Whole-brain atrophy rate in Alzheimer disease: identifying fast progressors
Sluimer JD, Vrenken H, Blankenstein MA, Fox NC, Scheltens P, Barkhof F, van der Flier WM.. Neurology, 2008-05-01
Topic: Amyloid, tau and blood-test diagnosis
Objective To assess which baseline clinical and MRI measures influence whole-brain atrophy rates, measured from serial MR imaging. Methods We recruited 65 patients with Alzheimer disease (mean +/- SD age 70 +/- 8 y, 58% women, Mini-Mental State Examination [MMSE] 22 +/- 5), scanned with an average interval of 1.7 +/- 0.6 years. Whole-brain atrophy rates were used as outcome measure. Baseline normalized brain volume, hippocampal volume, and whole-brain atrophy rates were measured using three-dimensional T1-weighted imaging. The influence of age, sex, apolipoprotein E genotype (APOE), baseline MMSE, baseline hippocampal volume, and baseline normalized brain volume on whole-brain atrophy rates was assessed using linear regression. Results The mean whole-brain atrophy rate was -1.9 +/- 0.9% per year. In the multivariate model, younger age (beta [SE] = 0.03 [0.01]; p = 0.04), absence of APOE epsilon 4 (beta [SE] = 0.61 [0.28]; p = 0.03), and a low MMSE (beta [SE] = 0.11 [0.03]; p Conclusions Our results suggest it is possible to characterize a subgroup of patients with Alzheimer disease (AD) who are at risk of faster loss of brain volume. Patients with more generalized, rather than focal hippocampal atrophy, who often have an onset before the age of 65, and are APOE epsilon 4 negative, seem to be at risk of faster whole-brain atrophy rates than the more commonly seen patients with AD, who are older, are APOE epsilon 4 positive, and have pronounced hippocampal atrophy.
Key findings
- Results The mean whole-brain atrophy rate was -1.9 +/- 0.9% per year.
- In the multivariate model, younger age (beta [SE] = 0.03 [0.01]; p = 0.04), absence of APOE epsilon 4 (beta [SE] = 0.61 [0.28]; p = 0.03), and a low MMSE (beta [SE] = 0.11 [0.03]; p < 0.001) were associated with a higher whole-brain atrophy rate.
Why it matters
In this group of Alzheimer patients, younger age, absence of APOE epsilon4, and lower MMSE scores were linked to faster whole-brain shrinkage over about 1.7 years. This describes which patients may lose brain volume faster and does not report a treatment.
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Study details
- Participants65
- Effect size0.9%
- Evidence strengthLow
How this study scored 53/100
Published in a leading specialty journal. Scored zero for study design and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Neurology) |
| Journal's citation record | 4 / 4 | Neurology: journal h-index 525 (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 | 2008 — within 20 year(s) of the newest study here |
| Sample size | 1 / 4 | 65 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| 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 | 2 / 5 | 5.5 citations a year over 20 year(s) since 2008 |
| Impact for its field and year | 3 / 6 | Cited 6.1× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 5 other studies in this library |
| Still being cited | 2 / 4 | Cited 17 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Wiesje M. van der Flier: h-index 132 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | Vrije Universiteit Amsterdam: institution h-index 1,014 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 3 institution(s) in 2 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 18458218) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 53 / 100 | — |
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Read the original
May need a subscription Unpaywall, Europe PMC and OpenAlex found no free copy of the full text (checked 10 Oct 2026), so the publisher may charge for it. The PubMed abstract is free.
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 names 7 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
APA 7th
Sluimer, J. D., Vrenken, H., Blankenstein, M. A., Fox, N. C., Scheltens, P., Barkhof, F., et al. (2008). Whole-brain atrophy rate in Alzheimer disease: identifying fast progressors. Neurology. https://doi.org/10.1212/01.wnl.0000311446.61861.e3
Vancouver
Sluimer JD, Vrenken H, Blankenstein MA, Fox NC, Scheltens P, Barkhof F, et al. Whole-brain atrophy rate in Alzheimer disease: identifying fast progressors. Neurology. 2008. doi:10.1212/01.wnl.0000311446.61861.e3. PMID: 18458218.
BibTeX
@article{sluimer2008-18458218,
author = {Sluimer, J. D. and Vrenken, H. and Blankenstein, M. A. and Fox, N. C. and Scheltens, P. and Barkhof, F. and van der Flier, W. M.},
title = {{Whole-brain atrophy rate in Alzheimer disease: identifying fast progressors}},
journal = {Neurology},
year = {2008},
doi = {10.1212/01.wnl.0000311446.61861.e3},
pmid = {18458218},
url = {https://doi.org/10.1212/01.wnl.0000311446.61861.e3}
}
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