Yeungnam Univ J Med.  2018 Dec;35(2):205-212. 10.12701/yujm.2018.35.2.205.

Association of head circumference with cognitive decline and symptoms of depression in elderly: a 3-year prospective study

Affiliations
  • 1Department of Neurology, Catholic University of Daegu School of Medicine, Daegu, Korea. dolbaeke@cu.ac.kr
  • 2Department of Preventive Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea.

Abstract

BACKGROUND
Brain volume is associated with dementia and depression in the elderly. An easy way to predict relative brain volume is to measure head circumference. In this study, we investigated the relationship between head circumference and cognition as well as depression in a non-demented elderly community.
METHODS
Baseline and follow-up surveys were conducted in 2007 and 2010. At baseline, community residents aged 65 years or over (n=382) within a rural area of South Korea were screened for dementia and symptoms of depression and were followed using the same screening battery after 3 years (n=279). Data from anthropometric measurements (head circumference, height, and body weight), demographics, and blood tests were gathered. Neuropsychological tests, including the Korean version of mini-mental state examination (K-MMSE), clinical dementia rating (CDR) including the CDR-sum of boxes, the Korean version of instrumental activities of daily living, and geriatric depression scale (GDS), were performed. None of the 279 subjects followed were demented.
RESULTS
Baseline performance on the K-MMSE and GDS was poorer for participants with smaller head circumferences. Follow-up performance on the MMSE was also poorer for participants with smaller head circumferences. Interestingly, participants with smaller head circumference showed worse GDS scores at baseline but on follow-up examination, participants with larger head circumference showed rapid worsening than those with smaller head circumference with marginal significance by ANOVA test. In regression coefficient analysis, GDS decline showed significant difference.
CONCLUSION
Head circumference was not associated with cognitive change but was associated with symptoms of depression in non-demented community residents.

Keyword

Clinical dementia rating; Cognition; Geriatric depression scale; Head circumference; Mini mental state examination

MeSH Terms

Activities of Daily Living
Aged*
Brain
Cognition
Dementia
Demography
Depression*
Follow-Up Studies
Head*
Hematologic Tests
Humans
Korea
Mass Screening
Neuropsychological Tests
Prospective Studies*

