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Brain atrophy can predict further cognitive decline in Alzheimer’s disease

March 27, 2012
Researchers from the Alzheimer Center, VU University Medical Center in Amsterdam, the Netherlands, have found a way to predict clinical progression of Alzheimer’s disease in subjects in the predementia stage. Patients with mild memory problems, who had brain atrophy on MRI scan or a high level of tau protein in cerebrospinal fluid showed more rapid cognitive decline than subjects without this shrinkage of the brain. The study is published in The Journal of Alzheimer’s Disease 29:2.

Alzheimer’s disease starts with mild cognitive impairment, typically memory impairment. The time between mild cognitive impairment and progression to dementia is however highly variable, ranging from a few months up to 10 years. Researchers from the Alzheimer Center of the VU University Medical Center have now demonstrated that time to dementia in subjects with mild cognitive impairment can be predicted with biomarkers.

This study included 91 patients who exhibited mild cognitive impairment at baseline and all progressed to dementia during follow up. At baseline the volume of the hippocampus, a specific brain structure involved in memory, was measured with an MRI scan. Also a lumbar puncture was performed to measure proteins in the cerebrospinal fluid.

Patients who already had shrinkage of the hippocampus at baseline progressed to dementia more rapidly. Also a high level of tau protein in the cerebrospinal fluid predicted rapid decline to dementia. Other known risk factors for Alzheimer’s disease such as high age or a decrease of beta amyloid protein in the cerebrospinal fluid did not predict further progression of the disease.

These results show that the rate of cognitive decline in Alzheimer’s disease is related to specific brain abnormalities. While some markers of Alzheimer’s disease can be used to diagnose the disease in an early stage, others may be suitable for predicting further progression of the disease. However, before progression can be predicted for individual patients, further research is needed.

VUmc Alzheimer Center

VUmcAlzheimerCenterwas founded in 2000. TheVUmcAlzheimerCentercombines high-quality patient care with excellent research in the field of Alzheimer’s disease and other forms of dementia. It focuses on dementia among younger patients, who display symptoms before the age of 65. The yearly number of new patients that visit the biggestAlzheimerCenterin theNetherlandsis 600.

Note for the editorial staff:

For more information contact Caroline Arps at VU University Medical Center Communication Services, +31-(0)20-4443444, fax +31-(0)20-4443450. You can find details of VU University Medical Center press releases at

Background information (not for publication)

VU University Medical Center’s core business consists of patient care, scientific research, and education. Its pivotal points in care and research are cancer and immunity, the brain, movement, vital functions and extramural care. Each year 38,000 patients are admitted (including one-day admissions), well over 300,000 patients visit the Outpatients department and 40,000 arrive at the Accident and Emergency department. Approximately 2,000 medical students are in training here. Each year, VU University Medical Center produces around 2,000 scientific publications and reports based on the scientific research carried out here. This includes the results of thesis research projects being carried out by 100 PhD students.

VU University Medical Center is a member of the Dutch Federation of University Medical Centers (NFU). The NFU is a collaborative venture of the eight university medical centers (UMCs) in theNetherlands. Its overall objective is to promote the common interests of the UMCs. The other members of the NFU are the AMC (AcademicMedicalCenterinAmsterdam), azM (University Hospital Maastricht), Erasmus MC (University Medical Center Rotterdam), LUMC (LeidenUniversityMedicalCenter), UMCG (University Medical Center Groningen), UMC Utrecht (University Medical Center Utrecht) and UMC St Radboud (RadboudUniversityNijmegenMedicalCenter). A total of 60,000 staff are employed by the eight UMCs.