ArticleNeurology2026
Comparison of Brain Age With Standard MRI Assessment for Dementia Risk Stratification in Subjective and Mild Cognitive Impairment.
Article in Neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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12 authors.
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Abstract
BACKGROUND AND
objectivesEarly dementia risk-stratification is crucial for timely intervention. Brain-predicted age difference (brain-PAD) derived from structural MRI reflects the gap between computer-estimated age and chronological age and has been linked to clinical progression to dementia. We evaluate whether brain-PAD has prognostic value for progression to dementia in subjective cognitive decline (SCD) and mild cognitive impairment (MCI) and whether brain-PAD provides added value beyond visual rating scales.
methodsThis retrospective cohort study included patients with SCD and MCI with up to 10-year follow-up assessments from the Amsterdam Dementia Cohort and SCIENCe project. Brain-PAD was computed from baseline MRI using 2 pretrained methods. Cox proportional hazards models assessed the association between brain-PAD and risk of progression to dementia, controlling for age, sex, Mini Mental State Examination, and visual rating scales. We tested interactions between brain-PAD and baseline diagnosis to assess stage-specific value and evaluated the added value beyond amyloid status in a biomarker-available subset.
resultsThe study included 799 patients (SCD 412, MCI 387; 39.4% female, 63.3 ± 8.0 years). During a median follow-up of 3.2 years, 235 (29.4%) progressed to dementia. Higher brain-PAD was associated with an increased risk of progression to dementia (hazard ratio [HR] 1.04, 95% CI 1.02-1.06) and improved model fit beyond visual ratings (χ DISCUSSION: MRI-derived brain-PAD predicts progression to dementia in memory clinic patients with SCD or MCI. In particular, brain-PAD provided additional predictive value to visual rating scales in patients with SCD.
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