title: Vascular risk factors, apolipoprotein E, and hippocampal decline on magnetic resonance imaging over a 10-year follow-up.
abstract: BACKGROUND
  Decline of hippocampal volume on magnetic resonance imaging (MRI) may be considered as a surrogate biomarker of accumulating Alzheimer disease (AD) pathology. Previously, we showed in the prospective population-based Rotterdam Scan Study that a higher rate of decline of hippocampal volume on MRI precedes clinical AD or memory decline. We studied potential risk factors for decline of hippocampal volume.
  
  
  METHODS
  At baseline (1995-1996), 518 nondemented elderly subjects were included, and the cohort was re-examined in 1999 and in 2006. At each examination, hippocampal volume was determined using an automated segmentation procedure. In all, 301 persons had at least two three-dimensional MRI scans to assess decline in hippocampal volume.
  
  
  RESULTS
  Persons carrying the apolipoprotein E (APOE) ɛ4 allele had lower hippocampal volumes than persons with the ɛ3/ɛ3 genotype, but the rate of decline was not influenced by APOE genotype. In persons who did not use antihypertensive treatment, both a high (>90 mm Hg) and a low (<70 mm Hg) diastolic blood pressure were associated with a faster decline in hippocampal volume. Also, white matter lesions on baseline MRI were associated with a higher rate of decline in hippocampal volume.
  
  
  CONCLUSIONS
  In a nondemented elderly population, persons with the APOE ɛ4 allele have a smaller hippocampal volume but not a higher rate of decline. Rate of decline of hippocampal volume was influenced by white matter lesions and diastolic blood pressure, supporting their hypothesized role in the pathogenesis of AD.
authors.affiliation: Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands. t.denheijer@sfg.nl
authors.forename: Tom
authors.initials: T
authors.lastname: den Heijer
authors.forename: Fedde
authors.initials: F
authors.lastname: van der Lijn
authors.forename: Arfan
authors.initials: A
authors.lastname: Ikram
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Koudstaal
authors.forename: Aad
authors.initials: A
authors.lastname: van der Lugt
authors.forename: Gabriel P
authors.initials: GP
authors.lastname: Krestin
authors.forename: Henri A
authors.initials: HA
authors.lastname: Vrooman
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.forename: Wiro J
authors.initials: WJ
authors.lastname: Niessen
authors.forename: Monique M B
authors.initials: MM
authors.lastname: Breteler
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000235:genetics* / Q000473:pathology*; D001057:Apolipoproteins E / Q000235:genetics*; D015331:Cohort Studies; D005260:Female; D006624:Hippocampus / Q000473:pathology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D012307:Risk Factors; D013997:Time Factors; D014652:Vascular Diseases / Q000453:epidemiology / Q000473:pathology
chemical_list: D001057:Apolipoproteins E