Reference

1. Krech D, Rosenzweig MR, Bennett EL. Effects of environmental complexity and training on brain chemistry. J Comp Physiol Psychol. 1960; 53:509–19.
Article
2. Diamond MC. Enriching heredity: the impact of the environment on the anatomy of the brain. New York: Free Press;London: Collier Macmillan;1988.
3. Duarte A, Hayasaka S, Du A, Schuff N, Jahng GH, Kramer J, et al. Volumetric correlates of memory and executive function in normal elderly, mild cognitive impairment and Alzheimer’s disease. Neurosci Lett. 2006; 406:60–5.
Article
4. Kwon OD, Cho SS, Seo SW, Na DL. Effect of illiteracy on neuropsychological tests and glucose metabolism of brain in later life. J Neuroimaging. 2012; 22:292–8.
Article
5. Bennett DA, Schneider JA, Wilson RS, Bienias JL, Arnold SE. Education modifies the association of amyloid but not tangles with cognitive function. Neurology. 2005; 65:953–5.
Article
6. Zhang MY, Katzman R, Salmon D, Jin H, Cai GJ, Wang ZY, et al. The prevalence of dementia and Alzheimer's disease in Shanghai, China: impact of age, gender, and education. Ann Neurol. 1990; 27:428–37.
Article
7. Katzman R, Terry R, DeTeresa R, Brown T, Davies P, Fuld P, et al. Clinical, pathological, and neurochemical changes in dementia: a subgroup with preserved mental status and numerous neocortical plaques. Ann Neurol. 1988; 23:138–44.
Article
8. Perneczky R, Wagenpfeil S, Lunetta KL, Cupples LA, Green RC, Decarli C, et al. Head circumference, atrophy, and cognition: implications for brain reserve in Alzheimer disease. Neurology. 2010; 75:137–42.
9. Reynolds MD, Johnston JM, Dodge HH, DeKosky ST, Ganguli M. Small head size is related to low Mini-Mental State Examination scores in a community sample of nondemented older adults. Neurology. 1999; 53:228–9.
Article
10. Gale CR, Walton S, Martyn CN. Foetal and postnatal head growth and risk of cognitive decline in old age. Brain. 2003; 126:2273–8.
Article
11. Wolf H, Julin P, Gertz HJ, Winblad B, Wahlund LO. Intracranial volume in mild cognitive impairment, Alzheimer’s disease and vascular dementia: evidence for brain reserve? Int J Geriatr Psychiatry. 2004; 19:995–1007.
Article
12. Espinosa PS, Kryscio RJ, Mendiondo MS, Schmitt FA, Wekstein DR, Markesbery WR, et al. Alzheimer’s disease and head circumference. J Alzheimers Dis. 2006; 9:77–80.
Article
13. Jenkins R, Fox NC, Rossor AM, Harvey RJ, Rossor MN. Intracranial volume and Alzheimer disease: evidence against the cerebral reserve hypothesis. Arch Neurol. 2000; 57:220–4.
14. Christensen H, Batterham PJ, Mackinnon AJ, Anstey KJ, Wen W, Sachdev PS. Education, atrophy, and cognitive change in an epidemiological sample in early old age. Am J Geriatr Psychiatry. 2009; 17:218–26.
Article
15. Elderkin-Thompson V, Boone KB, Hwang S, Kumar A. Neurocognitive profiles in elderly patients with frontotemporal degeneration or major depressive disorder. J Int Neuropsychol Soc. 2004; 10:753–71.
Article
16. Sözeri-Varma G, Kalkan-Oğuzhanoglu N, Efe M, Kıroglu Y, Duman T. Neurochemical metabolites in prefrontal cortex in patients with mild/moderate levels in first-episode depression. Neuropsychiatr Dis Treat. 2013; 9:1053–9.
17. Hu X, Meiberth D, Newport B, Jessen F. Anatomical correlates of the neuropsychiatric symptoms in Alzheimer’s disease. Curr Alzheimer Res. 2015; 12:266–77.
Article
18. Brommelhoff JA, Sultzer DL. Brain structure and function related to depression in Alzheimer’s disease: contributions from neuroimaging research. J Alzheimers Dis. 2015; 45:689–703.
Article
19. Kim YH, Kwon OD. Clinical correlates of Hachinski ischemic score and vascular factors in cognitive function of elderly. Biomed Res Int. 2014; 2014:852784.
Article
20. Perneczky R, Alexopoulos P, Wagenpfeil S, Bickel H, Kurz A. Head circumference, apolipoprotein E genotype and cognition in the Bavarian School Sisters Study. Eur Psychiatry. 2012; 27:219–22.
Article
21. Kang Y, Na DL, Hahn S. A validity study on the Korean Mini-Mental State Examination (K-MMSE) in dementia patients. J Korean Neurol Assoc. 1997; 15:300–8. Korean.
