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The metabolic brain signature of cognitive resilience in the 80+: beyond Alzheimer pathologies
Arenaza-Urquijo EM, Przybelski SA, Lesnick TL, Graff-Radford J, Machulda MM, Knopman DS, Schwarz CG, Lowe VJ et al.. Brain : a journal of neurology, 2019-04-01
Topic: Amyloid, tau and blood-test diagnosis
Our main findings were: (i) FDG-PET uptake in the bilateral anterior cingulate cortex and anterior temporal pole was associated with baseline global cognition in cognitively stable 80+ (the resilience signature); (ii) established Alzheimer's disease imaging biomarkers did not predict baseline global cognition in this subset of participants; (iii) in the full MCSA 80+ and ADNI cohorts, amyloid burden and FDG-PET in the resilience signature were the stronger predictors of baseline global cognition; (iv) sex and systemic vascular health predicted FDG-PET in the resilience signature, suggesting vascular health maintenance as a potential pathway to preserve the metabolism of these areas; and (v) the resilience signature provided significant information about global longitudinal cognitive change even when considering amyloid status in both the MCSA and ADNI cohorts.
Key findings
- Our main findings were: (i) FDG-PET uptake in the bilateral anterior cingulate cortex and anterior temporal pole was associated with baseline global cognition in cognitively stable 80+ (the resilience signature); (ii) established Alzheimer's disease imaging biomarkers did not predict baseline global cognition in this subset of participants; (iii) in the full MCSA 80+ and ADNI cohorts, amyloid burden and FDG-PET in the resilience signature were the stronger predictors of baseline global cognition; (iv) sex and systemic vascular health predicted FDG-PET in the resilience signature, suggesting vascular health maintenance as a potential pathway to preserve the metabolism of these areas; and (v) the resilience signature provided significant information about global longitudinal cognitive change even when considering amyloid status in both the MCSA and ADNI cohorts.
Why it matters
In cognitively stable people aged 80 and over, FDG-PET uptake in the anterior cingulate cortex and anterior temporal pole was linked to baseline cognition and to later cognitive change, while established Alzheimer's imaging biomarkers did not predict baseline cognition in this group. The findings suggest vascular health maintenance as a possible pathway to preserve metabolism in these areas, but this is not yet shown to prevent or treat Alzheimer's disease.
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Study details
- Study designlongitudinal study
- Participants192
- Evidence strengthModerate
How this study scored 64/100
Published in a leading specialty journal, and it is a longitudinal study following the same people over time. Scored zero for effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Brain : a journal of neurology) |
| Journal's citation record | 4 / 4 | Brain: journal h-index 503 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A longitudinal study following the same people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 2 / 5 | 2019 — within 10 year(s) of the newest study here |
| Sample size | 2 / 4 | 192 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 | 5 / 7 | Cited 110 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 12.2 citations a year over 9 year(s) since 2019 |
| Impact for its field and year | 4 / 6 | Cited 9.5× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 4 other studies in this library |
| Still being cited | 2 / 4 | Cited 38 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Prashanthi Vemuri: h-index 106 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | Mayo Clinic: institution h-index 1,606 (OpenAlex) |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 30851100) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 64 / 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. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Arenaza-Urquijo, E. M., Przybelski, S. A., Lesnick, T. L., Graff-Radford, J., Machulda, M. M., Knopman, D. S., et al. (2019). The metabolic brain signature of cognitive resilience in the 80+: beyond Alzheimer pathologies. Brain : a journal of neurology. https://doi.org/10.1093/brain/awz037
Vancouver
Arenaza-Urquijo EM, Przybelski SA, Lesnick TL, Graff-Radford J, Machulda MM, Knopman DS, et al. The metabolic brain signature of cognitive resilience in the 80+: beyond Alzheimer pathologies. Brain : a journal of neurology. 2019. doi:10.1093/brain/awz037. PMID: 30851100.
BibTeX
@article{arenazaurquijo2019-30851100,
author = {Arenaza-Urquijo, E. M. and Przybelski, S. A. and Lesnick, T. L. and Graff-Radford, J. and Machulda, M. M. and Knopman, D. S. and Schwarz, C. G. and Lowe, V. J. and others},
title = {{The metabolic brain signature of cognitive resilience in the 80+: beyond Alzheimer pathologies}},
journal = {Brain : a journal of neurology},
year = {2019},
doi = {10.1093/brain/awz037},
pmid = {30851100},
url = {https://doi.org/10.1093/brain/awz037}
}
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