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Abstract
Objective: To determine whether age-standardized brain morphometric and cognitive profiles differ in young-old (aged 60–75 years) and very-old (aged 80–91 years) patients with Alzheimer disease (AD).
Methods: Using a case-control retrospective design, we compared hippocampal volume and cortical gray matter thickness in areas known to be affected by AD in 105 patients with AD and 125 healthy control (HC) participants divided into young-old and very-old subgroups. Brain morphometric and cognitive scores of the AD groups were standardized to their respective age-appropriate HC subgroup and then compared.
Results: Several cognitive domains (executive function, immediate memory, and attention/processing speed) were less abnormal in the very old with AD than in the young old with AD. Similarly, the very old with AD showed less severe cortical thinning than the young old with AD in the left posterior cingulate cortex, right lateral temporal cortex, and bilateral parietal cortex and in overall cortical thickness. This effect is partially explained by an age-related decrease in cortical thickness in these brain regions in the HC participants.
Conclusions: The typical pattern of AD-related cognitive and morphometric changes seen in the young old appear to be less salient in the very old. Thus, mild cases of AD in the very old may go undetected if one expects to see the prototypical pattern and severity of cognitive or brain changes that occur in the young old with AD. These results underscore the importance of interpreting neuropsychological test performance and morphometric brain measures in reference to the individual's age. Neurology® 2011;77:713–721
GLOSSARY
- ACC=
- anterior cingulate cortex;
- AD=
- Alzheimer disease;
- ADNI=
- Alzheimer Disease Neuroimaging Initiative;
- CDR=
- Clinical Dementia Rating;
- DLPFC=
- dorsolateral prefrontal cortex;
- eTIV=
- estimated total cranial vault;
- HC=
- healthy control;
- MANOVA=
- multivariate analyses of variance;
- MCI=
- mild cognitive impairment;
- MMSE=
- Mini-Mental State Examination;
- MTL=
- medial temporal lobe;
- PCC=
- posterior cingulate cortex;
- RAVLT=
- Rey Auditory Verbal Learning Test;
- ROI=
- region of interest;
- WAIS-R=
- Wechsler Adult Intelligence Scale–Revised;
- WMS-R=
- Wechsler Memory Scale–Revised
Footnotes
-
Study funding: Funding information is provided at the end of the article.
Editorial, page 706
Supplemental data at www.neurology.org
The Alzheimer's Disease Neuroimaging Initiative Coinvestigators are listed in appendix e-1 on the Neurology® Web site at www.neurology.org.
Data used in the preparation of this article were obtained from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database (www.loni.ucla.edu\ADNI). As such, the investigators within the ADNI contributed to the design and implementation of ADNI and/or provided data but did not participate in analysis or writing of this report.
- Received October 7, 2010.
- Accepted March 22, 2011.
- Copyright © 2011 by AAN Enterprises, Inc.
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