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Use of hippocampal and amygdalar volumes on magnetic resonance imaging to predict dementia in cognitively intact elderly people.
Arch Gen Psychiatry 2006; 63(1):57-62AG

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.

Authors+Show Affiliations

Department of Epidemiology and Biostatistics, Erasmus Medical Center, Rotterdam, the Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

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 -