Subcortical gray matter volumes and 5-year dementia risk in individuals with subjective cognitive decline or mild cognitive impairment: A multi-cohort analysis.

INTRODUCTION

The prognostic value of subcortical gray matter structures for dementia beyond the hippocampus remains unclear.

METHODS

We included participants with subjective cognitive decline or mild cognitive impairment from two memory clinic-based cohorts (Amsterdam Dementia Cohort and National Alzheimer's Coordinating Center) and one population-based cohort (Rotterdam Study). We assessed volumes of subcortical structures on magnetic resonance imaging and determined 5-year dementia risk using Cox models.

RESULTS

Of 7076 participants (mean age: 66-69 years, 58.8%-61.0% women; NSCC = 5425, NMCI = 1661), 622 developed dementia within 5 years. Smaller volumes of the hippocampus and amygdala were consistently associated with increased dementia risk, independent of other subcortical structures. Smaller hippocampal volume was predominantly associated with the clinical diagnosis of Alzheimer's disease, but the prognostic value did not differ by amyloid status.

DISCUSSION: Hippocampal and amygdalar volume are consistently associated with dementia risk in individuals with subjective cognitive decline or mild cognitive impairment, which may hold potential for personalized prognosis.

HIGHLIGHTS: Seven thousand seventy-six participants from three large longitudinal cohorts were followed for a maximum of 5 years. Hippocampal volume is associated with 5-year risk of dementia in subjective cognitive decline (SCD) or mild cognitive impairment (MCI). Amygdalar volume is associated with a 5-year risk of dementia in SCD or MCI. Stratifying by SCD and MCI revealed no consistent major differences.