Longitudinal deterioration of white-matter integrity: heterogeneity in the ageing population

Abstract Deterioration in white-matter health plays a role in cognitive ageing. Our goal was to discern heterogeneity of white-matter tract vulnerability in ageing using longitudinal imaging data (two to five imaging and cognitive assessments per participant) from a population-based sample of 553 elderly participants (age ≥60 years). We found that different clusters (healthy white matter, fast white-matter decliners and intermediate white-matter group) were heterogeneous in the spatial distribution of white-matter integrity, systemic health and cognitive trajectories. White-matter health of specific tracts (genu of corpus callosum, posterior corona radiata and anterior internal capsule) informed about cluster assignments. Not surprisingly, brain amyloidosis was not significantly different between clusters. Clusters had differential white-matter tract vulnerability to ageing (commissural fibres > association/brainstem fibres). Identification of vulnerable white-matter tracts is a valuable approach to assessing risk for cognitive decline. White-matter health deterioration plays a role in cognitive ageing. Using longitudinal imaging data, Poulakis et al. found four heterogeneous clusters of individuals with distinct spatial patterns of white-matter integrity trajectories. This heterogeneity was related to systemic health and not to brain amyloidosis and was associated with distinct cognitive trajectories. Graphical Abstract Graphical Abstract