Affiliations: [a] Department of Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Switzerland
| [b] Department of Psychiatry, University of Geneva, Switzerland
| [c]
CIRD - Centre d’Imagerie Rive Droite in Geneva, Switzerland
| [d] Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden
| [e] Department of Neuroradiology, Faculty of Medicine of the University of Geneva, Geneva, Switzerland
| [f] Medical Direction, University of Geneva Hospitals, Geneva, Switzerland
| [g] Division of Nuclear Medicine and Molecular Imaging, Diagnostic Department, Geneva University Hospitals and University of Geneva, Switzerland
Correspondence:
[*]
Correspondence to: Prof. Panteleimon Giannakopoulos, Division of Institutional Measures, Geneva University Hospitals, 12 bis avenue de Rosemont, 1208 Geneva, Switzerland. Tel.: +41 22 305 5777; E-mail: Panteleimon.Giannakopoulos@unige.ch.
Note: [1] These authors contributed equally to this work.
Abstract: Background:The cognitive trajectories in normal aging may be affected by medial temporal atrophy (MTA) and amyloid burden, as well as vascular pathologies such as cortical microbleeds (CMB) and white matter hyperintensities (WMH). Objective:We addressed here the role of imaging markers in their prediction in a real-world situation. Methods:We performed a 4.5-year longitudinal study in 90 older community-dwellers coupling two neuropsychological assessments, MTA estimated with the Schelten’s scale, number of CMB, and WMH evaluated with the Fazekas score at inclusion and follow-up, visual rating of amyloid PET and glucose hypometabolism at follow-up, and APOE genotyping. Regression models were built to explore the association between the continuous cognitive score (CCS) and imaging parameters. Results:The number of strictly lobar CMB at baseline (4 or more) was related to a 5.5-fold increase of the risk of cognitive decrement. This association persisted in multivariable models explaining 10.6% of the CCS decrease variance. MTA, and Fazekas score at baseline and amyloid positivity or abnormal FDG PET, were not related to the cognitive outcome. The increase of right MTA at follow-up was the only correlate of CCS decrease both in univariate and multivariable models explaining 9.2% of its variance. Conclusion:The present data show that the accumulation of more than four CMB is associated with significant cognitive decrement over time in highly educated elderly persons. They also reveal that the progressive deterioration of cognitive performance within the age-adjusted norms is also related to the increase of visually assessed MTA.
