Abstract
ObjectiveCognitive impairment is associated with reductions in brain weight and volume. The factors related to morphometric brain changes in cognitively normal aging remain unknown. We aimed to identify which clinical factors are associated with morphometric brain changes in cognitively normal aging.MethodsA cross-sectional study of 414 subjects, ≥50 years old submitted to clinical assessment and brain autopsy, after informed consent, was carried out at the São Paulo Autopsy Service, Brazil. Data on cognitive and functional evaluations were collected through structured interview applied to the next-of-kin. Brain weight (g) and volume (mL) measurements were obtained and adjusted for head circumference (cm). Associations between brain weight/volume and related factors were obtained through univariate and multivariate analysis.ResultsParticipants were predominantly male (60.4%), Caucasian (69%), with mean age of 67.1 ± 10.9 years. Mean brain weight was 1219.2 ± 140.9 g, and mean brain volume was 1217.1 ± 152.3 mL. Head circumference was independently associated with low brain weight (p<0.001) and volume (p<0.001). Total and adjusted brain weight and volume decreased in some conditions. Female gender (p<0.001), hypertension (p<0.009), coronary artery disease (p<0.013) and walking assistance (p<0.011) were associated with lower adjusted brain weight while schooling was associated with higher adjusted brain weight (p<0.003). Female gender (p<0.001), age (p<0.001) and hypertension (p<0.011) were associated with low adjusted brain volume.ConclusionMorphometric brain changes occur despite the absence of cognitive impairment and were predominantly associated with age, female gender, mobility impairment and cardiovascular conditions. Schooling may be a protective factor.
Highlights
Normal and pathological brain aging has attracted great interest, largely due to the major impact of changes resulting from neurodegenerative diseases on the lives of elderly, their families and health/social support network.Studies of morphometric brain changes have been conducted and have proven that during aging, changes in brain weight and volume occur
Some studies have sought to identify factors associated with morphometric brain changes during aging, the majority of which describe the association of specific factors with cognitive impairment or neurodegenerative diseases but not with brain aging.[24,25,26,27,28,29]
Subjects were included after the study procedures had been explained to the knowledgeable informant (KI) and they had agreed to participate by signing an Informed Consent Form (ICF)
Summary
Normal and pathological brain aging has attracted great interest, largely due to the major impact of changes resulting from neurodegenerative diseases on the lives of elderly, their families and health/social support network.Studies of morphometric brain changes have been conducted and have proven that during aging, changes in brain weight and volume occur. Some factors have been associated with brain aging[3,12,14,15,16,17,18,19,20,21,22,23] but the role of clinical, social and demographic factors in causing morphometric brain changes remains unknown. Some studies have sought to identify factors associated with morphometric brain changes during aging, the majority of which describe the association of specific factors with cognitive impairment or neurodegenerative diseases but not with brain aging.[24,25,26,27,28,29] Besides the identification of factors associated with dementia, it is necessary to understand factors related to normal brain aging. In 1988, Drayer[14] suggested that the changes occurring in normal aging brains should be thoroughly studied before analyzing abnormal brains
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