Document Detail


Joint effect of white matter lesions and hippocampal volumes on severity of cognitive decline: the 3C-Dijon MRI study.
MedLine Citation:
PMID:  20164560     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Several brain magnetic resonance imaging (MRI) changes are observed in older individuals including white matter lesions (WML), silent brain infarcts (SBI), and cerebral atrophy. Few studies, however, have assessed the combined association of these changes on the severity of future cognitive decline. In the prospective population-based 3C-Dijon MRI study, 1701 non-demented participants aged 65 to 80 years at entry had a brain MRI. Information on WML, hippocampal volumes, SBI presence, and brain parenchymal fraction were obtained. At 4-year follow-up, participants were screened for cognitive decline and dementia. Severity of cognitive decline was defined as none, moderate, or severe calculated from neuropsychological test performance change. The relation between brain MRI markers and longitudinal change in cognition was studied using polytomous logistic regression and multiple linear regression models controlling for potential confounders. Two-by-two interactions were tested including with the apolipoprotein E genotype. At follow-up, 46 participants showed severe cognitive deterioration and 224 participants showed moderate cognitive deterioration. In multivariable analyses, risk of severe cognitive deterioration as well as the cognitive decline rate were significantly increased in participants with higher WML volume (p< 0.01) and smaller hippocampal volume (p< 0.01). The results suggested that WML and hippocampal volumes had a cumulative effect on the future level of cognitive decline. The APOE genotype was found to be an effect modifier of this association. Vascular brain changes and degenerative processes coexist in normal older individuals. The co-occurrence of degenerative and non-degenerative pathologies could strongly affect the course of dementia expression.
Authors:
Ophélia Godin; Christophe Tzourio; Olivier Rouaud; Yicheng Zhu; Pauline Maillard; Florence Pasquier; Fabrice Crivello; Annick Alpérovitch; Bernard Mazoyer; Carole Dufouil
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of Alzheimer's disease : JAD     Volume:  20     ISSN:  1875-8908     ISO Abbreviation:  J. Alzheimers Dis.     Publication Date:  2010  
Date Detail:
Created Date:  2010-05-27     Completed Date:  2010-09-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9814863     Medline TA:  J Alzheimers Dis     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  453-63     Citation Subset:  IM    
Affiliation:
Inserm, U708 Neuroepidemiology, Paris, France.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Cognition Disorders / pathology*
Female
Hippocampus / pathology*
Humans
Imaging, Three-Dimensional* / methods
Linear Models
Longitudinal Studies
Magnetic Resonance Imaging*
Male
Mental Status Schedule
Middle Aged
Nerve Fibers, Myelinated / pathology*
Neuropsychological Tests
Retrospective Studies
Severity of Illness Index

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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