Hippocampal volume in older adults at risk of cognitive decline: the role of sleep, vascular risk, and depression

Emma L. Elcombe, Jim Lagopoulos, Shantel L. Duffy, Simon J G Lewis, Louisa Norrie, Ian B. Hickie, Sharon L. Naismith*

*Corresponding author for this work

Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review


Background and Objectives: Decreased hippocampal volume in older adults is associated with neurodegenerative and psychiatric diseases. Several modifiable risk factors have been associated with the size of this structure, however the relative contribution of these factors to hippocampal atrophy is unclear. This study aimed to examine the relationship between modifiable risk factors and hippocampal volume in older adults at risk of cognitive decline.

Methods: Two hundred and eighteen participants (mean age = 67.3 years, MMSE= 28.6) with mood and/or memory complaints underwent clinical and neuropsychological assessment, and magnetic resonance imaging. Measures of depression, global cognitive functioning, exercise, vascular health, cognitive reserve, sleep, and memory were collected. Hippocampal volumes were derived using image segmentation as implemented by FMRIB Software Library.

Results: Smaller hippocampal volumes were strongly associated with poorer verbal learning and memory as well as diagnoses of either multiple or amnestic mild cognitive impairment. Based on univariate correlations, multivariable regressions were performed (controlling for age and total intracranial volume) to determine which modifiable risk factors were associated with hippocampal volume. For the left hippocampus, poor sleep efficiency and greater than five years untreated depressive illness remained significant predictors. For the right hippocampus, diabetes and low diastolic blood pressure remained significant predictors.

Conclusions: Although their contribution is small, lower sleep efficiency, low blood pressure, diabetes, and untreated depression are associated with reduced hippocampal volumes. Studies exploring the impact of early intervention for these risk factors on hippocampal integrity are warranted.

Original languageEnglish
Title of host publicationHandbook of depression in Alzheimer's disease
EditorsGwen S. Smith
Place of PublicationAmsterdam
PublisherIOS Press
Number of pages12
ISBN (Electronic)9781614995425
ISBN (Print)9781614995418
Publication statusPublished - 2015
Externally publishedYes

Publication series

NameAdvances in Alzheimer's Disease
ISSN (Print)2210-5727
ISSN (Electronic)2210-5735


  • dementia
  • depression
  • diabetes
  • hippocampus
  • hypertension
  • magnetic resonance imaging
  • mild cognitive impairment
  • sleep


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