Structural Brain Indicators of Cognitive Performance in Middle and Late Adulthood: The Human Connectome Project in Aging/Aging Adult Brain Connectome Cohort

IntroductionSignificant effort has been put towards mapping patterns of atrophy in the cerebral cortex that are related to pathological aging, including the characteristic patterns of neurodegeneration in Alzheimers disease (AD). In contrast, brain structural patterns that support preserved or even exceptional cognition throughout the adult age-span and especially in later life are much less known. It is possible that superior cognitive performance in late life is supported by a preservation of brain structures vulnerable to typical aging. Alternatively, elevated performance could be related to preservation of brain regions vulnerable to age-associated pathology. Examination of individuals that exhibit superior cognition throughout the adult lifespan may provide unique insights into neural mechanisms that support cognitive resilience in late life. MethodsWe examined cross-sectional associations between cortical brain structure and cognitive performance across three stages of adulthood: midlife (36-59), young-old (60-79), and older adults (80+) in typically aging individuals enrolled as part of the Human Connectome Project Lifespan-Aging (HCP-A)/Aging Adult Brain Connectome (AABC) studies. Participants were considered generally healthy and excluded for significant and/or atypical health conditions for their demographic category, including a clinical diagnosis of cognitive impairment or dementia. Domain-specific cognitive factor scores representing memory, fluid intelligence, and crystalized intelligence were sex-stratified and residualized relative to age, and participants were classified as high, middle, or low performers based on their unique performance relative to the study sample. ResultsIn the full sample, high performers demonstrated greater cortical thickness in regions of somatomotor, visual, and auditory cortices, as well as cortical areas in the frontal, parietal, and insular cortices (e.g., 5m, LIPv, MBelt). We also found associations between medial temporal and cingulate cortical thickness and cognitive performance, but only for select analyses. Group differences in cortical thickness were greatest when contrasting high and low performers for fluid intelligence compared to the other cognitive factors and were most prominent in the midlife participants compared to the other age strata. These group differences were primarily driven by reduced cortical thickness in the low performing individuals in the younger age bins relative to the typically performing sample. Effects were rather limited when contrasting high and low performers in the 80+ age group. The cortical areas of high statistical significance appeared to show a cross-sectional convergence effect, such that the differences in cortical thickness between high vs. low cognitive performance groups diminished with increasing age. Despite lower statistical power, effect sizes were greatest when contrasting individuals at the extremes of performance (e.g., top 10% vs. bottom 10% performers). These effects were robust to subsample replications using longitudinally defined cognitive classifications. DiscussionElevated cognitive performance was cross-sectionally associated with increased regional cortical thickness and effects were most prominent in mid-life compared to later ages. Notably, contrary to brain regions that may be expected to support such high-order cognitive performance, a significant portion of primary sensory, motor, and insular cortical areas exhibited group differences between the high- and low-performing groups in this relatively younger age group. Group differences were due to lower thickness in these regions in the low performing group relative to the typical performers. In contrast to the younger portion of the sample, regions typically considered vulnerable to Alzheimers disease (i.e., regions in the medial temporal lobe) were only infrequently implicated. These results suggest that specific patterns of cortical brain structural integrity including preserved thickness of primary motor and sensory cortical regions may be a necessary but not sufficient mechanism supporting superior cognitive abilities in earlier adulthood, while alternate neural mechanisms may support cognitive resilience later in life. These results must be interpreted with caution given the cross-sectional nature of this study. Cognitive capacity can only be estimated from a single timepoint, and several factors contribute to inter-individual variation that will not be accounted for in the models applied here. Longitudinal assessment of cognitive resilience in the HCP-A/AABC cohort will be performed in future work.