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Wan MD, Liu H, Liu XX, Zhang WW, Xiao XW, Zhang SZ, Jiang YL, Zhou H, Liao XX, Zhou YF, Tang BS, Wang JL, Guo JF, Jiao B, Shen L. Associations of multiple visual rating scales based on structural magnetic resonance imaging with disease severity and cerebrospinal fluid biomarkers in patients with Alzheimer’s disease. Front Aging Neurosci 2022; 14:906519. [PMID: 35966797 PMCID: PMC9374170 DOI: 10.3389/fnagi.2022.906519] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 07/13/2022] [Indexed: 12/11/2022] Open
Abstract
The relationships between multiple visual rating scales based on structural magnetic resonance imaging (sMRI) with disease severity and cerebrospinal fluid (CSF) biomarkers in patients with Alzheimer’s disease (AD) were ambiguous. In this study, a total of 438 patients with clinically diagnosed AD were recruited. All participants underwent brain sMRI scan, and medial temporal lobe atrophy (MTA), posterior atrophy (PA), global cerebral atrophy-frontal sub-scale (GCA-F), and Fazekas rating scores were visually evaluated. Meanwhile, disease severity was assessed by neuropsychological tests such as the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and Clinical Dementia Rating (CDR). Among them, 95 patients were tested for CSF core biomarkers, including Aβ1–42, Aβ1–40, Aβ1–42/Aβ1–40, p-tau, and t-tau. As a result, the GCA-F and Fazekas scales showed positively significant correlations with onset age (r = 0.181, p < 0.001; r = 0.411, p < 0.001, respectively). Patients with late-onset AD (LOAD) showed higher GCA-F and Fazekas scores (p < 0.001, p < 0.001). With regard to the disease duration, the MTA and GCA-F were positively correlated (r = 0.137, p < 0.05; r = 0.106, p < 0.05, respectively). In terms of disease severity, a positively significant association emerged between disease severity and the MTA, PA GCA-F, and Fazekas scores (p < 0.001, p < 0.001, p < 0.001, p < 0.05, respectively). Moreover, after adjusting for age, gender, and APOE alleles, the MTA scale contributed to moderate to severe AD in statistical significance independently by multivariate logistic regression analysis (p < 0.05). The model combining visual rating scales, age, gender, and APOE alleles showed the best performance for the prediction of moderate to severe AD significantly (AUC = 0.712, sensitivity = 51.5%, specificity = 84.6%). In addition, we observed that the MTA and Fazekas scores were associated with a lower concentration of Aβ1–42 (p < 0.031, p < 0.022, respectively). In summary, we systematically analyzed the benefits of multiple visual rating scales in predicting the clinical status of AD. The visual rating scales combined with age, gender, and APOE alleles showed best performance in predicting the severity of AD. MRI biomarkers in combination with CSF biomarkers can be used in clinical practice.
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Affiliation(s)
- Mei-dan Wan
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Hui Liu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Xi-xi Liu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Wei-wei Zhang
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, China
| | - Xue-wen Xiao
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Si-zhe Zhang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Ya-ling Jiang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Hui Zhou
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Xin-xin Liao
- National Clinical Research Center for Geriatric Disorders, Central South University, Changsha, China
- Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, China
- Department of Geriatrics, Xiangya Hospital, Central South University, Changsha, China
| | - Ya-fang Zhou
- National Clinical Research Center for Geriatric Disorders, Central South University, Changsha, China
- Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, China
- Department of Geriatrics, Xiangya Hospital, Central South University, Changsha, China
| | - Bei-sha Tang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Central South University, Changsha, China
- Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, China
- Engineering Research Center of Hunan Province in Cognitive Impairment Disorders, Central South University, Changsha, China
- Hunan International Scientific and Technological Cooperation Base of Neurodegenerative and Neurogenetic Diseases, Changsha, China
| | - Jun-Ling Wang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Central South University, Changsha, China
- Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, China
- Engineering Research Center of Hunan Province in Cognitive Impairment Disorders, Central South University, Changsha, China
- Hunan International Scientific and Technological Cooperation Base of Neurodegenerative and Neurogenetic Diseases, Changsha, China
| | - Ji-feng Guo
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Central South University, Changsha, China
- Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, China
- Engineering Research Center of Hunan Province in Cognitive Impairment Disorders, Central South University, Changsha, China
- Hunan International Scientific and Technological Cooperation Base of Neurodegenerative and Neurogenetic Diseases, Changsha, China
| | - Bin Jiao
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Central South University, Changsha, China
- Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, China
- Engineering Research Center of Hunan Province in Cognitive Impairment Disorders, Central South University, Changsha, China
- Hunan International Scientific and Technological Cooperation Base of Neurodegenerative and Neurogenetic Diseases, Changsha, China
- Bin Jiao,
| | - Lu Shen
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Central South University, Changsha, China
- Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, China
- Engineering Research Center of Hunan Province in Cognitive Impairment Disorders, Central South University, Changsha, China
- Hunan International Scientific and Technological Cooperation Base of Neurodegenerative and Neurogenetic Diseases, Changsha, China
- Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, China
- *Correspondence: Lu Shen,
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Zhang H, Sun M, Hu Z, Cao Y, Hao M, Li Y, Jin L, Sun X, Wang X, Jiang X. Association of Arterial Stiffness with Functional Disability and Mobility Limitation: The Rugao Longitudinal Ageing Study. J Nutr Health Aging 2022; 26:598-605. [PMID: 35718869 DOI: 10.1007/s12603-022-1802-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Arterial stiffness is a common issue that may represent an indicator of vascular ageing. We aimed to investigate the association of arterial stiffness with the risk of functional disability and mobility limitation in older adults. DESIGN Prospective cohort study. SETTING AND PARTICIPANTS A total of 1699 older adults from the Rugao Longitudinal Ageing Study were included and analysed. MEASUREMENTS Arterial stiffness was assessed by brachial-ankle pulse wave velocity (baPWV). Functional disability and mobility limitation were evaluated by the activities of daily living and the Timed Up and Go test, respectively. The associations of baPWV and risk of functional disability and mobility limitation were analysed using logistic regression models. Restricted cubic spline regressions were applied to estimate the possible nonlinear relationships between them. RESULTS During the 3.5-year follow-up, 97 (10.00%) and 285 (31.11%) individuals were defined as new-onset functional disability and mobility limitation, respectively. After adjusting for confounding factors, elevated baPWV was significantly associated with a higher risk of incident functional disability (odds ratio [OR] 1.18, 95% confidence interval [CI] 1.06-1.31) and mobility limitation (OR 1.08, 95% CI 1.01-1.16). Additionally, consistent results were obtained from the stratified analyses of the different subgroups. Multivariable restricted cubic spline regression analysis further demonstrated that a near-linear association occurred between baPWV and the risk of incident functional disability and mobility limitation (P-overall < 0.01, P-nonlinear >0.05). CONCLUSION Arterial stiffness, as assessed by baPWV, was associated with the risk of functional disability and mobility limitation in this community-based cohort, and these associations were nearly linear.
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Affiliation(s)
- H Zhang
- Xiaoyan Jiang, Key Laboratory of Arrhythmias, Ministry of Education, Department of Pathology and Pathophysiology, School of Medicine, Tongji University, Shanghai, China. E-mail address:
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