Memory complaints associated with structural brain abnormalities and increased dementia risk

People with subjective memory complaints may have structural brain abnormalities that make them more susceptible to greater cognitive decline, MRIs show. 

Experts recently analyzed MRI brain scans of 900 participants and found that white matter hyperintensity volumes were significantly higher in those who displayed memory impairment on cognitive assessments and personal questionnaires. These findings were found to be associated with faster cognitive decline. Experts involved in the study suggested that their findings could be utilized to further investigate the manifestations of neurodegenerative diseases, such as Alzheimer dementia

“Alzheimer dementia has a long prodromal phase, providing a critical time window for potential interventions to successfully postpone or prevent the disease’s onset,” corresponding author Anisa Dhana, MD, from the Rush Institute for Healthy Aging at Rush University Medical Center in Chicago, and co-authors explained. “Therefore, it is a public health priority to identify people at very early stages of cognitive impairment and consequently to prevent or postpone neurodegenerative diseases.” 

Research over the last several years has indicated that people who show no obvious signs of cognitive decline can still go on to develop dementia. But something that has been found to be a common theme in many of these individuals is their concerns regarding subjective memory. People who report subjective memory complaints (SMCs) are at a higher risk of faster cognitive decline and incidental dementia, the authors explained.

Studies have investigated the associations of SMCs and brain structure, but most have been lacking in age and ethnically diverse cohorts, especially pertaining to African Americans. This inhibits researchers’ abilities to identify those who may be most at risk of cognitive decline and, therefore, hinders early intervention efforts. 

In this study, experts analyzed the MRI brain scans of 900 individuals, nearly 60% of whom were African American, with an average age of 79.5. In participants who reported feeling very concerned about their subjective memory, higher white matter hyperintensity (WMH) volumes were observed. Experts shared that those individuals had 174% faster cognitive decline based on follow-up exams compared to patients who expressed no concerns with their memory. Cognitive decline was found to have significant associations with large WMH volumes, but experts reported they did not uncover any information that would lead them to believe that age, sex, or race and ethnicity had any varying correlation with these volumes or cognitive impairment. 

“These findings may suggest that SMCs could originate from different neural mechanisms, but when they coexist with larger WMH volumes, SMCs are an important sign that may indicate cognitive impairment in older adults,” the authors wrote. “When both are present in an individual, they may have a synergistic effect that significantly increases the risk of cognitive decline.” 

The detailed study can be viewed in JAMA Network Open

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In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She joined Innovate Healthcare in 2021 and has since put her unique expertise to use in her editorial role with Health Imaging.

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