Tags

Type your tag names separated by a space and hit enter

Use of hippocampal and amygdalar volumes on magnetic resonance imaging to predict dementia in cognitively intact elderly people.

Abstract

CONTEXT

The recent focus on the development of preventive interventions for Alzheimer disease has fueled the search for biomarkers of presymptomatic disease. Patients with Alzheimer disease and mild cognitive impairment have marked atrophy of the hippocampus and amygdala compared with healthy elderly people. Whether atrophy of these structures is also present in persons without cognitive impairment who later develop dementia is unknown.

OBJECTIVE

To assess whether volumetric assessment of the hippocampus and amygdala using magnetic resonance imaging (MRI) predicts dementia in elderly people without cognitive impairment.

DESIGN

Longitudinal cohort study.

SETTING

A general community in the Netherlands.

PARTICIPANTS

Five hundred eleven persons, aged 60 to 90 years, free of dementia at baseline were followed up during 3043 person-years (mean per person, 6.0 years). We performed volumetric assessment of the hippocampus and amygdala, obtained information about daily memory problems, and performed extensive neuropsychological testing in all study participants.

MAIN OUTCOME MEASURE

Dementia, as assessed by repeated neuropsychological screening and monitoring of medical records.

RESULTS

Thirty-five persons developed dementia (26 with Alzheimer disease). Hippocampal and amygdalar volumes were strongly associated with the risk of dementia; the age-, sex-, and education-adjusted hazard ratio per 1-SD decrease in volume was 3.0 (95% confidence interval, 2.0-4.6) for the hippocampus and 2.1 (95% confidence interval, 1.5-2.9) for the amygdala. The hazard ratios associated with atrophy were similar in persons without memory complaints or low cognitive function at baseline. Compared with those remaining free of dementia, baseline brain volumes were 17% smaller in persons who received a clinical diagnosis of dementia within 2 to 3 years after MRI and still 5% smaller in those whose conditions were diagnosed 6 years after MRI.

CONCLUSION

Atrophy of the hippocampus and amygdala on MRI in cognitively intact elderly people predicts dementia during a 6-year follow-up.

Links

  • Aggregator Full Text
  • Authors+Show Affiliations

    ,

    Department of Epidemiology and Biostatistics, Erasmus Medical Center, Rotterdam, the Netherlands.

    , , , ,

    Source

    Archives of general psychiatry 63:1 2006 Jan pg 57-62

    MeSH

    Aged
    Alzheimer Disease
    Amygdala
    Atrophy
    Biomarkers
    Cerebral Infarction
    Cognition
    Cognition Disorders
    Cohort Studies
    Dementia
    Female
    Follow-Up Studies
    Hippocampus
    Humans
    Longitudinal Studies
    Magnetic Resonance Imaging
    Male
    Neuropsychological Tests
    Prognosis
    Psychiatric Status Rating Scales
    Psychomotor Performance
    Risk Factors

    Pub Type(s)

    Comparative Study
    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    16389197

    Citation

    den Heijer, Tom, et al. "Use of Hippocampal and Amygdalar Volumes On Magnetic Resonance Imaging to Predict Dementia in Cognitively Intact Elderly People." Archives of General Psychiatry, vol. 63, no. 1, 2006, pp. 57-62.
    den Heijer T, Geerlings MI, Hoebeek FE, et al. Use of hippocampal and amygdalar volumes on magnetic resonance imaging to predict dementia in cognitively intact elderly people. Arch Gen Psychiatry. 2006;63(1):57-62.
    den Heijer, T., Geerlings, M. I., Hoebeek, F. E., Hofman, A., Koudstaal, P. J., & Breteler, M. M. (2006). Use of hippocampal and amygdalar volumes on magnetic resonance imaging to predict dementia in cognitively intact elderly people. Archives of General Psychiatry, 63(1), pp. 57-62.
    den Heijer T, et al. Use of Hippocampal and Amygdalar Volumes On Magnetic Resonance Imaging to Predict Dementia in Cognitively Intact Elderly People. Arch Gen Psychiatry. 2006;63(1):57-62. PubMed PMID: 16389197.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Use of hippocampal and amygdalar volumes on magnetic resonance imaging to predict dementia in cognitively intact elderly people. AU - den Heijer,Tom, AU - Geerlings,Mirjam I, AU - Hoebeek,Freek E, AU - Hofman,Albert, AU - Koudstaal,Peter J, AU - Breteler,Monique M B, PY - 2006/1/4/pubmed PY - 2006/2/16/medline PY - 2006/1/4/entrez SP - 57 EP - 62 JF - Archives of general psychiatry JO - Arch. Gen. Psychiatry VL - 63 IS - 1 N2 - CONTEXT: The recent focus on the development of preventive interventions for Alzheimer disease has fueled the search for biomarkers of presymptomatic disease. Patients with Alzheimer disease and mild cognitive impairment have marked atrophy of the hippocampus and amygdala compared with healthy elderly people. Whether atrophy of these structures is also present in persons without cognitive impairment who later develop dementia is unknown. OBJECTIVE: To assess whether volumetric assessment of the hippocampus and amygdala using magnetic resonance imaging (MRI) predicts dementia in elderly people without cognitive impairment. DESIGN: Longitudinal cohort study. SETTING: A general community in the Netherlands. PARTICIPANTS: Five hundred eleven persons, aged 60 to 90 years, free of dementia at baseline were followed up during 3043 person-years (mean per person, 6.0 years). We performed volumetric assessment of the hippocampus and amygdala, obtained information about daily memory problems, and performed extensive neuropsychological testing in all study participants. MAIN OUTCOME MEASURE: Dementia, as assessed by repeated neuropsychological screening and monitoring of medical records. RESULTS: Thirty-five persons developed dementia (26 with Alzheimer disease). Hippocampal and amygdalar volumes were strongly associated with the risk of dementia; the age-, sex-, and education-adjusted hazard ratio per 1-SD decrease in volume was 3.0 (95% confidence interval, 2.0-4.6) for the hippocampus and 2.1 (95% confidence interval, 1.5-2.9) for the amygdala. The hazard ratios associated with atrophy were similar in persons without memory complaints or low cognitive function at baseline. Compared with those remaining free of dementia, baseline brain volumes were 17% smaller in persons who received a clinical diagnosis of dementia within 2 to 3 years after MRI and still 5% smaller in those whose conditions were diagnosed 6 years after MRI. CONCLUSION: Atrophy of the hippocampus and amygdala on MRI in cognitively intact elderly people predicts dementia during a 6-year follow-up. SN - 0003-990X UR - https://www.unboundmedicine.com/medline/citation/16389197/Use_of_hippocampal_and_amygdalar_volumes_on_magnetic_resonance_imaging_to_predict_dementia_in_cognitively_intact_elderly_people_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=16389197.ui DB - PRIME DP - Unbound Medicine ER -