Baseline Brain Volumes Predict Cognitive Decline More Robustly Than Atrophy Rates: Evidence for Brain Reserve

This longitudinal study of 75 Alzheimer's Disease Neuroimaging Initiative participants found that baseline brain structure measurements (particularly lateral ventricle size and hippocampal/thalamic volumes) were stronger predictors of cognitive decline and MCI conversion than rates of brain atrophy. The findings support the brain reserve concept, showing that structural capacity at baseline is more informative than dynamic changes for predicting cognitive trajectories across the disease continuum.