Acceleration of Brain Atrophy and Progression From Normal Cognition to Mild Cognitive Impairment

 

EXACTLY HOW IS YOUR COMPETENT? DOCTOR PREVENTING BRAIN ATROPHY?

Your doctor is responsible for fixing brain atrophy post stroke and has had years to come up with  a solution. Was s/he incompetent in not solving that problem?

With your brain atrophy post stroke you'll have to ask your doctor about this. 

 What is your doctor's protocol to prevent both brain and muscle atrophy?  No protocol, call the president and ask when competent persons will be hired.

• brain atrophy (31 posts to July 2015)

• cerebral atrophy (2 posts to April 2016)

• Cortical atrophy (1 post to February 2019)
  

• Frontal Cortical Atrophy (1 post to June 2016)

• hippocampal atrophy (1 post to October 2019)

  The latest here: 

Acceleration of Brain Atrophy and Progression From Normal Cognition to Mild Cognitive Impairment

Yuto Uchida, MD, PhD¹; Kei Nishimaki¹; Anja Soldan, PhD²; et al Abhay Moghekar, MBBS³; Marilyn Albert, PhD²; Kenichi Oishi, MD, PhD^1,2,3

Author Affiliations Article Information

JAMA Netw Open. 2024;7(10):e2441505. doi:10.1001/jamanetworkopen.2024.41505

editorial comment icon

Editorial

Comment

• Invited Commentary
  Optimizing Strategies to Prevent Cognitive Decline With 20-Year Brain Imaging
  Shohei Fujita, MD, PhD
  JAMA Network Open

Key Points

Question  What factors are associated with the acceleration of brain atrophy and progression to mild cognitive impairment (MCI) based on long-term longitudinal data for individuals with normal cognition at baseline?

Findings  In the cohort study, 185 participants with normal cognition underwent a mean follow-up of 20 years with brain magnetic resonance imaging scans. Type 2 diabetes and abnormal amyloid-β concentration in the cerebrospinal fluid were associated with accelerated brain atrophy and an earlier progression to MCI.

Meaning  These results support the importance of identifying individuals who have accelerated brain atrophy to optimize strategies to prevent MCI.

Abstract

Importance  It remains unclear which risk factors accelerate brain atrophy along with a progression from normal cognition to mild cognitive impairment (MCI).

Objective  To examine risk factors associated with the acceleration of brain atrophy and progression from normal cognition to MCI based on long-term longitudinal data for middle-aged and older adults.

Design, Setting, and Participants  Data for this cohort study were extracted from the Biomarkers for Older Controls at Risk for Dementia (BIOCARD) cohort, initiated at the National Institutes of Health from January 1, 1995, to December 31, 2005, and continued at Johns Hopkins University from January 1, 2015, to October 31, 2023. All participants were cognitively normal at baseline. The participants whose structural magnetic brain imaging (MRI) of the brain and cerebrospinal fluid (CSF) measures were available for over 10 years were included.

Exposures  Longitudinal structural MRI of the brain and measurement of CSF biomarkers for Alzheimer disease pathology (ratio of amyloid β peptide 42 [Aβ₄₂] to Aβ₄₀, tau phosphorylated at threonine 181, and total tau).

Main Outcomes and Measures  Annual change rates of segmental brain volumes, Kaplan-Meier survival curves plotting time to event for progression to MCI symptom onset, and hazard ratios (HRs) determined by Cox proportional hazards regression models.

Results  A total of 185 participants (mean [SD] age, 55.4 [8.4] years; 116 women [63%]) were included and followed up for a maximum of 27 years (median, 20 [IQR, 18-22] years). The groups with high levels of atrophy in the white matter and enlargement in the ventricles had an earlier progression from normal cognition to MCI symptom onset (HR for white matter, 1.86 [95% CI, 1.24-2.49]; P = .001; HR for ventricles, 1.71 [95% CI, 1.19-2.24]; P = .009). Diabetes was associated with progression to MCI (HR, 1.41 [95% CI, 1.06-1.76]; P = .04), as was a low CSF Aβ₄₂:Aβ₄₀ ratio (HR, 1.48 [95% CI, 1.09-1.88]; P = .04), and their combination had a higher HR of 1.55 (95% CI, 1.13-1.98]; P = .03), indicating a synergic association of diabetes and amyloid pathology with MCI progression.

Conclusions and Relevance  In this cohort study of middle-aged and older adults, higher rates of volume change in the white matter and ventricles, along with the presence of diabetes and a low CSF Aβ₄₂:Aβ₄₀ ratio, were identified as important risk factors for the progression to MCI. These results support the importance of identifying individuals who have accelerated brain atrophy to optimize preventive strategies for progression to MCI.

More at link.