• Taro Nakazawa, Tomoyuki Ohara, Naoki Hirabayashi, Yoshihiko Furuta, Jun Hata, Mao Shibata, Takanori Honda, Takanari Kitazono, Tomohiro Nakao, and Toshiharu Ninomiya.
• Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
• J. Neurol. Neurosurg. Psychiatr. 2022 Mar 1; 93 (3): 263-271.

ObjectiveTo assess the association of regional grey matter atrophy with dementia risk in a general older Japanese population.MethodsWe followed 1158 dementia-free Japanese residents aged ≥65 years for 5.0 years. Regional grey matter volume (GMV) at baseline was estimated by applying voxel-based morphometry methods. The GMV-to-total brain volume ratio (GMV/TBV) was calculated, and its association with dementia risk was estimated using Cox proportional hazard models. We assessed whether the predictive ability of a model based on known dementia risk factors could be improved by adding the total number of regions with grey matter atrophy among dementia-related brain regions, where the cut-off value for grey matter atrophy in each region was determined by receiver operating characteristic curves.ResultsDuring the follow-up, 113 participants developed all-cause dementia, including 83 with Alzheimer's disease (AD). Lower GMV/TBV of the medial temporal lobe, insula, hippocampus and amygdala were significantly/marginally associated with higher risk of all-cause dementia and AD (all p for trend ≤0.08). The risks of all-cause dementia and AD increased significantly with increasing total number of brain regions exhibiting grey matter atrophy (both p for trend <0.01). Adding the total number of regions with grey matter atrophy into a model consisting of known risk factors significantly improved the predictive ability for AD (Harrell's c-statistics: 0.765-0.802; p=0.02).ConclusionsOur findings suggest that the total number of regions with grey matter atrophy among the medial temporal lobe, insula, hippocampus and amygdala is a significant predictor for developing dementia, especially AD, in the general older population.© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ.

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