OBSERVATIONAL LONGITUDINAL STUDY OF BRAIN MRI CHARACTERISTICS AND CLINICAL MEASURES OF FUNCTION AND DISEASE PROGRESSION IN PATIENTS WITH DEMENTIA

Abstract

Longitudinal brain magnetic resonance imaging (MRI) has shown that changes in white matter and medial temporal atrophy are biomarkers of Alzheimer's disease (AD); however, the correlation with MRI findings and progression of AD has not been fully established. In this prospective, 12-month observational study, consecutive dementia outpatients were recruited from 29 centers across South Korea. Baseline assessments included confirmation of AD (brain MRI data), cognitive function, dementia severity, activities of daily living (ADL), and AD medication use. Follow-up assessments were conducted at 6 and 12 months. Among the 899 enrolled patients with dementia, 748 were diagnosed with AD based on MRI assessment; 654 (87%) were using AD medications. In AD patients, changes in cognitive deficit were not correlated with changes in white matter on brain MRI and changes in IADL, but not other cognitive function, correlated with the changes in hippocampal atrophy on brain MRI. These results were more prominent in untreated group. Positive drinking status and higher CDR score were correlated with more severe white matter changes and age, dementia family history, physical exercise, and the results of neuropsychological assessment were correlated with hippocampal atrophy. We confirmed that there is a relationship between the loss of hippocampal volume in MRI and changes in IADL decline with AD patients, especially untreated group, and showed that patient's lifestyle behaviors are more important than non-modifiable factors in the progression of the MRI findings in this study.