Abstract

Well-established literature indicates that older adults have poorer cerebral white matter integrity, as measured through diffusion tensor imaging (DTI). Age differences in DTI have been observed widely across white matter, although some tracts appear more sensitive to the effects of aging than others. Factors like APOE ε4 status and sex may contribute to individual differences in white matter integrity that also selectively impact certain tracts, and could influence DTI changes in aging. The present study explored the degree to which age, APOE ε4, and sex exerted global vs. tract specific effects on DTI metrics in cognitively healthy late middle-aged to older adults. Data from 49 older adults (ages 54–92) at two time-points separated by approximately 2.7 years were collected. DTI metrics, including fractional anisotropy (FA) and mean diffusivity (MD), were extracted from nine white matter tracts and global white matter. Results showed that across timepoints, FA and MD increased globally, with no tract-specific changes observed. Baseline age had a global influence on both measures, with increasing age associated with lower FA and higher MD. After controlling for global white matter FA, age additionally predicted FA for the genu, callosum body, inferior fronto-occipital fasciculus (IFOF), and both anterior and posterior cingulum. Females exhibited lower global FA on average compared to males. In contrast, MD was selectively elevated in the anterior cingulum and superior longitudinal fasciculus (SLF), for females compared to males. APOE ε4 status was not predictive of either measure. In summary, these results indicate that age and sex are associated with both global and tract-specific alterations to DTI metrics among a healthy older adult cohort. Older women have poorer white matter integrity compared to older men, perhaps related to menopause-induced metabolic changes. While age-related alterations to white matter integrity are global, there is substantial variation in the degree to which tracts are impacted, possibly as a consequence of tract anatomical variability. The present study highlights the importance of accounting for global sources of variation in DTI metrics when attempting to investigate individual differences (due to age, sex, or other factors) in specific white matter tracts.

Highlights

  • Cerebral white matter undergoes multiple changes throughout healthy aging

  • We investigated the influence of age, Apolipoprotein E (APOE) ε4 status, and sex on white matter microstructure by examining changes in diffusion tensor imaging (DTI) metrics across two time-points separated by an average of 2.7 years

  • The results of this study provide evidence of a complex pattern of global and tract-specific white matter differences influenced by time, baseline age, and sex, but not APOE ε4 status, on fractional anisotropy (FA) and mean diffusivity (MD) metrics

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Summary

Introduction

Dysmyelination, axonal degeneration, ischemia, and inflammatory processes associated with aging may compromise the structural integrity of axonal fibers within cerebral white matter bundles (Peters, 2009). Increasing age is typically associated with higher MD and lower FA (Lebel et al, 2012; Cox et al, 2016; Storsve et al, 2016; for review, see Madden et al, 2009), likely reflecting the impact of a combination of age-related phenomena including dysmyelination, glial-induced inflammatory activity, dysfunctional glial clearance of extracellular debris, axonal degeneration, and ischemic injury (Peters, 2009; Raj et al, 2017; Chapman and Hill, 2020)

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