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Neurobiol Aging. 2008 May;29(5):676-92. Epub 2007 Jan 11.

Hippocampal hypometabolism predicts cognitive decline from normal aging.

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  • 1New York University School of Medicine, New York, NY 10016, USA.

Abstract

OBJECTIVE:

This longitudinal study used FDG-PET imaging to predict and monitor cognitive decline from normal aging.

METHODS:

Seventy-seven 50-80-year-old normal (NL) elderly received longitudinal clinical examinations over 6-14 years (561 person-years, mean per person 7.2 years). All subjects had a baseline FDG-PET scan and 55 subjects received follow-up PET exams. Glucose metabolic rates (MRglc) in the hippocampus and cortical regions were examined as predictors and correlates of clinical decline.

RESULTS:

Eleven NL subjects developed dementia, including six with Alzheimer's disease (AD), and 19 declined to mild cognitive impairment (MCI), on average 8 years after the baseline exam. The baseline hippocampal MRglc predicted decline from NL to AD (81% accuracy), including two post-mortem confirmed cases, from NL to other dementias (77% accuracy), and from NL to MCI (71% accuracy). Greater rates of hippocampal and cortical MRglc reductions were found in the declining as compared to the non-declining NL.

CONCLUSIONS:

Hippocampal MRglc reductions using FDG-PET during normal aging predict cognitive decline years in advance of the clinical diagnosis. Future studies are needed to increase preclinical specificity in differentiating dementing disorders.

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