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Article type: Research Article
Authors: Hirose, Daisukea; * | Shimizu, Soichiroa | Hirao, Kentaroa | Ogawa, Yusukea | Sato, Tomohikoa | Kaneko, Yoshitsugua | Takenoshita, Naotoa | Namioka, Nayutaa | Fukasawa, Raitaa | Umahara, Takahikoa | Sakurai, Hirofumia | Watanabe, Ryob | Hanyu, Haruoa
Affiliations: [a] Department of Geriatric Medicine, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan | [b] Kanagawa University of Human Services, Yokosuka City, Kanagawa Prefecture, Japan
Correspondence: [*] Correspondence to: Daisuke Hirose, MD, Department of Geriatric Medicine, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan. Tel.: +81 3 3342 6111; Fax: +81 3 3342 2305; E-mail: [email protected].
Abstract: Background/Objective:Although frailty is closely linked to dementia, particularly Alzheimer’s disease (AD), underlying pathophysiology of frailty associated with AD remains uncertain. This study aimed to investigate differences in structural and functional brain imaging abnormalities between AD with and without frailty. Methods:A total of 191 outpatients with probable AD (men: 91; women: 100; age: 80.7±6.3 years) who underwent both magnetic resonance imaging (MRI) and single-photon emission computed tomography (SPECT) were enrolled in this study. Frailty was determined in accordance with the Obu study Health Promotion for the Elderly. We compared numbers of small infarctions in the subcortical gray and white matter and severity of white matter abnormalities (periventricular hyperintensity [PVH] and deep white matter hyperintensity [DWMH]) on MRI, and regional cerebral blood flow (rCBF) changes on SPECT between AD with and without frailty. Results:The prevalence of frailty was 43.4% in patients with AD. PVH and DWMH scores were significantly higher in AD with frailty compared to those without frailty. AD with frailty had a trend of decreased rCBF in the bilateral anterior cingulate gyrus, whereas those without frailty tend to have decreased rCBF in the left dominant parietal lobe and precuneus. Conclusion:Our MRI and SPECT imaging studies suggest different underlying pathophysiology in the brain between AD with frailty and without frailty.
Keywords: Alzheimer’s disease, frailty, magnetic resonance imaging, single-photon emission computed tomography
DOI: 10.3233/JAD-180701
Journal: Journal of Alzheimer's Disease, vol. 67, no. 4, pp. 1201-1208, 2019
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