Association of Indication for Hospitalization With Subsequent Amyloid Positron Emission Tomography and Magnetic Resonance Imaging Biomarkers
Author:
Sprung Juraj1ORCID, Laporta Mariana L1, Knopman David S2, Petersen Ronald C2, Mielke Michelle M34ORCID, Jack Clifford R5, Martin David P1, Hanson Andrew C4, Schroeder Darrell R4, Schulte Phillip J4, Przybelski Scott A4, Valencia Morales Diana J1ORCID, Weingarten Toby N1ORCID, Vemuri Prashanthi5ORCID, Warner David O1ORCID
Affiliation:
1. Department of Anesthesiology and Perioperative Medicine, Mayo Clinic , Rochester, Minnesota , USA 2. Department of Neurology, Mayo Clinic , Rochester, Minnesota , USA 3. Division of Epidemiology, Mayo Clinic , Rochester, Minnesota , USA 4. Department of Quantitative Health Sciences, Division of Clinical Trials and Biostatistics, Mayo Clinic , Rochester, Minnesota , USA 5. Department of Radiology, Mayo Clinic , Rochester, Minnesota , USA
Abstract
Abstract
Background
Hospitalization in older age is associated with accelerated cognitive decline, typically preceded by neuropathologic changes. We assess the association between indication for hospitalization and brain neurodegeneration.
Methods
Included were participants from the Mayo Clinic Study of Aging, a population-based longitudinal study, with ≥1 brain imaging available in those older than 60 years of age between 2004 and 2017. Primary analyses used linear mixed-effects models to assess association of hospitalization with changes in longitudinal trajectory of cortical thinning, amyloid accumulation, and white matter hyperintensities (WMH). Additional analyses were performed with imaging outcomes dichotomized (normal vs abnormal) using Cox proportional hazards regression.
Results
Of 2 480 participants, 1 966 had no hospitalization and 514 had ≥1 admission. Hospitalization was associated with accelerated cortical thinning (annual slope change −0.003 mm [95% confidence interval (CI) −0.005 to −0.001], p = .002), but not amyloid accumulation (0.003 [95% CI −0.001 to 0.006], p = .107), or WMH increase (0.011 cm3 [95% CI −0.001 to 0.023], p = .062). Interaction analyses assessing whether trajectory changes are dependent on admission type (medical vs surgical) found interactions for all outcomes. While surgical hospitalizations were not, medical hospitalizations were associated with accelerated cortical thinning (−0.004 mm [95% CI −0.008 to −0.001, p = .014); amyloid accumulation (0.010, [95% CI 0.002 to 0.017, p = .011), and WMH increase (0.035 cm3 [95% CI 0.012 to 0.058, p = .006). Hospitalization was not associated with developing abnormal cortical thinning (p = .407), amyloid accumulation (p = .596), or WMH/infarctions score (p = .565).
Conclusions
Medical hospitalizations were associated with accelerated cortical thinning, amyloid accumulation, and WMH increases. These changes were modest and did not translate to increased risk for crossing the abnormality threshold.
Funder
National Institutes of Health Mayo Clinic Center for Clinical and Translational Science National Center for Advancing Translational Sciences
Publisher
Oxford University Press (OUP)
Subject
Geriatrics and Gerontology,Aging
Reference49 articles.
1. Association of hospitalization with long–term cognitive trajectories in older adults;Sprung;J Am Geriatr Soc,2021 2. Patterns of cognitive change in elderly patients during and 6 months after hospitalisation: a prospective cohort study;Chen;Int J Nurs Stud,2011 3. Hospitalization, Alzheimer’s disease and related neuropathologies, and cognitive decline;James;Ann Neurol,2019 4. Association of hospitalization, critical illness, and infection with brain structure in older adults;Walker;J Am Geriatr Soc,2018 5. Association of hospitalization with long-term cognitive and brain MRI changes in the ARIC cohort;Brown;Neurology,2015
|
|