Joint trajectories of brain atrophy, white matter hyperintensities and cognition quantify brain maintenance
Abstract
Abstract Brain maintenance – the preservation of brain structure or function relevant to cognitive performance – remains challenging to quantify. Here, we propose a domain-general brain maintenance index derived by jointly modelling the longitudinal co-evolution of ageing-related atrophy (via medial temporal lobe to ventricle ratio, MTLV-ratio), white matter hyperintensities (WMH), and global cognition assessed by the preclinical Alzheimer’s cognitive composite (PACC5) using latent growth curve modelling. We demonstrate its utility in 543 cognitively unimpaired older adults from the DELCODE cohort, followed annually over four years. We show that changes in MTLV-ratio and WMH additively predict cognitive change. We further show that higher neuroticism, depressive symptoms, lower openness, and faster biological ageing are related to unfavourable domain-specific trajectories and poorer brain maintenance. Our findings highlight the combined relevance of WMH and ageing-related atrophy dynamics for brain maintenance. Maintaining cerebrovascular and mental health alongside cognitive engagement could promote brain maintenance, delay cognitive decline and dementia.
Article Details
Authors (49)
Inga Menze
Jose Bernal
Rogier A. Kievit
Kumar Parijat Tripathi
Timo Kaleck
Renat Yakupov
Slawek Altenstein
Claudia Bartels
Katharina Buerger
Michaela Butryn
Peter Dechent
Michael Ewers
Klaus Fliessbach
Ingo Frommann
Maria Gemenetzi
Wenzel Glanz
Daria Gref
Julian Hellmann-Regen
Stefan Hetzer
Enise I. Incesoy
Daniel Janowitz
Ingo Kiliman
Luca Kleineidam
Marie Theres Kronmüller
Christoph Laske
Debora Melo van Lent
Falk Lüsebrink
Robert Perneczky
Oliver Peters
Lukas Preis
Josef Priller
Boris-Stephan Rauchmann
Ayda Rostamzadeh
Sandra Roeske
Klaus Scheffler
Björn-Hendrik Schott
Anja Schneider
Sebastian Sodenkamp
Annika Spottke
Eike Jakob Spruth
Melina Stark
Stefan Teipel
Michael Wagner
Jens Wiltfang
Frank Jessen
Alfredo Ramirez
Stefanie Schreiber
Emrah Düzel
Gabriel Ziegler