White matter changes on DTI may predict frailty in older adults with cardiometabolic diseases

Published on July 27, 2022

Imagine your brain is a complex highway system, with white matter tracts as the roads connecting different regions. Researchers used a special imaging technique called diffusion tensor imaging (DTI) to examine the integrity of these roads in older adults with cardiometabolic diseases. They found that alterations in the white matter were associated with the incidence of frailty, particularly in patients with diabetes mellitus. The most significant differences were observed in the anterior thalamic radiation (ATR), a major road in the brain. High mean diffusivity (MD) values in the left ATR were linked to a higher risk of developing frailty. These findings suggest that abnormalities in the left ATR could be a potential marker for frailty progression in individuals with cardiometabolic diseases. If you’re interested in learning more about this fascinating research, check out the link below!

Diffusion tensor imaging (DTI) can be used for the early detection of abnormal changes in the integrity of cerebral white matter tracts, and we have previously reported that these changes are associated with indices of early atherosclerotic lesions. Although these changes have been demonstrated to be associated with the incidence of frailty in older adults, no studies have investigated this relationship in patients at high risk for vascular disease. In this longitudinal study, we followed outpatients with cardiometabolic diseases for a maximum of 6 years (median, 3 years) and evaluated the association of baseline DTI data of seven white matter tracts with the incidence of frailty. The modified version of the Cardiovascular Health Study criteria and the Kihon Checklist were used as indices of frailty; fractional anisotropy (FA) and mean diffusivity (MD) were used as indices of white matter changes. Patients who developed frailty based on both indices had low FA and high MD in many of the tracts tested, with the most significant difference found in the MD of the anterior thalamic radiation (ATR). Cox proportional hazard model analysis revealed a significantly high risk of frailty defined by both indices in the groups with high MD values in the left ATR. Similar results were found in patients with diabetes mellitus but not in those without diabetes mellitus. Therefore, abnormalities in the integrity of the left ATR could be associated with the progression of frailty in older adults with cardiometabolic disease, particularly those with diabetes mellitus.

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