Association between midlife dementia risk factors and longitudinal brain atrophy: the PREVENT-Dementia study

Journal of Neurology, Neurosurgery and Psychiatry - Tập 91 Số 2 - Trang 158-161 - 2020
John T. O’Brien1, Michael Firbank2, Karen Ritchie3,4, Katie Wells5, Guy Williams6, Craig Ritchie3, Li Su1
1Department of Psychiatry, University of Cambridge, Cambridge, Cambridgeshire, UK
2Institute of Neuroscience and Newcastle University Institute for Ageing, Newcastle University, Newcastle upon Tyne NE4 5PL, UK
3Centre for Dementia Prevention, University of Edinburgh Centre for Clinical Brain Sciences, Edinburgh, UK
4INSERM, University of Montpellier, Montpellier, France
5The Centre for Psychiatry, Imperial College London, London, UK
6Wolfson Brain Imaging Center, University of Cambridge, Cambridge, Cambridgeshire, UK

Tóm tắt

BackgroundIncreased rates of brain atrophy on serial MRI are frequently used as a surrogate marker of disease progression in Alzheimer’s disease and other dementias. However, the extent to which they are associated with future risk of dementia in asymptomatic subjects is not clear. In this study, we investigated the relationship between the Cardiovascular Risk Factors, Aging, and Dementia (CAIDE) risk score and longitudinal atrophy in middle-aged subjects.Materials and methodsA sample of 167 subjects (aged 40–59 at baseline) from the PREVENT-Dementia programme underwent MRI scans on two separate occasions (mean interval 735 days; SD 44 days). We measured longitudinal rates of brain atrophy using the FSL Siena toolbox.ResultsAnnual percentage rates of brain volume and ventricular volume change were greater in those with a high (>6) vs low CAIDE score—absolute brain volume percentage loss 0.17% (CI 0.07 to 0.27) and absolute ventricular enlargement 1.78% (CI 1.14 to 2.92) higher in the at risk group. Atrophy rates did not differ between subjects with and without a parental history of dementia, but were significantly correlated with age. Using linear regression, with covariates of age, sex and education, CAIDE score >6 was the only significant predictor of whole brain atrophy rates (p=0.025) while age (p=0.009), sex (p=0.002) and CAIDE>6 (p=0.017) all predicted ventricular expansion rate.ConclusionOur results show that progressive brain atrophy is associated with increased risk of future dementia in asymptomatic middle-aged subjects, two decades before dementia onset.

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Journal of Neurology, Neurosurgery and Psychiatry

Tập 91 Số 2

158-161

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