Neuroimaging and clinical characteristics of cognitive migration in community-dwelling older adults

• Published in: NeuroImage clinical 2022-01, Vol.36, p.103232, Article 103232
• Main Authors: Duran, Tugce, Bateman, James R., Williams, Benjamin J., Espeland, Mark A., Hughes, Timothy M., Okonmah-Obazee, Stephanie, Rundle, Melissa M., Craft, Suzanne, Lockhart, Samuel N.
• Format: Article
• Language: English
• Subjects: Aged; Alzheimer Disease - pathology; Biomarkers; Cognition; Cognitive Dysfunction - pathology; Dementia; Disease Progression; Humans; Independent Living; Magnetic Resonance Imaging; MRI; Neuroimaging; Neuropsychological Tests; OGTT; Regular
• ISSN: 2213-1582; 2213-1582
• DOI: 10.1016/j.nicl.2022.103232

•We defined a multidirectional transition for cognitive function as cognitive migration over a one-year period.•Lower gray matter volumes in temporal and frontal regions may predict worse cognitive migration in early stages of cognitive impairment or decline.•Impaired glucose tolerance (measured by OGTT-2h) was associated with worse cognitive migration status among community-based volunteers aged 55 years and older who were free of diabetes.•Cognitive and functional changes identified within one year may inform disease profiling. Multiple neuroimaging and clinical biomarkers have been identified to predict cognitive decline and clinical progression to mild cognitive impairment (MCI) or dementia. However, early biomarkers associated with transition to and reversion from cognitive impairment (cognitive migration) require further understanding. We investigated the impacts of baseline neuroimaging and clinical biomarkers on cognitive migration in a community-dwelling older cohort. We studied 391 participants from the Wake Forest Alzheimer’s Disease Research Center Clinical Core cohort who underwent neuropsychological assessment and magnetic resonance imaging (MRI). At baseline, each participant was categorized to a functional/cognitive state using global Clinical Dementia Rating (CDR) score: CDR = 0 indicates normal cognitive function; CDR = 0.5 is minimal cognitive impairment. The primary outcome was cognitive migration status determined by CDR change between baseline and follow-up (mean difference = 13.9 months): CDR-0 Stables (no migration; maintained CDR = 0), CDR-0.5 Stables (no migration; maintained CDR = 0.5), Migrants− (negative migration; CDR 0 to CDR 0.5), and Reverters+ (positive migration; CDR 0.5 to CDR 0). Baseline T1-weighted MRI was analyzed for gray matter (GM) volume using voxel-based morphometry (VBM). For VBM, we used a two-sample t-test controlling for age, sex, education years and intracranial volume for group comparisons: CDR-0 Stables vs CDR-0.5 Stables, CDR-0 Stables vs Migrants−, CDR-0.5 Stables vs Reverters+ and Migrants− vs Reverters+ (thresholded at k = 30 voxels, p