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A Relationship

Peter W. Schofield, FRACP; Roger E. Mosesson, MD; Yaakov Stern, PhD; Richard Mayeux, MD

Arch Neurol. 1995;52(1):95-98.

Abstract
Objective: To examine the possibility that premorbid brain size may influence the age at onset of symptoms of Alzheimer's disease (AD).

Design

Retrospective case series.

Setting
Outpatients attending a memory disorders clinic in a tertiary referral center.

Patients
Twenty-eight female patients with the diagnosis of probable AD, selected for the availability of informant derived estimates of age at onset of symptoms and computed tomographic scans of the head satisfying angulation criteria.

Main Outcome Measure
An average intracranial area of two adjacent computed tomographic scan sections appropriately angled was used as a correlate of premorbid brain size. Strict intracranial volume measurement was not performed.

Results
Age at onset of symptoms of AD correlated positively (r=.48, P=.009) with our measure of premorbid brain size. There was no confounding by education, height, or ethnicity.

Conclusion
Premorbid brain size may be an important determinant of the age at onset of symptoms of AD. Epidemiologic studies of AD may need to assess the relationship between brain size and putative risk factors, eg, low educational attainment, since there is evidence that brain size is not distributed uniformly across populations.

Author Affiliations
From the Gertrude H. Sergievsky Center (Drs Schofield, Stern, and Mayeux); the Center for Alzheimer's Disease Research in the City of New York (Drs Stern and Mayeux); and the Departments of Neurology (Drs Schofield, Stern, and Mayeux), Psychiatry (Drs Stern and Mayeux), and Radiology (Dr Mosesson), College of Physicians and Surgeons at Columbia University, New York, NY.

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