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BrainAGE in Mild Cognitive Impaired Patients: Predicting the Conversion to Alzheimer's Disease
Gaser C, Franke K, Klöppel S, Koutsouleris N, Sauer H, Alzheimer's Disease Neuroimaging Initiative.. PloS one, 2013-06-27
Topic: Amyloid, tau and blood-test diagnosis
Alzheimer's disease (AD), the most common form of dementia, shares many aspects of abnormal brain aging. We present a novel magnetic resonance imaging (MRI)-based biomarker that predicts the individual progression of mild cognitive impairment (MCI) to AD on the basis of pathological brain aging patterns. By employing kernel regression methods, the expression of normal brain-aging patterns forms the basis to estimate the brain age of a given new subject. If the estimated age is higher than the chronological age, a positive brain age gap estimation (BrainAGE) score indicates accelerated atrophy and is considered a risk factor for conversion to AD. Here, the BrainAGE framework was applied to predict the individual brain ages of 195 subjects with MCI at baseline, of which a total of 133 developed AD during 36 months of follow-up (corresponding to a pre-test probability of 68%). The ability of the BrainAGE framework to correctly identify MCI-converters was compared with the performance of commonly used cognitive scales, hippocampus volume, and state-of-the-art biomarkers derived from cerebrospinal fluid (CSF). With accuracy rates of up to 81%, BrainAGE outperformed all cognitive scales and CSF biomarkers in predicting conversion of MCI to AD within 3 years of follow-up. Each additional year in the BrainAGE score was associated with a 10% greater risk of developing AD (hazard rate: 1.10 [CI: 1.07-1.13]). Furthermore, the post-test probability was increased to 90% when using baseline BrainAGE scores to predict conversion to AD. The presented framework allows an accurate prediction even with multicenter data. Its fast and fully automated nature facilitates the integration into the clinical workflow. It can be exploited as a tool for screening as well as for monitoring treatment options.
Key findings
- The ability of the BrainAGE framework to correctly identify MCI-converters was compared with the performance of commonly used cognitive scales, hippocampus volume, and state-of-the-art biomarkers derived from cerebrospinal fluid (CSF).
- Each additional year in the BrainAGE score was associated with a 10% greater risk of developing AD (hazard rate: 1.10 [CI: 1.07-1.13]).
Why it matters
In 195 people with mild cognitive impairment, 133 of whom developed Alzheimer's within three years, an MRI-based "brain age" score (BrainAGE) predicted who would progress with accuracy of up to 81%, compared with a 68% starting probability, and the study reports it outperformed cognitive scales and spinal-fluid (CSF) biomarkers. Each extra year of estimated brain age above a person's real age was associated with about a 10% higher risk of developing Alzheimer's (hazard rate 1.10, CI 1.07–1.13). It is a prediction measure tested in an already high-risk group; it does not test any treatment, cure or prevention.
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Study details
- Participants195
- Evidence strengthLow
How this study scored 57/100
Published in a peer-reviewed journal. Scored zero for study design, effect reported and randomised / blinded because the record does not state it. We have no data on senior author's track record, so that was left out: it earned 55 of the 96 points we could judge it on, which is 57 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (PloS one) |
| Journal's citation record | 4 / 4 | PLoS ONE: journal h-index 594 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2013 — within 20 year(s) of the newest study here |
| Sample size | 2 / 4 | 195 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 6 / 7 | Cited 550 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 36.7 citations a year over 15 year(s) since 2013 |
| Impact for its field and year | 4 / 6 | Cited 8.3× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 17 other studies in this library |
| Still being cited | 3 / 4 | Cited 178 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | 1 / 3 | Ludwig-Maximilians-Universität München: institution h-index 1,224 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 4 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 23826273) |
| Free to read | 2 / 2 | Free to read |
| Points | 55 / 96 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 55 of the 96 points we could judge it on is 57 out of 100. |
| Total | 57 / 100 | — |
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Read the original
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Gaser, C., Franke, K., Klöppel, S., Koutsouleris, N., Sauer, H., & Alzheimer's Disease Neuroimaging Initiative. (2013). BrainAGE in Mild Cognitive Impaired Patients: Predicting the Conversion to Alzheimer's Disease. PloS one. https://doi.org/10.1371/journal.pone.0067346
Vancouver
Gaser C, Franke K, Klöppel S, Koutsouleris N, Sauer H, Alzheimer's Disease Neuroimaging Initiative. BrainAGE in Mild Cognitive Impaired Patients: Predicting the Conversion to Alzheimer's Disease. PloS one. 2013. doi:10.1371/journal.pone.0067346. PMID: 23826273.
BibTeX
@article{gaser2013-23826273,
author = {Gaser, C. and Franke, K. and Klöppel, S. and Koutsouleris, N. and Sauer, H. and {Alzheimer's Disease Neuroimaging Initiative}},
title = {{BrainAGE in Mild Cognitive Impaired Patients: Predicting the Conversion to Alzheimer's Disease}},
journal = {PloS one},
year = {2013},
doi = {10.1371/journal.pone.0067346},
pmid = {23826273},
url = {https://doi.org/10.1371/journal.pone.0067346}
}
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