Focal atrophy and cerebrovascular disease increase dementia risk among cognitively normal older adults.
OBJECTIVE
This study investigated the association of medial temporal lobe (MTL) atrophy and cerebrovascular disease (white matter hyperintensities [WMH], subclinical infarcts) with the risk of developing Alzheimer's disease (AD) among cognitively normal older adults.


METHODS
Risk of developing AD was examined for 155 cognitively normal older adults (77.4 years, 60% women, 81% white). The MTL volumes and the presence of WMH and of subclinical infarcts were determined from brain magnetic resonance imaging (MRI) at the beginning of the study. Follow-up cognitive evaluations (average 4.3 years) identified those who developed AD.


RESULTS
The presence of either MTL atrophy or subclinical infarcts was independently and significantly associated with a greater risk to develop AD (OR [95% CI]: 4.4 [1.5, 12.3] and 2.7 [1.0, 7.1], respectively). In addition, those participants with both MTL atrophy and at least one brain infarct had a 7-fold increase in the risk of developing AD (OR [95% CI]: 7.0 [1.5, 33.1]), compared to those who had neither of these conditions.


CONCLUSIONS
In cognitively normal older adults, markers of neurodegeneration (as reflected by MTL atrophy) and of cerebrovascular disease (as reflected by infarcts on MRI) independently contribute to the risk to develop AD.
Rosano
Caterina
C
School of Public Health, Department of Epidemiology, University of Pittsburgh, Pennysylvania, USA. RosanoC@edc.pitt.edu
Aizenstein
Howard J
HJ
Wu
Minjie
M
Newman
Anne B
AB
Becker
James T
JT
Lopez
Oscar L
OL
Kuller
Lewis H
LH
D000368:Aged; D000544:Alzheimer Disease / Q000209:etiology* / Q000473:pathology; D000704:Analysis of Variance; D001284:Atrophy; D002561:Cerebrovascular Disorders / Q000150:complications* / Q000473:pathology; D003071:Cognition; D005260:Female; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D012307:Risk Factors; D013702:Temporal Lobe / Q000473:pathology*; D014481:United States