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Adam M. Brickman, PhD; Nicole Schupf, PhD; Jennifer J. Manly, PhD; José A. Luchsinger, MD, MPH; Howard Andrews, PhD; Ming X. Tang, PhD; Christiane Reitz, MD, PhD; Scott A. Small, MD; Richard Mayeux, MD, MS; Charles DeCarli, MD; Truman R. Brown, PhD

Arch Neurol. 2008;65(8):1053-1061.

Background  Aging is accompanied by a decrease in brain volume and by an increase in cerebrovascular disease.

Objective  To examine the effects of age, sex, race/ethnicity, and vascular disease history on measures of brain morphology, including relative brain volume, ventricular volume, hippocampus and entorhinal cortex volumes, and white matter hyperintensity (WMH) burden, in a large community-based cohort of racially/ethnically diverse older adults without dementia.

Design  The associations of age, sex, race/ethnicity, and self-reported vascular disease history with brain morphology were examined in a cross-sectional study using multiple linear regression analyses. Sex x race/ethnicity interactions were also considered.

Setting  The Washington Heights–Inwood Columbia Aging Project, a community-based epidemiological study of older adults from 3 racial/ethnic groups (white, Hispanic, and African American) from northern Manhattan.

Participants  Beginning in 2003, high-resolution quantitative magnetic resonance (MR) images were acquired in 769 participants without dementia.

Main Outcome Measures  Relative brain volume (total brain volume/intracranial volume), ventricular volume, and hippocampus and entorhinal cortex volumes were derived manually on high-resolution MR images. White matter hyperintensities were quantified semiautomatically on fluid-attenuated inversion recovery–T2-weighted MR images.

Results  Older age was associated with decreased relative brain volume and with increased ventricular and WMH volumes. Hispanic and African American participants had larger relative brain volumes and more severe WMH burden than white participants, but the associations of these variables with age were similar across racial/ethnic groups. Compared with men, women had larger relative brain volumes. Vascular disease was associated with smaller relative brain volume and with higher WMH burden, particularly among African Americans.

Conclusions  Older age and vascular disease, particularly among African Americans, are associated with increased brain atrophy and WMH burden. African American and Hispanic subjects have larger relative brain volumes and more WMH than white subjects. Racial/ethnic group differences in WMH severity seem to be partially attributable to differences in vascular disease. Future work will focus on the determinants and cognitive correlates of these differences.

Author Affiliations: Taub Institute for Research on Alzheimer's Disease and the Aging Brain (Drs Brickman, Schupf, Manly, Luchsinger, Reitz, Small, and Mayeux) and Departments of Neurology (Drs Brickman, Manly, Luchsinger, Small, and Mayeux), Psychiatry (Drs Schupf and Mayeux), Medicine (Dr Luchsinger), and Radiology (Dr Brown), and Gertrude H. Sergievsky Center (Drs Brickman, Schupf, Manly, Tang, Reitz, Small, and Mayeux), College of Physicians and Surgeons, Departments of Epidemiology (Drs Schupf, Luchsinger, and Mayeux) and Biostatistics (Drs Andrews and Tang), Joseph P. Mailman School of Public Health, and Department of Biomedical Engineering (Dr Brown), Columbia University, New York, New York; and Department of Neurology and Imaging of Dementia and Aging Laboratory, Center for Neuroscience, University of California at Davis, Sacramento (Dr DeCarli).

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