Martin Roesel MD, Presenter: Nothing to Disclose

Manuel Gmeiner MD, Abstract Co-Author: Nothing to Disclose

Andreas Nachbagauer BSc, Abstract Co-Author: Nothing to Disclose

Wolfgang Krampla MD, Abstract Co-Author: Nothing to Disclose

Peter Fischer, Abstract Co-Author: Nothing to Disclose

Walter F. Hruby MD, Abstract Co-Author: Nothing to Disclose

Karl-Heinz Tragl, Abstract Co-Author: Nothing to Disclose

To determine if baseline measurements of cerebral atrophy predict the rate of future cognitive decline in the non-demented elderly.  

Data were drawn from the Vienna Transdanube Aging (VITA) study. Magnetic resonance images of 532 non-demented subjects aged 75-76 years at baseline were analyzed to assess 7 cerebral atrophy markers, including hippocampal head and tail measurements for both sides and three ventricular indices. A population averaged model with the corresponding analytical technique of generalized estimating equations (GEE) were applied to the birth-cohort to determine whether baseline MRI measurements predicted the rate of cognitive decline at three follow-up investigations after 30, 60 and 90 months. Cognitive tests were comprised of the Mini Mental State Examination (MMSE), Boston Naming Test (BNT), Fuld Object Memory Evaluation (FOME) and the Trail Making Tests A and B (TMTA, TMTB). Vascular risk factors and several other covariates that were available in the VITA database were included as additional predictors in the longitudinal data analysis. 

Severity of right hippocampal head atrophy predicted the rate of cognitive decline in all 5 test scores. (MMSE: β = −0.310; p = 0.033, BNT: β = −0.219; p = 0.001, FOME: β = −1.354; p < 0.001, TMTA: Exp(β) = 0.185; p = 0.009, TMTB: Exp(β) = 1.149; p < 0.001); severity of left hippocampal head atrophy followed closely, predicting decline in 4 out of 5 test scores. The degree of ventricular atrophy assessed using the nucleus caudatus index predicted cognitive decline in MMSE scores (β = −0.287; p < 0.001) and FOME scores (β = −0.614; p < 0.001); the cella media index predicted the rate of cognitive decline in MMSE scores (β = −0.374; p < 0.001) and FOME scores (β = −0.732; p = 0.003).

The degree of hippocampal head atrophy is the strongest predictor of cognitive decline in the VITA birth-cohort showing statistically significant associations in 9 out of 10 hippocampal models. Moreover, generalized estimating equation models demonstrated, that lower educational level, presence of the Apo E ε4 allele, being male, positive history of depression, higher scores on the short geriatric depression scale and the degree of atrophy assessed with described markers have a synergistic effect on future cognitive decline.

The degree of cerebral atrophy is associated with the rapidity of cognitive decline in the non-demented elderly.

Roesel, M, Gmeiner, M, Nachbagauer, A, Krampla, W, Fischer, P, Hruby, W, Tragl, K, The Value of Structural MRI Measurements of Cerebral Atrophy in Predicting the Rate of Cognitive Decline in the Non-demented Elderly. A GEE Analysis Based on Data from the Vienna Transdanube Aging (VITA) Study.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12030882.html