Brain MRI-markers Associate Differentially with Cognitive Versus Functional Decline Leading to Dementia.
BACKGROUND
Brain MRI-markers are risk factors of dementia and decline in cognition and daily functioning. It is unknown to what extent the associations of brain MRI-markers with cognition and daily functioning are part of the pathway leading to dementia. We aimed to investigate associations of brain MRI-markers with change in cognition and daily functioning during 15 years of follow-up, including their relation to dementia.


METHODS
Four hundred and sixty three stroke-free and non-demented participants from the population-based Rotterdam Study that underwent brain-MRI, yielding brain volumetrics, between 1995 and 1996.


METHODS
We assessed cognition using the Mini-Mental State Examination (MMSE) and daily functioning using instrumental and basic activities of daily living (IADL and BADL) up to seven times between 1990 and 2011. Analyses were performed both including and excluding incident demented participants.


RESULTS
Smaller brain volume associated with larger decline in MMSE, IADL, and BADL. Larger white matter lesion volume associated with larger decline in MMSE. Frontal lobe volume associated strongest with decline in IADL and BADL, and temporal lobe volume with decline in MMSE. After excluding incident demented participants (n = 63), associations with IADL and BADL remained, while associations with MMSE disappeared.


CONCLUSIONS
Smaller brain volumes and larger white matter volume associate with larger decline in cognition and daily functioning, during 15 years of follow-up. Importantly, the relation of brain volume with cognition, but not daily functioning, was driven by those individuals that ultimately developed dementia.
Department of Epidemiology, Erasmus MC University Medical Centre Rotterdam, Rotterdam, The Netherlands.|Department of Radiology, Erasmus MC University Medical Centre Rotterdam, Rotterdam, The Netherlands.
Vincentius J A
VJA
Verlinden
Department of Neuroscience, Erasmus MC University Medical Centre Rotterdam, Rotterdam, The Netherlands.
Jos N
JN
van der Geest
Department of Epidemiology, Erasmus MC University Medical Centre Rotterdam, Rotterdam, The Netherlands.|Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Albert
A
Hofman
Department of Radiology, Erasmus MC University Medical Centre Rotterdam, Rotterdam, The Netherlands.|Department of Medical Informatics, Erasmus MC University Medical Centre Rotterdam, Rotterdam, The Netherlands.|Faculty of Applied Sciences, Delft University of Technology, Delft, The Netherlands.
Wiro J
WJ
Niessen
Department of Radiology, Erasmus MC University Medical Centre Rotterdam, Rotterdam, The Netherlands.
Aad
A
van der Lugt
Department of Epidemiology, Erasmus MC University Medical Centre Rotterdam, Rotterdam, The Netherlands.|Department of Radiology, Erasmus MC University Medical Centre Rotterdam, Rotterdam, The Netherlands.
Meike W
MW
Vernooij
Department of Epidemiology, Erasmus MC University Medical Centre Rotterdam, Rotterdam, The Netherlands.|Department of Radiology, Erasmus MC University Medical Centre Rotterdam, Rotterdam, The Netherlands.|Department of Neurology, Erasmus MC University Medical Centre Rotterdam, Rotterdam, The Netherlands.
M Arfan
MA
Ikram
D000203:Activities of Daily Living; D000368:Aged; D001921:Brain / Q000473:pathology*; D003071:Cognition; D003072:Cognition Disorders / Q000175:diagnosis; D003704:Dementia / Q000175:diagnosis; D018450:Disease Progression; D005260:Female; D006801:Humans; D057187:Independent Living; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data*; D008297:Male; D009426:Netherlands; D009483:Neuropsychological Tests / Q000706:statistics & numerical data

MRI
; activities of daily living; brain; cognition; dementia