Rate of brain aging associates with future executive function in Asian children and older adults

Joint Public Review:

Summary:

The authors of the study investigated the generalization capabilities of a deep learning brain age model across different age groups within the Singaporean population, encompassing both elderly individuals aged 55 to 88 years and children aged 4 to 11 years. The model, originally trained on a dataset primarily consisting of Caucasian adults, demonstrated a varying degree of adaptability across these age groups. For the elderly, the authors observed that the model could be applied with minimal modifications, whereas for children, significant fine-tuning was necessary to achieve accurate predictions. Through their analysis, the authors established a correlation between changes in the brain age gap and future executive function performance across both demographics. Additionally, they identified distinct neuroanatomical predictors for brain age in each group: lateral ventricles and frontal areas were key in elderly participants, while white matter and posterior brain regions played a crucial role in children. These findings underscore the authors' conclusion that brain age models hold the potential for generalization across diverse populations, further emphasizing the significance of brain age progression as an indicator of cognitive development and aging processes.

Strengths:

(1) The study tackles a crucial research gap by exploring the adaptability of a brain age model across Asian demographics (Chinese, Malay, and Indian Singaporeans), enriching our knowledge of brain aging beyond Western populations.
(2) It uncovers distinct anatomical predictors of brain aging between elderly and younger individuals, highlighting a significant finding in the understanding of age-related changes and ethnic differences.

Weaknesses:

(1) Clarity in describing the fine-tuning process is essential for improved comprehension.
(2) The analysis often limits its findings to p-values, omitting the effect sizes crucial for understanding the relationship with cognition.
(3) Employing a predictive framework for cognition using brain age could offer more insight than mere statistical correlations.
(4) Expanding the study's scope to evaluate the model's generalisability to unseen Caucasian samples is vital for establishing a comparative baseline.

In summary, this paper underscores the critical need to include diverse ethnicities in model testing and estimation.