HOME HELP FEEDBACK SUBSCRIPTIONS ALL ISSUES SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a Colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Cook, I. A. Articles by Rosenberg, S. Search for Related Content PubMed PubMed Citation Articles by Cook, I. A. Articles by Rosenberg, S.

Longitudinal Progression of Subclinical Structural Brain Disease in Normal Aging

Received November 21, 2002; revised January 21, 2003; accepted September 4, 2003. From the UCLA Neuropsychiatric Institute and the Department of Psychiatry and Biobehavioral Sciences, UCLA School of Medicine, Los Angeles, CA. Send correspondence to Dr. Cook, UCLA NPI&H, 760 Westwood Plaza, Los Angeles, CA 90024-1759. e-mail: icook{at}ucla.edu
© 2004 American Association for Geriatric Psychiatry

Objective: The authors describe four types of brain structural change in "normal aging:" cortical atrophy, central atrophy, deep white-matter hyperintensities (DWMH), and periventricular hyperintensities (PVH). Cross-sectional investigations have reported that greater volumes of these forms of "subclinical structural brain disease" (SSBD) were found with increasing age. Greater volumes were also associated with poorer cognition, even though subjects performed within the normal range. The natural history of these forms of SSBD and their functional impact are not well established. Methods: Twenty-nine normal subjects, ages 60–89, were examined longitudinally by volumetric magnetic resonance imagery, with two assessments performed at least 2 years apart; 26 also completed neuropsychological testing to evaluate processing speed, executive functions, language, and other cognitive functions. Associations between structure and function were evaluated with regression models. Results: For most subjects, the volumes for signs of all types of SSBD were found to have increased; for many subjects, increases were small, and a few showed no change or small decreases. PVH and DWMH increases were predicted by baseline cerebrovascular risk factors. Cognitive test performance changed little over time for these normal subjects. Conclusions: SSBD volumes increased for most subjects over time, with small average increases for most types. Pretreatment cerebrovascular risk factors were associated with greater increases of PVH and DWMH, suggesting that progression of these types of SSBD may be amenable to intervention.

Key Words: Depression • Primary Care • Medical Comorbidity • Normal Aging

This article has been cited by other articles:

				J. F. Karp, J. W. Shega, N. E. Morone, and D. K. Weiner Advances in understanding the mechanisms and management of persistent pain in older adults Br. J. Anaesth., July 1, 2008; 101(1): 111 - 120. [Abstract] [Full Text] [PDF]

				Y. W. Chen, M. E. Gurol, J. Rosand, A. Viswanathan, S. M. Rakich, T. R. Groover, S. M. Greenberg, and E. E. Smith Progression of white matter lesions and hemorrhages in cerebral amyloid angiopathy. Neurology, July 11, 2006; 67(1): 83 - 87. [Abstract] [Full Text] [PDF]

				J. Gunstad, R. H. Paul, A. M. Brickman, R. A. Cohen, M. Arns, D. Roe, J. J. Lawrence, and E. Gordon Patterns of cognitive performance in middle-aged and older adults: a cluster analytic examination. J Geriatr Psychiatry Neurol, June 1, 2006; 19(2): 59 - 64. [Abstract] [PDF]

				A. J. Ross, P. S. Sachdev, W. Wen, and H. Brodaty Longitudinal changes during aging using proton magnetic resonance spectroscopy. J. Gerontol. A Biol. Sci. Med. Sci., March 1, 2006; 61(3): 291 - 298. [Abstract] [Full Text] [PDF]

				D M J van den Heuvel, V H ten Dam, A J M de Craen, F Admiraal-Behloul, H Olofsen, E L E M Bollen, J Jolles, H M Murray, G J Blauw, R G J Westendorp, et al. Increase in periventricular white matter hyperintensities parallels decline in mental processing speed in a non-demented elderly population J. Neurol. Neurosurg. Psychiatry, February 1, 2006; 77(2): 149 - 153. [Abstract] [Full Text] [PDF]

				E Garde, E Lykke Mortensen, E Rostrup, and O B Paulson Decline in intelligence is associated with progression in white matter hyperintensity volume J. Neurol. Neurosurg. Psychiatry, September 1, 2005; 76(9): 1289 - 1291. [Abstract] [Full Text] [PDF]