Hospitalization Tied to Brain Abnormalities in Older Adults
MONDAY, Oct. 15, 2018 -- Hospitalization is associated with lower white matter integrity among older adults, according to a study published online Sept. 24 in the Journal of the American Geriatrics Society.
Keenan A. Walker, Ph.D., from Johns Hopkins University in Baltimore, and colleagues conducted a prospective cohort study involving a community sample of adults aged 44 to 66 years at baseline. Hospitalization information on all 1,689 participants was obtained over a 24-year surveillance period. To quantify total and regional brain volumes, white matter hyperintensity (WMH) volume, and white matter microstructural integrity, a subset of participants underwent 3-Tesla brain magnetic resonance imaging.
The researchers found that during the surveillance period, 72 percent of participants were hospitalized and 14 and 4 percent had a major infection and a critical illness, respectively. Compared with no hospitalization, hospitalization was correlated with 0.12-standard deviation (SD) greater WMH volume and poorer white matter microstructural integrity (0.17-SD lower fractional anisotropy; 0.16-SD greater mean diffusivity). A dose-dependent relationship was seen between the number of hospitalizations, smaller brain volumes, and lower white matter integrity. Critical illness was correlated with smaller Alzheimer's disease (AD) signature regions in hospitalized participants (−1.64 cm³); major infection was correlated with smaller AD signature region (−1.28 cm³) and larger ventricular volume (3.79 cm³).
"By demonstrating an association between hospitalized events and abnormalities in brain structure, our results highlight the potential role of hospitalization, critical illness, and infection in the pathological processes underlying cognitive decline and neurodegenerative disease," the authors write.
Two authors disclosed financial ties to the pharmaceutical and medical device industries.
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Posted: October 2018