Distinct profiles of brain and cognitive changes in the very old with Alzheimer disease

N. H. Stricker; Y. L. Chang; C. Fennema-Notestine; L. Delano-Wood; D. P. Salmon; M. W. Bondi; A. M. Dale

doi:10.1212/WNL.0b013e31822b0004

Distinct profiles of brain and cognitive changes in the very old with Alzheimer disease

N. H. Stricker, Y. L. Chang, C. Fennema-Notestine, L. Delano-Wood, D. P. Salmon, M. W. Bondi, A. M. Dale

Psychiatry and Psychology

Research output: Contribution to journal › Article › peer-review

28 Scopus citations

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 ageappropriate 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.

Original language	English (US)
Pages (from-to)	713-721
Number of pages	9
Journal	Neurology
Volume	77
Issue number	8
DOIs	https://doi.org/10.1212/WNL.0b013e31822b0004
State	Published - Aug 23 2011

ASJC Scopus subject areas

Clinical Neurology

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10.1212/WNL.0b013e31822b0004

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@article{7813628b04ab4fe881695abb119473dc,

title = "Distinct profiles of brain and cognitive changes in the very old with Alzheimer disease",

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 ageappropriate 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.",

author = "Stricker, {N. H.} and Chang, {Y. L.} and C. Fennema-Notestine and L. Delano-Wood and Salmon, {D. P.} and Bondi, {M. W.} and Dale, {A. M.}",

note = "Funding Information: Dr. Stricker receives/has received research support from The Rosalind and Arthur Gilbert Foundation/American Federation for Aging Research (AFAR) and the NIH/NIMH. Dr. Chang receives research support from the Alzheimer's Association and the Stein Institute for Research on Aging, University of California, San Diego. Dr. Fennema-Notestine receives/has received research support from the NIH, the US Department of Veterans Affairs, and the Alzheimer's Association. Dr. Delano-Wood receives research support from the Alzheimer's Association. Dr. Salmon serves as a consultant for CHDI Foundation, Novartis, and Bristol-Meyers Squibb and receives/has received research support from the NIH and the State of California Department of Health Services. Dr. Bondi serves as an Associate Editor for the Journal of the International Neuropsychological Society and receives research support from the Alzheimer's Association and the NIH/NIA. Dr. Dale receives research support from the NIH; receives funding to his laboratory from GE Heathcare as part of a Master Research Agreement with UCSD; and is a founder of, holds equity in, and serves on the scientific advisory board for CorTechs Labs, Inc. The terms of this arrangement have been reviewed and approved by UCSD in accordance with its conflict of interest policies. ",

year = "2011",

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doi = "10.1212/WNL.0b013e31822b0004",

language = "English (US)",

volume = "77",

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TY - JOUR

T1 - Distinct profiles of brain and cognitive changes in the very old with Alzheimer disease

AU - Stricker, N. H.

AU - Chang, Y. L.

AU - Fennema-Notestine, C.

AU - Delano-Wood, L.

AU - Salmon, D. P.

AU - Bondi, M. W.

AU - Dale, A. M.

N1 - Funding Information: Dr. Stricker receives/has received research support from The Rosalind and Arthur Gilbert Foundation/American Federation for Aging Research (AFAR) and the NIH/NIMH. Dr. Chang receives research support from the Alzheimer's Association and the Stein Institute for Research on Aging, University of California, San Diego. Dr. Fennema-Notestine receives/has received research support from the NIH, the US Department of Veterans Affairs, and the Alzheimer's Association. Dr. Delano-Wood receives research support from the Alzheimer's Association. Dr. Salmon serves as a consultant for CHDI Foundation, Novartis, and Bristol-Meyers Squibb and receives/has received research support from the NIH and the State of California Department of Health Services. Dr. Bondi serves as an Associate Editor for the Journal of the International Neuropsychological Society and receives research support from the Alzheimer's Association and the NIH/NIA. Dr. Dale receives research support from the NIH; receives funding to his laboratory from GE Heathcare as part of a Master Research Agreement with UCSD; and is a founder of, holds equity in, and serves on the scientific advisory board for CorTechs Labs, Inc. The terms of this arrangement have been reviewed and approved by UCSD in accordance with its conflict of interest policies.

PY - 2011/8/23

Y1 - 2011/8/23

N2 - 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 ageappropriate 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.

AB - 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 ageappropriate 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.

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Distinct profiles of brain and cognitive changes in the very old with Alzheimer disease

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