BMC medicine · 2025
Risk and protective factors associated with brain grey matter patterns in a population-based cohort of cognitively unimpaired 70 years old.
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Lorenzon Giulia, Marseglia Anna, Poulakis Konstantinos, Imbimbo Camillo, Rydén Lina, Galaris Evangelos, Lindberg Olof, Shams Sara, Mohanty Rosaleena, Ferreira Daniel, Kivipelto Miia, Eriksdotter Maria, Kern Silke, Skoog Ingmar, Westman Eric
Аннотация
BACKGROUND: Ageing involves heterogeneous brain grey matter (GM) patterns that may overlap with dementia-related changes. We evaluated cognitively unimpaired older adults to identify specific GM patterns, their clinical and cognitive profiles, and longitudinal trajectories.
METHODS: We analysed 746 participants from the Gothenburg H70 study using random forest cross-sectional clustering based on MRI measures of cortical thickness and subcortical volume across 41 regions. Using regression-based models, we examined associations with clinical, MRI variables, biochemical, and CSF Alzheimer biomarkers (n = 286) and assessed 5-year longitudinal cognitive and brain trajectories.
RESULTS: Five clusters emerged, mainly differing in frontoparietal regions. Compared to Cluster 1 (reference), Cluster 2 showed diffuse GM loss, higher odds of diabetes (OR = 2.54, 95% CI [1.27-5.06]) and at-risk alcohol consumption (OR = 1.83, 95% CI [1.13-2.97]), poorer episodic memory (β = - 0.19, p = 0.014) and visuospatial abilities (β = - 0.21, p = 0.044), and greater longitudinal decline in MMSE (βslope = - 0.45, p = 0.035) and increase in white matter hyperintensity volume (βslope = 1.84, p = 0.004). Cluster 3 showed thicker GM and lower BMI (OR = 0.57, 95% CI [0.35-0.94]). Cluster 4 had preserved GM, lower smoking habits (OR = 0.62, 95% CI [0.40-0.95]), triglyceride levels (OR = 0.55, 95% CI [0.32-0.95]) and depression (OR = 0.17, 95% CI [0.05-0.56]), higher education (OR = 2.52, 95% CI [1.08-5.87]), and better cognition in multiple domains. Cluster 5 had a mixed GM pattern and higher odds of heart disease (OR = 3.44, 95% CI [1.48-8.01]).
CONCLUSIONS: Cardiovascular and psychosocial factors influence GM integrity, which in turn relates to cognition. Targeting these risk factors may preserve brain health in late life.
METHODS: We analysed 746 participants from the Gothenburg H70 study using random forest cross-sectional clustering based on MRI measures of cortical thickness and subcortical volume across 41 regions. Using regression-based models, we examined associations with clinical, MRI variables, biochemical, and CSF Alzheimer biomarkers (n = 286) and assessed 5-year longitudinal cognitive and brain trajectories.
RESULTS: Five clusters emerged, mainly differing in frontoparietal regions. Compared to Cluster 1 (reference), Cluster 2 showed diffuse GM loss, higher odds of diabetes (OR = 2.54, 95% CI [1.27-5.06]) and at-risk alcohol consumption (OR = 1.83, 95% CI [1.13-2.97]), poorer episodic memory (β = - 0.19, p = 0.014) and visuospatial abilities (β = - 0.21, p = 0.044), and greater longitudinal decline in MMSE (βslope = - 0.45, p = 0.035) and increase in white matter hyperintensity volume (βslope = 1.84, p = 0.004). Cluster 3 showed thicker GM and lower BMI (OR = 0.57, 95% CI [0.35-0.94]). Cluster 4 had preserved GM, lower smoking habits (OR = 0.62, 95% CI [0.40-0.95]), triglyceride levels (OR = 0.55, 95% CI [0.32-0.95]) and depression (OR = 0.17, 95% CI [0.05-0.56]), higher education (OR = 2.52, 95% CI [1.08-5.87]), and better cognition in multiple domains. Cluster 5 had a mixed GM pattern and higher odds of heart disease (OR = 3.44, 95% CI [1.48-8.01]).
CONCLUSIONS: Cardiovascular and psychosocial factors influence GM integrity, which in turn relates to cognition. Targeting these risk factors may preserve brain health in late life.