Resilience and MRI correlates of cognitive impairment in community-dwelling elders

Anya Topiwala, Charlotte L Allan, Vyara Valkanova, Enikő Zsoldos, Nicola Filippini, Claire E Sexton, Abda Mahmood, Archana Singh-Manoux, Clare E Mackay, Mika Kivimäki, Klaus P Ebmeier, Anya Topiwala, Charlotte L Allan, Vyara Valkanova, Enikő Zsoldos, Nicola Filippini, Claire E Sexton, Abda Mahmood, Archana Singh-Manoux, Clare E Mackay, Mika Kivimäki, Klaus P Ebmeier

Abstract

Background: The contribution of education and intelligence to resilience against age-related cognitive decline is not clear, particularly in the presence of 'normal for age' minor brain abnormalities.

Method: Participants (n = 208, mean age 69.2 years, s.d. = 5.4) in the Whitehall II imaging substudy attended for neuropsychological testing and multisequence 3T brain magnetic resonance imaging. Images were independently rated by three trained clinicians for global and hippocampal atrophy, periventricular and deep white matter changes.

Results: Although none of the participants qualified for a clinical diagnosis of dementia, a screen for cognitive impairment (Montreal Cognitive Assessment (MoCA) <26) was abnormal in 22%. Hippocampal atrophy, in contrast to other brain measures, was associated with a reduced MoCA score even after controlling for age, gender, socioeconomic status, years of education and premorbid IQ. Premorbid IQ and socioeconomic status were associated with resilience in the presence of hippocampal atrophy.

Conclusions: Independent contributions from a priori risk (age, hippocampal atrophy) and resilience (premorbid function, socioeconomic status) combine to predict measured cognitive impairment.

Conflict of interest statement

Declaration of interest

K.P.E. has received consultation fees from Lilly in relation to Amyvid™.

© The Royal College of Psychiatrists 2015.

Figures

Fig. 1
Fig. 1
Distribution (histograms) of global atrophy, Scheltens and Fazekas scores.

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Source: PubMed

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