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MRI Markers Predict Cognitive Decline Assessed by Telephone Interview: The Northern Manhattan Study

Wright, Clinton B. MD, MS; Dong, Chuanhui PhD; Caunca, Michelle R. BS; DeRosa, Janet MPH; Kuen Cheng, Ying PhD; Rundek, Tatjana MD, PhD; Elkind, Mitchell S.V. MD, MS; DeCarli, Charles MD; Sacco, Ralph L. MD, MS

Alzheimer Disease & Associated Disorders: January-March 2017 - Volume 31 - Issue 1 - p 34–40
doi: 10.1097/WAD.0000000000000158
Original Articles

Background: Brain magnetic resonance imaging (MRI) allows researchers to observe structural pathology that may predict cognitive decline. Some populations are less accessible through traditional in-person visits, and may be under-represented in the literature.

Methods: We examined white matter hyperintensity volume (WMHV) and cerebral parenchymal fraction (CPF) as predictors of cognitive decline measured by a modified Telephone Interview for Cognitive Status (TICS-m) in the Northern Manhattan Stroke Study, a racially and ethnically diverse cohort study. Participants were stroke-free, above 50 years old, and had no contraindications to MRI. A total of 1143 participants had MRI and TICS-m data available [mean age 70 (SD=9), 61% women, 66% Hispanic, 17% Black, 15% white].

Results: Those in the third and fourth quartiles of WMHV had significantly greater decline in TICS-m over time as compared with those in the first quartile (Q3: −0.17 points/year, Q4: −0.30 points/year). Those in the bottom 2 quartiles of CPF had significantly greater decline in TICS-m than those in the top quartile (Q1: −0.3 points/year, Q2: −0.2 points/year). Apolipoprotein E (APOE) e4 allele carriers had greater cognitive decline per unit of CPF. Those with greater CPF preserve TICS-m performance better despite greater WMHV.

Conclusions: Telephone cognitive assessments can detect decline due to white matter lesions and smaller brain volumes.

Supplemental Digital Content is available in the text.

*Evelyn F. McKnight Brain Institute

Departments of Neurology

Public Health Sciences, Leonard M. Miller School of Medicine, University of Miami, Miami, FL

Departments of §Epidemiology

Biostatistics, Mailman School of Public Health

Department of Neurology, College of Physicians and Surgeons of Columbia University, New York, NY

#Department of Neurology and Center for Neuroscience, University of California, Davis, Sacramento, CA

C.B.W.: study concept and design; study supervision; acquisition of data; analysis and interpretation of data; critical revision of the manuscript for important intellectual content. C.D.: study concept and design; statistical analysis; analysis and interpretation of data; drafting of the manuscript; critical revision of the manuscript for important intellectual content. M.R.C.: analysis and interpretation of data; drafting of the manuscript; critical revision of the manuscript for important intellectual content. J.D.: analysis and interpretation of data; drafting of the manuscript; critical revision of the manuscript for important intellectual content. Y.K.C.: analysis and interpretation of data; drafting of the manuscript; critical revision of the manuscript for important intellectual content. T.R.: critical revision of the manuscript for important intellectual content; obtained funding. M.S.V.E.: acquisition of data; critical revision of the manuscript for important intellectual content; obtained funding. C.D.: acquisition of data; critical revision of the manuscript for important intellectual content. R.L.S: acquisition of data; critical revision of the manuscript for important intellectual content; obtained funding.

C.B.W. receives federal grant support (K02 NS 059729, R01 HL 108623, SPRINT MRI WFUHS 330214, R01 NS 29993) and private foundation support (American Heart Association Bugher Center project 14BFSC17690003). He receives royalties from UpToDate for 2 vascular dementia chapters. M.S.V.E. receives compensation for providing consultative services for BioTelemetry/Cardionet, BMS-Pfizer Partnership, Boehringer-Ingelheim, Daiichi-Sankyo, Janssen Pharmaceuticals, and Sanofi-Regeneron Partnership; receives research support from diaDexus Inc., Bristol-Myers Squibb/Sanofi Pharmaceuticals Partnership, and the NIH/NINDS; has given expert legal opinions on behalf of Organon (NuvaRing and stroke litigation) and Hi-Tech; and serves on the National, Founders Affiliate, and New York City chapter boards of the American Heart Association/American Stroke Association. He receives royalties from UpToDate for chapters related to stroke. D.C. receives federal grant support (P30 AG010129) and is a consultant of Novartis pharmaceuticals. R.L.S. receives federal grant support (R01 NS 29993), private foundation support (American Heart Association Bugher Center), and pharma research support (Boehringer Ingelheim). The remaining authors declare no conflicts of interest.

Reprints: Clinton B. Wright, MD, MS, Evelyn F. McKnight Brain Institute, Miller School of Medicine, University of Miami, 1120 NW 14th Street, CRB 1349, Miami, FL 33136 (e-mail: c.wright21@med.miami.edu).

Received March 7, 2016

Accepted May 19, 2016

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