MTA and Koedam Score Contributes to Cognitive Impairment in Probable Alzheimer, Vascular and Mixed Dementia: A Memory Clinic Study in Indonesia

Abstract

Abstract Background. Medial Temporal Atrophy (MTA) and Parietal Atrophy (Koedam score) have been used in clinical practice to help the diagnosis of Alzheimer’s disease. However, the role of this brain imaging marker in early detection of other type of dementia remains elusive. The study aims to investigate the association between MTA and Koedam scores with the cognitive function in dementia patients (Alzheimer, vascular and mixed dementia). Method This was across-sectional study usingdata from a Memory Clinic in Dr. Sardjito General Hospital Yogyakarta, Indonesia. The data was collected from January 2020 until December 2022. We collected the data regarding demographic and clinical characteristics, including head MRI data and Montreal Cognitive Assessment (MoCA) score. The cut-off points of MTA score and Koedam score were determined by using Receiver Operating Curve (ROC) and Youden Index. Multivariate analysis was performed to investigate variables which were associated with the cognitive function. Result From 61 dementia patients, 22.95% was probable Alzheimer’s disease, 59.01% was vascular dementia, and 18.03% was mixed dementia. Correlation test showed that MTA and Koedam score were negatively associated with Montreal Cognitive Assessment-Indonesian Version (MoCA-INA) score. A bivariate analysis supports the findings that patients with combination of MTA score ≥3 and Koedam score ≥2 was more likely to have poor cognitive function (OR= 11.33; p<0.05). Multivariate analysis showed higher MTA (≥3) and Koedam (≥2) scores were associated with poor cognitive function in dementia patients (OR= 13.54, 95% CI= 1.77-103.43, p=0.01 and OR= 5.52, 95% CI= 1.08-28.19, p=0.04) Conclusion Higher MTA and Koedam score contribute to worse cognitive function in any type of dementia patients.