Comparison of the clinical value of MRI and plasma markers for cognitive impairment in patients aged ≥75 years: a retrospective study

Background: Dementia has become the main cause of disability in older adults aged & GE;75 years. Cerebral small vessel disease (CSVD) is involved in cognitive impairment (CI) and dementia and is a cause of vascular CI (VCI), which is manageable and its onset and progression can be delayed. Simple and effective markers will be beneficial to the early detection and intervention of CI. The aim of this study is to investigate the clinical application value of plasma amyloid (31-42 (A(342), phosphorylated tau 181 (p-tau181) and conventional structural magnetic resonance imaging (MRI) parameters for cognitive impairment (CI) in patients aged & GE;75 years.Methods: We retrospectively selected patients who visited the Affiliated Hospital of Xuzhou Medical University and were clinically diagnosed with or without cognitive dysfunction between May 2018 and November 2021. Plasma indicators (A(342 and p-tau181) and conventional structural MRI parameters were collected and analyzed. Multivariate logistic regression and receiver operator characteristic (ROC) curve were used to evaluate the diagnostic value.Results: One hundred and eighty-four subjects were included, including 54 cases in CI group and 130 cases in noncognitive impairment (NCI) groups, respectively. Univariate logistic regression analysis revealed that the percentages of A(342+, P-tau 181+, and A(342+/P-tau181+ showed no significant difference between the groups of CI and NCI (all P > 0.05). Multivariate logistic regression analysis showed that moderate/severe periventricular WMH (PVWMH) (OR 2.857, (1.365-5.983), P = 0.005), lateral ventricle body index (LVBI) (OR 0.413, (0.243-0.700), P = 0.001), and cortical atrophy (OR 1.304, (1.079-1.575), P = 0.006) were factors associated with CI. The combined model including PVWMH, LVBI, and cortical atrophy to detect CI and NCI showed an area under the ROC curve (AUROC) is 0.782, with the sensitivity and specificity 68.5% and 78.5%, respectively.Conclusion: For individuals & GE;75 years, plasma A(342 and P-tau181 might not be associated with cognitive impairment, and MRI parameters, including PVWMH, LVBI and cortical atrophy, are related to CI. The cognitive statuses of people over 75 years old were used as the endpoint event in this study. Therefore, it can be considered that these MRI markers might have more important clinical significance for early assessment and dynamic observation, but more studies are still needed to verify this hypothesis.

Automated summary

This study investigates the clinical application value of plasma amyloid (31-42), phosphorylated tau 181, and MRI parameters for cognitive impairment in older adults aged 75 and above. The results indicate that plasma markers are not significantly associated with cognitive impairment, while periventricular WMH, lateral ventricle body index, and cortical atrophy are related to cognitive impairment. The study suggests that MRI parameters have important clinical significance for early assessment and dynamic observation.