Purpose To examine the relationship between claustrophobia while undergoing MRI and possible cognitive impairment among older adults in a large population-based study, the Age, Gene/Environment Susceptibility-Reykjavik Study. Background A considerable limitation of magnetic resonance imaging (MRI) is its association with incomplete or cancelled examinations due to patient anxiety or claustrophobic symptoms(1,2,3). As a consequence, patients must be excluded from a diagnostic assessment which often is regarded as a “first choice” examination. Additionally, incomplete or cancelled studies are costly in terms of valuable scan time and...

Material and Methods A total of 801 males and 1101 females aged 68 to 96 years (mean 76±6) participated in the study. They were scheduled for brain MRI using a 1.5 Tesla system with a gantry bore of 60 cm in diameter. Claustrophobia was defined if subjects cancelled the appointment at the time of examination or had premature termination of the MRI examination due to anxiety or related symptoms. A screening cut-off to identify subjects with possible cognitive impairment was defined by a Mini Mental...

Results In the total sample of 1902, 4.7% (n=90) failed MRI due to claustrophobia. Out of the 90 who failed MRI, 24.4% (n=22) performed below the screening criteria for possible cognitive impairment compared to 18% (n=340) of the whole cohort. After adjusting for age, gender, education, physical function and abdominal waist circumference, subjects with claustrophobia did significantly worse on the screening tests than those who completed the MRI (odds ratio = 2.1; 95% confidence interval, 1.2-3.8; p=0.008) (Figure 1-2).

Conclusions Participants with incomplete MRI scan due to claustrophobia did significantly worse on cognitive screening tests than those who were able to complete the MRI. Management strategies for those individuals, taking possible cognitive impairment into account, should be considered to increase their comfort, reduce motion artefacts and reduce the number of cancelled or prematurely terminated studies.

References Spouse E and Gedroyc W.M. MRI of the claustrophobic patient: interventionally configured magnets. British Journal of Radiology 2000; 73(866): 146-151 Sarji , Abdullah B.J., Kumar G., Tan A.H., Narayanan P. Failed Magnetic Resonance Imaging Examinations due to Claustrophobia. Australas Radiolo. 1998; 42(4): 293-295 McIsaac K.H., Thordarson S.D., Shafran R., Rachman S., Poole G. Claustrophobia and the Magnetic Resonance Imaging Procedure. Journal of Behavioral Medicine 1998; 21(3): 255-268

Authors: Sigurdur Sigurdsson1, Milan Chang1 Thor Aspelund 1, Maria K. Jonsdottir1, Grimheidur F. Johannsdottir1, Bylgja Valtysdottir1, Gudny Eiriksdottir1, Lenore Launer2 and Vilmundur Gudnason1 1Icelandic Heart Association Research Institute, Kopavogur , 2National Institute on Aging, Bethesda, , E-mail address of first author: [email protected]