BACKGROUND: On average, cognition declines as people age, but improvement can also occur. OBJECTIVE: To evaluate the dynamics of age-related changes in brain structure and cognitive function in patients with mild Alzheimer's disease (AD) and mild cognitive impairment (MCI) and in healthy control (HC) older adults. METHODS: High-resolution 3-Tesla MRI and clinical data were obtained from the Alzheimer's Disease Neuroimaging Initiative in 187 subjects (a cohort aged 55-91 years; AD=43, MCI=84, HC=60). At 24 months, 151 people had clinical and 128 had MRI follow-up. Brain structure was assessed using the Medial Temporal Atrophy Scale (MTAS) and the Brain Atrophy and Lesion Index (BALI). Cognition was assessed using the Mini-Mental State Examination (MMSE) and the Alzheimer Disease Assessment Scale-cognitive subscale (ADAS-cog). Responsiveness was tested. Changes were analysed using a multistate dynamic model, adjusted for age, gender, ApoE4 genotype and vascular risk factors. RESULTS: Over 2 years, decline in brain structure and cognition predominated, each showing detectable effect sizes (Cohen's d=0.33 for MTAS, 0.32 for BALI, 0.41 for MMSE, 0.38 for ADAS-cog; standard response mean=0.71, 0.69, 0.50 and 0.47, respectively). Structural improvement was observed (10.2% in BALI and 0.8% in MTAS), as was cognitive improvement (23.2% MMSE, 27.2% ADAS-cog). Most people (66.7%) whose BALI score improved also improved in either the MMSE or ADAS-cog. No patient with MCI whose MTAS or BALI improved converted to AD. CONCLUSIONS: Despite average decline in brain structure, improvement was observed and related to cognition and MCI-AD conversion. Ageing-related brain changes reflect a dynamic process.
BACKGROUND: On average, cognition declines as people age, but improvement can also occur. OBJECTIVE: To evaluate the dynamics of age-related changes in brain structure and cognitive function in patients with mild Alzheimer's disease (AD) and mild cognitive impairment (MCI) and in healthy control (HC) older adults. METHODS: High-resolution 3-Tesla MRI and clinical data were obtained from the Alzheimer's Disease Neuroimaging Initiative in 187 subjects (a cohort aged 55-91 years; AD=43, MCI=84, HC=60). At 24 months, 151 people had clinical and 128 had MRI follow-up. Brain structure was assessed using the Medial Temporal Atrophy Scale (MTAS) and the Brain Atrophy and Lesion Index (BALI). Cognition was assessed using the Mini-Mental State Examination (MMSE) and the Alzheimer Disease Assessment Scale-cognitive subscale (ADAS-cog). Responsiveness was tested. Changes were analysed using a multistate dynamic model, adjusted for age, gender, ApoE4 genotype and vascular risk factors. RESULTS: Over 2 years, decline in brain structure and cognition predominated, each showing detectable effect sizes (Cohen's d=0.33 for MTAS, 0.32 for BALI, 0.41 for MMSE, 0.38 for ADAS-cog; standard response mean=0.71, 0.69, 0.50 and 0.47, respectively). Structural improvement was observed (10.2% in BALI and 0.8% in MTAS), as was cognitive improvement (23.2% MMSE, 27.2% ADAS-cog). Most people (66.7%) whose BALI score improved also improved in either the MMSE or ADAS-cog. No patient with MCI whose MTAS or BALI improved converted to AD. CONCLUSIONS: Despite average decline in brain structure, improvement was observed and related to cognition and MCI-AD conversion. Ageing-related brain changes reflect a dynamic process.
Authors: Michael W Weiner; Dallas P Veitch; Paul S Aisen; Laurel A Beckett; Nigel J Cairns; Jesse Cedarbaum; Robert C Green; Danielle Harvey; Clifford R Jack; William Jagust; Johan Luthman; John C Morris; Ronald C Petersen; Andrew J Saykin; Leslie Shaw; Li Shen; Adam Schwarz; Arthur W Toga; John Q Trojanowski Journal: Alzheimers Dement Date: 2015-06 Impact factor: 21.566
Authors: David R Roalf; Megan Quarmley; Dawn Mechanic-Hamilton; David A Wolk; Steven E Arnold; Paul J Moberg Journal: J Alzheimers Dis Date: 2016-08-10 Impact factor: 4.472
Authors: H Guo; X Song; R Vandorpe; Y Zhang; W Chen; N Zhang; M H Schmidt; K Rockwood Journal: AJNR Am J Neuroradiol Date: 2013-08-29 Impact factor: 3.825
Authors: Sebastian Heinzel; Florian G Metzger; Ann-Christine Ehlis; Robert Korell; Ahmed Alboji; Florian B Haeussinger; Isabel Wurster; Kathrin Brockmann; Ulrike Suenkel; Gerhard W Eschweiler; Walter Maetzler; Daniela Berg; Andreas J Fallgatter Journal: PLoS One Date: 2015-09-22 Impact factor: 3.240
Authors: Lindsay M K Wallace; Olga Theou; Sultan Darvesh; David A Bennett; Aron S Buchman; Melissa K Andrew; Susan A Kirkland; John D Fisk; Kenneth Rockwood Journal: Neurology Date: 2020-09-28 Impact factor: 9.910