Brain Age Tied to Dementia Risk in Those With Memory Issues

TOPLINEAn automated MRI-derived brain age measure, brain-predicted age difference (brain-PAD), predicted progression to dementia and improved risk prediction beyond routine visual MRI ratings mainly in patients with subjective cognitive decline (SCD). Added value was inconsistent in patients with mild cognitive impairment (MCI).METHODOLOGYResearchers conducted a retrospective cohort study to assess whether an automated MRI measure of brain age (brain-PAD) predicted progression to dementia and added value beyond routine visual MRI ratings in patients with SCD or MCI.They used data from the Amsterdam Dementia Cohort and the SCIENCe project and included 799 patients from memory clinics (mean age, 63.3 years; 39.4% women). Of them, 412 had SCD and 387 had MCI.Brain-PAD was calculated as the difference between MRI-estimated brain age (using two pretrained methods) and chronologic age. Additional assessments included visual rating of atrophy and other relevant clinical data.Researchers assessed progression to dementia over up to 10 years, with a median follow-up duration of 3.2 years.TAKEAWAYBrain-PAD was associated with an increased risk for progression to dementia (adjusted hazard ratio [aHR], 1.06 per year; P < .001) and remained significant (although slightly reduced) after adjustment for visual MRI ratings (aHR, 1.04; P = .003).In patients with SCD, brain-PAD was associated with a 9% increased risk for dementia per year (aHR, 1.09; P = .003), and this association persisted after adjusting for visual ratings and amyloid status (P < .05 for both).In patients with MCI, brain-PAD did not add predictive value beyond visual MRI ratings using one pretrained method (BrainageR). With the cNeuro method, brain-PAD remained a significant predictor in MCI.A data-driven brain-PAD cutoff of -2.6 years in patients with SCD yielded a negative predictive value exceeding 90% over 10 years, suggesting that lower brain age was strongly associated with remaining dementia-free.IN PRACTICE"Although further validation is required, our findings highlight the potential of brain-PAD as a sensitive, automated complement to assessment of visual rating scales for identifying individuals at a risk of progressing to dementia," the authors of the study wrote.SOURCEThe study was led by Stefan De Vries, Amsterdam UMC in Amsterdam, Netherlands. It was published online on August 10 in Neurology.LIMITATIONSThe cohort mainly consisted of younger patients, which may have limited generalizability to older individuals at risk for dementia. Most patients developed Alzheimer disease dementia, limiting the assessment of prognostic value of brain-PAD for other dementia types. Visual rating scales may not have reflected the MRI evaluation by a trained radiologist.DISCLOSURESThe collaboration project was co-funded by the PPP Allowance made available by Health-Holland, Top Sector Life Sciences & Health. Alzheimer Center Amsterdam was supported by Stichting Alzheimer Nederland and Stichting Steun Alzheimercentrum Amsterdam. The SCIENCe project received funding from Houbolt stichting and Noaber foundation. Several authors reported receiving grants, consulting fees, or research support from pharmaceutical companies and other organizations. Detailed author disclosures are reported in the original article.This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.