The impact of medial temporal and parietal atrophy on cognitive function in dementia

Abstract

Although medial temporal atrophy (MTA) and parietal atrophy (Koedam score) have been used to diagnose Alzheimer's disease (AD), early detection of other dementia types remains elusive. The study aims to investigate the association between these brain imaging markers and cognitive function in dementia. This cross-sectional study collected data from the Memory Clinic of Dr. Sardjito General Hospital Yogyakarta, Indonesia from January 2020 until December 2022. The cut-off value of MTA and Koedam score was set with Receiver Operating Curve. Multivariate analysis was performed to investigate the association between MTA and Koedam score with cognitive function. Of 61 patients, 22.95% had probable AD, 59.01% vascular dementia, and 18.03% mixed dementia. Correlation test showed that MTA and Koedam score were negatively associated with Montreal Cognitive Assessment-Indonesian Version (MoCA-INA) score. MTA score ≥ 3 (AUC 0.69) and Koedam score ≥ 2 (AUC 0.67) were independently associated with higher risk of poor cognitive function (OR 13.54, 95% CI 1.77-103.43, p = 0.01 and OR 5.52, 95% CI 1.08-28.19, p = 0.04). Higher MTA and Koedam score indicate worse cognitive function in dementia. Future study is needed to delineate these findings as prognostic markers of dementia severity.

Keywords: Cognitive function; Dementia; Imaging marker; Koedam score; Medial temporal atrophy (MTA).

Figure 1

(A) ROC curve for the discrimination quality of MTA score in dementia patients (weak categorization). MTA score cut-off point of 3 with AUC 0.69 was used. (B) ROC curve for the discrimination quality of Koedam scores in dementia patients (weak categorization). Koedam score cut-off point of 2 with AUC 0.67 was used. (A) ROC curve for MTA score in dementia patients. (B)ROC curve for Koedam score in dementia patients.