Although vascular risk factors such as diabetes and hypertension “likely contribute to some of the cognitive impairments known to occur with normal aging, they do not fully overlap with the findings reported by Jack et al,” said Dr. DeCarli. Genetic differences such as gender and APOE ε4 status also may play a role.
Additional genetic and animal research may reveal specific cell types and cortical networks that change dramatically during the first 50 years of life. Understanding these early processes will help neurologists identify ways to maintain cognitive health and resist dementia. “Such work requires the necessary motivation found by seminal work, such as that of Jack et al, which tell us where and when to investigate these processes,” said Dr. DeCarli. “Establishing what is normal creates avenues for new research, increasing the likelihood of discovering novel therapeutics for late-life disease states, which is a laudable goal indeed,” he concluded.
—Erik Greb