progression of cognitive decline in nondemented elderly attending a memory clinic.
OBJECTIVE
To investigate whether MRI-based volumes of whole brain, medial temporal lobe and white matter hyperintensities (WMH) predict progression of cognitive decline in a sample of nondemented elderly.


METHODS
Thirty-seven nondemented elderly attending a memory clinic and 28 elderly controls participated in this follow-up study. The average follow-up period was 1.8 years. Cognitive function was measured at baseline and follow-up with the Cambridge Cognitive Examination (CAMCOG). Baseline Magnetic Resonance Imaging (MRI) provided quantitative measures of whole brain, medial temporal lobe and WMH. Linear mixed models controlled for age and sex were used to assess the independent associations between MRI measures, baseline cognition, and annual decline in cognition.


RESULTS
Medial temporal lobe volume was independently associated with baseline CAMCOG score (p < 0.01), whereas whole brain volume (p < 0.01) and WMH (p < 0.05) were associated with annual decline in CAMCOG score.


CONCLUSIONS
These data suggest that regional damage to the medial temporal lobes underlies initial mild cognitive impairment, whereas more global brain changes, such as whole brain atrophy and WMH, contribute to further progression of cognitive decline.
van der Flier
Wiesje M
WM
Department of Neurology and Alzheimer Center, VU Medical Center, The Netherlands. vdflier@vumc.nl
van der Vlies
Annelies E
AE
Weverling-Rijnsburger
Annelies W E
AW
de Boer
Nel L
NL
Admiraal-Behloul
Faiza
F
Bollen
Eduard L E M
EL
Westendorp
Rudi G J
RG
van Buchem
Mark A
MA
Middelkoop
Huub A M
HA
D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000473:pathology*; D003072:Cognition Disorders / Q000473:pathology*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016014:Linear Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008569:Memory Disorders / Q000473:pathology*; D009483:Neuropsychological Tests; D011379:Prognosis; D011446:Prospective Studies; D013702:Temporal Lobe / Q000473:pathology