22. Hughes CP, Berg L, Danziger WL, Coben LA, Martin RL. A new clinical scale for the staging of dementia. Br J Psychiatry. 1982; 140:566–72.
Article
23. Kang SJ, Choi SH, Lee BH, Kwon JC, Na DL, Han SH, et al. The reliability and validity of the Korean instrumental activities of daily living (K-IADL). J Korean Neurol Assoc. 2002; 20:8–14. Korean.
24. Burke WJ, Roccaforte WH, Wengel SP. The short form of the Geriatric Depression Scale: a comparison with the 30-item form. J Geriatr Psychiatry Neurol. 1991; 4:173–8.
Article
25. Dewey ME, Copeland JR. Diagnosis of dementia from the history and aetiology schedule. Int J Geriatr Psychiatry. 2001; 16:912–7.
Article
26. Schofield PW, Logroscino G, Andrews HF, Albert S, Stern Y. An association between head circumference and Alzheimer’s disease in a population-based study of aging and dementia. Neurology. 1997; 49:30–7.
Article
27. Borenstein Graves A, Mortimer JA, Bowen JD, McCormick WC, McCurry SM, Schellenberg GD, et al. Head circumference and incident Alzheimer's disease: modification by apolipoprotein E. Neurology. 2001; 57:1453–60.
Article
28. Schofield PW, Mosesson RE, Stern Y, Mayeux R. The age at onset of Alzheimer's disease and an intracranial area measurement. A relationship. Arch Neurol. 1995; 52:95–8.
Article
29. Graves AB, Mortimer JA, Larson EB, Wenzlow A, Bowen JD, McCormick WC. Head circumference as a measure of cognitive reserve. Association with severity of impairment in Alzheimer’s disease. Br J Psychiatry. 1996; 169:86–92.
Article
30. Mori E, Hirono N, Yamashita H, Imamura T, Ikejiri Y, Ikeda M, et al. Premorbid brain size as a determinant of reserve capacity against intellectual decline in Alzheimer's disease. Am J Psychiatry. 1997; 154:18–24.
Article
31. Tisserand DJ, Bosma H, Van Boxtel MP, Jolles J. Head size and cognitive ability in nondemented older adults are related. Neurology. 2001; 56:969–71.
Article
32. Edland SD, Xu Y, Plevak M, O'Brien P, Tangalos EG, Petersen RC, et al. Total intracranial volume: normative values and lack of association with Alzheimer's disease. Neurology. 2002; 59:272–4.
Article
33. Mortimer JA, Snowdon DA, Markesbery WR. Head circumference, education and risk of dementia: findings from the Nun Study. J Clin Exp Neuropsychol. 2003; 25:671–9.
Article
34. Wolf H, Kruggel F, Hensel A, Wahlund LO, Arendt T, Gertz HJ. The relationship between head size and intracranial volume in elderly subjects. Brain Res. 2003; 973:74–80.
Article
35. Tramo MJ, Loftus WC, Stukel TA, Green RL, Weaver JB, Gazzaniga MS. Brain size, head size, and intelligence quotient in monozygotic twins. Neurology. 1998; 50:1246–52.
Article
36. Lowe DA, Balsis S, Miller TM, Benge JF, Doody RS. Greater precision when measuring dementia severity: establishing item parameters for the Clinical Dementia Rating Scale. Dement Geriatr Cogn Disord. 2012; 34:128–34.
Article
37. O'Bryant SE, Waring SC, Cullum CM, Hall J, Lacritz L, Massman PJ, et al. Staging dementia using Clinical Dementia Rating Scale Sum of Boxes scores: a Texas Alzheimer’s research consortium study. Arch Neurol. 2008; 65:1091–5.
38. Mahoney FI, Barthel DW. Functional evaluation: the Barthel Index. Md State Med J. 1965; 14:61–5.
39. Yesavage JA, Brink TL, Rose TL, Lum O, Huang V, Adey M, et al. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res. 1983; 17:37–49.
Article
40. Melchior M, Moffitt TE, Milne BJ, Poulton R, Caspi A. Why do children from socioeconomically disadvantaged families suffer from poor health when they reach adulthood? A lifecourse study. Am J Epidemiol. 2007; 166:966–74.
Article
41. Steingard RJ, Renshaw PF, Hennen J, Lenox M, Cintron CB, Young AD, et al. Smaller frontal lobe white matter volumes in depressed adolescents. Biol Psychiatry. 2002; 52:413–7.
Article
42. Shanmugan S, Epperson CN. Estrogen and the prefrontal cortex: towards a new understanding of estrogen's effects on executive functions in the menopause transition. Hum Brain Mapp. 2014; 35:847–65.
Article
Full Text Links
  • YUJM
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr