Baseline brain magnetic resonance imaging findings as predictors of dementia progression: insights from a Mexican memory clinic

Abstract

Background: Dementia is a progressive syndrome characterized by cognitive decline. Brain atrophy has been associated with disease progression, but its predictive value in Latin American populations remains underexplored. Objective: To assess whether brain atrophy, evaluated through visual rating scales, predicts progression from mild to moderate dementia over one year, using the CDR-SB. Materials and methods: A retrospective cohort study was conducted in a memory clinic with 73 participants aged ≥ 65 years with mild dementia and baseline brain magnetic resonance imaging. Temporal and parietal atrophy were assessed using Scheltens and Koedam scales, and white matter hyperintensities were evaluated with Fazekas. Logistic regression models adjusted for age, education, depression, and vitamin D/B12 deficiencies were used to estimate the risk of progression. Results: Fifteen participants (21%) progressed to moderate dementia. Moderate-to-severe atrophy in the parietal (OR: 6.84; 95% CI: 1.29-36.2; p = 0.024) and temporal lobes (OR: 6.33; 95% CI: 1.23-32.43; p = 0.027) significantly increased the odds of progression. Conclusions: At one-year follow-up, moderate-to-severe atrophy in the parietal and temporal lobes was associated with dementia progression, supporting the potential clinical utility of visual rating scales for monitor-ing disease progression.