Roger T. Staff, PhD, Alison D. Murray,w Trevor Ahearn, PhD,z Sima Salarirad, MB,§
Donald Mowat, MB,k John M. Starr, MB,# Ian J. Deary, PhD,ww Helen Lemmon, MA,k and
Lawrence J. Whalley, MD
OBJECTIVES: To test the prediction of survival using
magnetic resonance imaging (MRI)–derived global and regional
brain volumes in subjects aged 78 to 79 without
dementia.
DESIGN: Observational follow-up study.
SETTING: University teaching hospital.
PARTICIPANTS: Participants born in 1921, recruited in
1997/98 to a longitudinal study, who underwent brain MRI
in 1999/2000.
MEASUREMENTS: Vital status on May 12, 2006, global
and regional brain volumes.
RESULTS: Thirty-seven of 98 (34.9%) participants died
during follow-up. After adjustment for cognitive ability at
time ofMRI examination, childhood intelligence, sex, hypertension,
smoking history, obesity, hyperlipidemia, and age at
MRI, proportion of intracranial volume occupied by the
brain (brain fraction) predicted death before age 85
(P5.04). Participants with brain fraction less than 0.726
had more than twice the relative risk (2.8, 95% confidence
interval51.1–7.3) of death than participants with brain
fraction greater 0.726. Lower survival was significantly associated
with lower gray matter volumes in bilateral parietal
and left frontoparietal areas and with lower white matter
volumes in left parietal and right posterior temporal regions.
Cox regression analysis showed that parietal white matter
volume (P5.003), a subsequent diagnosis of dementia
(Po.001), and sex (P5.004) were independent predictors
of survival.
Donald Mowat, MB,k John M. Starr, MB,# Ian J. Deary, PhD,ww Helen Lemmon, MA,k and
Lawrence J. Whalley, MD
OBJECTIVES: To test the prediction of survival using
magnetic resonance imaging (MRI)–derived global and regional
brain volumes in subjects aged 78 to 79 without
dementia.
DESIGN: Observational follow-up study.
SETTING: University teaching hospital.
PARTICIPANTS: Participants born in 1921, recruited in
1997/98 to a longitudinal study, who underwent brain MRI
in 1999/2000.
MEASUREMENTS: Vital status on May 12, 2006, global
and regional brain volumes.
RESULTS: Thirty-seven of 98 (34.9%) participants died
during follow-up. After adjustment for cognitive ability at
time ofMRI examination, childhood intelligence, sex, hypertension,
smoking history, obesity, hyperlipidemia, and age at
MRI, proportion of intracranial volume occupied by the
brain (brain fraction) predicted death before age 85
(P5.04). Participants with brain fraction less than 0.726
had more than twice the relative risk (2.8, 95% confidence
interval51.1–7.3) of death than participants with brain
fraction greater 0.726. Lower survival was significantly associated
with lower gray matter volumes in bilateral parietal
and left frontoparietal areas and with lower white matter
volumes in left parietal and right posterior temporal regions.
Cox regression analysis showed that parietal white matter
volume (P5.003), a subsequent diagnosis of dementia
(Po.001), and sex (P5.004) were independent predictors
of survival.
CONCLUSION:
global brain fraction predicted survival to approximately
age 85. Smaller regional volumetric brain reductions, seen
in Alzheimer’s disease (AD), also predicted survival independent
of dementia. The presence of prodromal AD probably
explain the main findings.
695, 2010.
In participants aged 78 to 79, a lowerJ Am Geriatr Soc 58:688– Key words: survival; structural MRI; dementia; risk
factors
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