Longitudinal patterns of brain aging and neurodegeneration among older adults with dual decline in memory and gait

IF 11.1 1区 医学 Q1 CLINICAL NEUROLOGY Alzheimer's & Dementia Pub Date : 2025-02-23 DOI:10.1002/alz.14612
Qu Tian, Erin E. Greig, Keenan A. Walker, Michael R. Duggan, Zhijian Yang, Abhay Moghekar, Bennett A. Landman, Christos Davatzikos, Susan M. Resnick, Luigi Ferrucci
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Abstract

INTRODUCTION

Dual cognitive and mobility decline is more strongly associated with dementia risk than cognitive decline only. It remains unknown whether this syndrome is associated with brain atrophy patterns, white matter (WM) damage, or pathology.

METHODS

In the Baltimore Longitudinal Study of Aging participants with and without dual decline, we used linear mixed-effects models to compare up to 13-year longitudinal changes in MRI-derived atrophy patterns, WM hyperintensities (n = 339), microstructure (n = 307), plasma glial fibrillary acidic protein (GFAP), neurofilament light chain (NfL), amyloid beta 42/40 (Aβ42/40) ratio (n = 349), and phosphorylated tau 181 (pTau181) (n = 258).

RESULTS

Those experiencing dual decline showed accelerated atrophy in medial temporal (p = .004), parietotemporal (p = .029), and perisylvian regions (p = .028), whereas gait decline only showed accelerated parietotemporal atrophy (p = .035) and memory decline only showed perisylvian atrophy (p = .021). Dual decline was also associated with unique microstructural deterioration in several WM tracts (p < .05), a greater decrease in Aβ42/40 ratio (p = .015), and greater increases in GFAP (p = .009) and NfL (p < .001).

DISCUSSION

Individuals experiencing dual decline are at an increased risk for regional brain atrophy, microstructural degradation, and biomarker-defined molecular changes underlying dementia.

Highlights

  • Those experiencing dual decline showed several accelerated brain atrophy patterns.
  • Those experiencing dual decline showed unique microstructural deterioration.
  • Dual decline showed a greater decline in plasma Aβ42/40 ratio.
  • Dual decline showed greater increases in plasma GFAP and NfL.
  • Dual decline may indicate brain and blood markers underlying dementia.

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记忆和步态双重衰退的老年人脑老化和神经变性的纵向模式
与仅认知能力下降相比,双重认知和活动能力下降与痴呆风险的关系更为密切。目前尚不清楚这种综合征是否与脑萎缩模式、白质(WM)损伤或病理有关。方法在巴尔的摩纵向研究中,我们使用线性混合效应模型比较了13年来mri衍生的萎缩模式、WM高强度(n = 339)、微观结构(n = 307)、血浆胶质纤维酸性蛋白(GFAP)、神经丝轻链(NfL)、淀粉样蛋白β42/40 (Aβ42/40)比(n = 349)、磷酸化tau 181 (pTau181) (n = 258)。结果双功能衰退患者内侧颞叶区(p = 0.004)、顶叶区(p = 0.029)和左脑区(p = 0.028)萎缩加速,而步态衰退仅表现为顶叶区加速萎缩(p = 0.035),记忆衰退仅表现为左脑萎缩(p = 0.021)。双衰退还与几个WM束独特的显微结构恶化有关(p <;0.05), a - β42/40比值下降幅度较大(p = 0.015), GFAP (p = 0.009)和NfL (p <;措施)。经历双重衰退的个体发生区域性脑萎缩、微结构退化和生物标志物定义的痴呆分子变化的风险增加。那些经历双重衰退的人表现出几种加速的脑萎缩模式。经历双重衰退的人表现出独特的微观结构恶化。双下降显示血浆a β42/40比值下降幅度较大。双重下降显示血浆GFAP和NfL有较大的增加。双重衰退可能表明痴呆背后的大脑和血液标志物。
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来源期刊
Alzheimer's & Dementia
Alzheimer's & Dementia 医学-临床神经学
CiteScore
14.50
自引率
5.00%
发文量
299
审稿时长
3 months
期刊介绍: Alzheimer's & Dementia is a peer-reviewed journal that aims to bridge knowledge gaps in dementia research by covering the entire spectrum, from basic science to clinical trials to social and behavioral investigations. It provides a platform for rapid communication of new findings and ideas, optimal translation of research into practical applications, increasing knowledge across diverse disciplines for early detection, diagnosis, and intervention, and identifying promising new research directions. In July 2008, Alzheimer's & Dementia was accepted for indexing by MEDLINE, recognizing its scientific merit and contribution to Alzheimer's research.
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