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| Item Type: | Article |
|---|---|
| Title: | Joint trajectories of brain atrophy, white matter hyperintensities and cognition quantify brain maintenance |
| Creators: |
Menze, Inga  ORCID: https://orcid.org/0009-0001-4567-1655, Bernal, Jose ORCID: https://orcid.org/0000-0003-3167-5134, Kievit, Rogier A, Tripathi, Kumar Parijat ORCID: https://orcid.org/0000-0002-3998-599X, Kaleck, Timo, Yakupov, Renat ORCID: https://orcid.org/0000-0002-3868-284X, Altenstein, Slawek, Bartels, Claudia, Buerger, Katharina, Butryn, Michaela, Dechent, Peter, Ewers, Michael ORCID: https://orcid.org/0000-0001-5231-1714, Fliessbach, Klaus, Frommann, Ingo ORCID: https://orcid.org/0000-0002-7244-2014, Gemenetzi, Maria, Glanz, Wenzel, Gref, Daria ORCID: https://orcid.org/0000-0003-2497-9324, Hellmann-Regen, Julian ORCID: https://orcid.org/0000-0003-0411-9204, Hetzer, Stefan, Incesoy, Enise I., Janowitz, Daniel, Kiliman, Ingo, Kleineidam, Luca ORCID: https://orcid.org/0009-0006-3309-6856, Kronmüller, Marie Theres, Laske, Christoph, van Lent, Debora Melo ORCID: https://orcid.org/0000-0002-7392-9289, Lüsebrink, Falk, Perneczky, Robert ORCID: https://orcid.org/0000-0003-1981-7435, Peters, Oliver ORCID: https://orcid.org/0000-0003-0568-2998, Preis, Lukas ORCID: https://orcid.org/0000-0001-7601-6410, Priller, Josef ORCID: https://orcid.org/0000-0001-7596-0979, Rauchmann, Boris-Stephan ORCID: https://orcid.org/0000-0003-4547-6240, Rostamzadeh, Ayda, Roeske, Sandra, Scheffler, Klaus, Schott, Björn-Hendrik ORCID: https://orcid.org/0000-0002-8237-4481, Schneider, Anja ORCID: https://orcid.org/0000-0001-9540-8700, Sodenkamp, Sebastian, Spottke, Annika, Spruth, Eike Jakob, Stark, Melina ORCID: https://orcid.org/0009-0005-3812-023X, Teipel, Stefan, Wagner, Michael ORCID: https://orcid.org/0000-0003-2589-6440, Wiltfang, Jens ORCID: https://orcid.org/0000-0003-1492-5330, Jessen, Frank, Ramirez, Alfredo ORCID: https://orcid.org/0000-0003-4991-763X, Schreiber, Stefanie ORCID: https://orcid.org/0000-0003-4439-4374, Düzel, Emrah and Ziegler, Gabriel ORCID: https://orcid.org/0000-0001-6589-6416
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| Abstract: | Brain maintenance - the preservation of brain structure or function relevant to cognitive performance - remains challenging to quantify. Here, we propose a domain-general brain maintenance index derived by jointly modelling the longitudinal co-evolution of ageing-related atrophy (via medial temporal lobe to ventricle ratio, MTLV-ratio), white matter hyperintensities (WMH), and global cognition assessed by the preclinical Alzheimer's cognitive composite (PACC5) using latent growth curve modelling. We demonstrate its utility in 543 cognitively unimpaired older adults from the DELCODE cohort, followed annually over four years. We show that changes in MTLV-ratio and WMH additively predict cognitive change. We further show that higher neuroticism, depressive symptoms, lower openness, and faster biological ageing are related to unfavourable domain-specific trajectories and poorer brain maintenance. Our findings highlight the combined relevance of WMH and ageing-related atrophy dynamics for brain maintenance. Maintaining cerebrovascular and mental health alongside cognitive engagement could promote brain maintenance, delay cognitive decline and dementia. |
| Keywords: | Aging, Atrophy, Brain, Cognition, Cognitive Dysfunction, Magnetic Resonance Imaging, White Matter |
| Source: | Nature Communications |
| ISSN: | 2041-1723 |
| Publisher: | Nature Publishing Group |
| Volume: | 17 |
| Number: | 1 |
| Page Range: | 5846 |
| Date: | 4 July 2026 |
| Official Publication: | https://doi.org/10.1038/s41467-026-74957-2 |
| PubMed: | View item in PubMed |
| Related to: |
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