Global Cerebral Atrophy Detected by Routine Imaging: Relationship with Age, Hippocampal Atrophy, and White Matter Hyperintensities

Omar M. Al-Janabi, Pradeep Panuganti, Erin L. Abner, Ahmed A. Bahrani, Ronan Murphy, Shoshana H. Bardach, Allison Caban-Holt, Peter T. Nelson, Brian T. Gold, Charles D. Smith, Donna M. Wilcock, Gregory A. Jicha

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


BACKGROUND AND PURPOSE: Interpreting the clinical significance of moderate-to-severe global cerebral atrophy (GCA) is a conundrum for many clinicians, who visually interpret brain imaging studies in routine clinical practice. GCA may be attributed to normal aging, Alzheimer's disease (AD), or cerebrovascular disease (CVD). Understanding the relationships of GCA with aging, AD, and CVD is important for accurate diagnosis and treatment decisions for cognitive complaints. METHODS: To elucidate the relative associations of age, moderate-to-severe white matter hyperintensities (WMHs), and moderate-to-severe medial temporal lobe atrophy (MTA), with moderate-to-severe GCA, we visually rated clinical brain imaging studies of 325 participants from a community based sample. Logistic regression analysis was conducted to assess the relations of GCA with age, WMH, and MTA. RESULTS: The mean age was 76.2 (±9.6) years, 40.6% were male, and the mean educational attainment was 15.1 (±3.7) years. Logistic regression results demonstrated that while a 1-year increase in age was associated with GCA (OR = 1.04; P =.04), MTA (OR = 3.7; P <.001), and WMH (OR = 8.80; P <.001) were strongly associated with GCA in our study population. Partial correlation analysis showed that the variance of GCA explained by age is less than the variance attributed to MTA and WMH (r =.13,.21, and.43, respectively). CONCLUSIONS: Moderate-to-severe GCA is most likely to occur in the presence of AD or CVD and should not be solely attributed to age when evaluating clinical imaging findings in the workup of cognitive complaints. Developing optimal diagnostic and treatment strategies for cognitive decline in the setting of GCA requires an understanding of its risk factors in the aging population.

Original languageEnglish
Pages (from-to)301-306
Number of pages6
JournalJournal of Neuroimaging
Issue number3
StatePublished - May 1 2018

Bibliographical note

Funding Information:
Acknowledgments and Disclosure: This study was funded by NIH P30 AG028383, UH2 NS100606, NR014189, and R01 AG042419. The authors have nothing to disclose

Publisher Copyright:
Copyright © 2018 by the American Society of Neuroimaging


  • Alzheimer's disease
  • Global cerebral atrophy
  • cerebrovascular disease

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology


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