TY - JOUR
T1 - Brain MRI-markers Associate Differentially with Cognitive Versus Functional Decline Leading to Dementia
AU - Verlinden, Vincentius J A
AU - van der Geest, Jos N.
AU - Hofman, Albert
AU - Niessen, Wiro J.
AU - van der Lugt, Aad
AU - Vernooij, Meike W.
AU - Ikram, M. Arfan
PY - 2017/2
Y1 - 2017/2
N2 - 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. Design, Setting, and Participants: 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. Measurements: 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.
AB - 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. Design, Setting, and Participants: 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. Measurements: 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.
KW - MRI
KW - Activities of daily living
KW - Brain
KW - Cognition
KW - Dementia
UR - http://www.scopus.com/inward/record.url?scp=85012888856&partnerID=8YFLogxK
U2 - 10.1111/jgs.14775
DO - 10.1111/jgs.14775
M3 - Article
AN - SCOPUS:85012888856
SN - 0002-8614
VL - 65
SP - 1258
EP - 1266
JO - American Geriatrics Society. Journal
JF - American Geriatrics Society. Journal
IS - 6
ER -