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Four Tissue Segmentation in ADNI II

While Alzheimer’s disease (AD) is the most common cause for dementia among older individuals 1,2 and the primary goal of ADNI, the lifetime risk for stroke equals and may exceed the risk of AD in some circumstances . In addition, MRI evidence of asymptomatic cerebrovascular disease (CVD) occurs in one-third of older individuals . In community based studies, mixed pathologies account for the most common cause of dementia 5 and the impact of cerebrovascular and AD pathology is additive, particularly when the AD pathological burden is mild . Similarly, MRI community based studies have shown that white matter hyperintensities (WMH) increase with advancing age and associated vascular risk factors 4,7 and are associated with an array of cognitive deficits in cross-sectional studies . Similar cross-sectional differences are also seen with clinically silent brain infarctions noted on MRI . Importantly, community based studies show that both WMH and SBI are associated with cognitive decline and incident MCI and dementia .