Brain atrophy can predict further cognitive decline in Alzheimer’s disease

23 March 2012

Researchers from the Alzheimer Center, VU University Medical Center in Amsterdam, the Netherlands, have found a way to predict clinical progression of Alzheimer’s disease in subjects in the predementia stage. Patients with mild memory problems, who had brain atrophy on MRI scan or a high level of tau protein in cerebrospinal fluid showed more rapid cognitive decline than subjects without this shrinkage of the brain. The study is published in The Journal of Alzheimer’s Disease 29:2.

Alzheimer’s disease starts with mild cognitive impairment, typically memory impairment. The time between mild cognitive impairment and progression to dementia is however highly variable, ranging from a few months up to 10 years. Researchers from the Alzheimer Center of the VU University Medical Center have now demonstrated that time to dementia in subjects with mild cognitive impairment can be predicted with biomarkers.

This study included 91 patients who exhibited mild cognitive impairment at baseline and all progressed to dementia during follow up. At baseline the volume of the hippocampus, a specific brain structure involved in memory, was measured with an MRI scan. Also a lumbar puncture was performed to measure proteins in the cerebrospinal fluid.

Patients who already had shrinkage of the hippocampus at baseline progressed to dementia more rapidly. Also a high level of tau protein in the cerebrospinal fluid predicted rapid decline to dementia. Other known risk factors for Alzheimer’s disease such as high age or a decrease of beta amyloid protein in the cerebrospinal fluid did not predict further progression of the disease.

These results show that the rate of cognitive decline in Alzheimer’s disease is related to specific brain abnormalities. While some markers of Alzheimer’s disease can be used to diagnose the disease in an early stage, others may be suitable for predicting further progression of the disease. However, before progression can be predicted for individual patients, further research is needed.

Caroline Arps
VU University Medical Center Communication Services
Tel: +31-(0)20-4443444
Fax: +31-(0)20-4443450