Structural and Microstructural Brain Changes Predict Impairment in Daily Functioning - 21/11/14
Abstract |
Background |
Brain changes on magnetic resonance imaging (MRI) reflect accumulating pathology and have clinically disabling consequences, such as dementia. However, little is known on the relation of these MRI markers with daily functioning in nondemented individuals. We investigated whether structural and microstructural brain changes are associated with impairment in activities of daily living in a community-dwelling population.
Methods |
Between 2005 and 2009, 2025 stroke-free nondemented participants (aged 59.9 years) from the population-based Rotterdam Study underwent brain MRI, yielding global MRI markers, focal MRI markers, and microstructural MRI markers. We used the Stanford Health Assessment Questionnaire to assess basic activities of daily living, and the Instrumental Activities of Daily Living Scale to assess instrumental activities of daily living. Follow-up on activities of daily living was obtained between 2008 and 2013 (mean follow-up 5.7 years). We used linear regression to analyze continuous scores of daily living and logistic regression for incident impairment.
Results |
Eighty-two participants became impaired in basic and 33 in instrumental activities of daily living. Smaller brain and hippocampal volume and higher diffusivity were associated with larger change in activities of daily living. Smaller brain volume (odds ratio [OR] 4.05 per SD; 95% confidence interval [CI], 1.81–9.02), larger white matter lesion volume (OR 1.33/SD; 95% CI 1.02–1.72) and higher mean (OR 1.55/SD; 95% CI, 1.11–2.15), axial (OR 1.49/SD; 95% CI, 1.08–2.07), and radial diffusivity (OR 1.51/SD; 95% CI, 1.09-2.10) were associated with higher risk of impairment in basic activities of daily living.
Conclusions |
In community-dwelling individuals, brain changes are associated with deterioration and incident impairment in daily functioning.
Le texte complet de cet article est disponible en PDF.Keywords : Activities of daily living, Brain, DTI, Epidemiology, MRI
Plan
| Funding: The Rotterdam Study is supported by the Erasmus Medical Centre and Erasmus University Rotterdam; The Netherlands Organization for Scientific Research (NWO); The Netherlands Organization for Health Research and Development (ZonMw); the Research Institute for Diseases in the Elderly (RIDE); The Netherlands Genomics Initiative; the Ministry of Education, Culture and Science; the Ministry of Health, Welfare and Sports; the European Commission (DG XII); and the Municipality of Rotterdam. |
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| Conflicts of Interest: WJN reports that the institution received payment for consultancy to Quantib BV, and that he is cofounder and shareholder of Quantib BV; AVDL reports that the institution received payment from GE HealthCare for lectures; the other authors report no conflicts of interest. |
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| Authorship: The manuscript represents original work and all authors meet criteria for authorship, including having access to the data, accepting responsibility for the scientific content of the manuscript, and a significant role in writing the manuscript. |
Vol 127 - N° 11
P. 1089 - novembre 2014 Retour au numéro
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