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Sannemann L, Bartels C, Brosseron F, Buerger K, Fliessbach K, Freiesleben SD, Frommann I, Glanz W, Heneka MT, Janowitz D, Kilimann I, Kleineidam L, Lammerding D, Laske C, Munk MHJ, Perneczky R, Peters O, Priller J, Rauchmann BS, Rostamzadeh A, Roy-Kluth N, Schild AK, Schneider A, Schneider LS, Spottke A, Spruth EJ, Teipel S, Wagner M, Wiltfang J, Wolfsgruber S, Duezel E, Jessen F. Symptomatic Clusters Related to Amyloid Positivity in Cognitively Unimpaired Individuals. J Alzheimers Dis 2024; 100:193-205. [PMID: 38848176 DOI: 10.3233/jad-231335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2024]
Abstract
Background The NIA-AA Research Framework on Alzheimer's disease (AD) proposes a transitional stage (stage 2) characterized by subtle cognitive decline, subjective cognitive decline (SCD) and mild neurobehavioral symptoms (NPS). Objective To identify participant clusters based on stage 2 features and assess their association with amyloid positivity in cognitively unimpaired individuals. Methods We included baseline data of N = 338 cognitively unimpaired participants from the DELCODE cohort with data on cerebrospinal fluid biomarkers for AD. Classification into the AD continuum (i.e., amyloid positivity, A+) was based on Aβ42/40 status. Neuropsychological test data were used to assess subtle objective cognitive dysfunction (OBJ), the subjective cognitive decline interview (SCD-I) was used to detect SCD, and the Neuropsychiatric Inventory Questionnaire (NPI-Q) was used to assess NPS. A two-step cluster analysis was carried out and differences in AD biomarkers between clusters were analyzed. Results We identified three distinct participant clusters based on presented symptoms. The highest rate of A+ participants (47.6%) was found in a cluster characterized by both OBJ and SCD. A cluster of participants that presented with SCD and NPS (A+:26.6%) and a cluster of participants with overall few symptoms (A+:19.7%) showed amyloid positivity in a range that was not higher than the expected A+ rate for the age group. Across the full sample, participants with a combination of SCD and OBJ in the memory domain showed a lower Aβ42/ptau181 ratio compared to those with neither SCD nor OBJ. Conclusions The cluster characterized by participants with OBJ and concomitant SCD was enriched for amyloid pathology.
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Affiliation(s)
- Lena Sannemann
- Department of Psychiatry, University of Cologne, Medical Faculty, Cologne, Germany
| | - Claudia Bartels
- Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, University of Goettingen, Göttingen, Germany
| | | | - Katharina Buerger
- German Center for Neurodegenerative Diseases - DZNE, Munich, Germany
- Institute for Stroke and Dementia Research - ISD, University Hospital, LMU Munich, Munich, Germany
| | - Klaus Fliessbach
- German Center for Neurodegenerative Diseases - DZNE, Bonn, Germany
- Department of Neurodegenerative Disease and Geriatric Psychiatry/Psychiatry, University of Bonn Medical Center, Bonn, Germany
| | - Silka Dawn Freiesleben
- German Center for Neurodegenerative Diseases - DZNE, Berlin, Germany
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin-Department of Psychiatry and Neurosciences, Berlin, Germany
| | - Ingo Frommann
- German Center for Neurodegenerative Diseases - DZNE, Bonn, Germany
- Department of Neurodegenerative Disease and Geriatric Psychiatry/Psychiatry, University of Bonn Medical Center, Bonn, Germany
| | - Wenzel Glanz
- German Center for Neurodegenerative Diseases - DZNE, Magdeburg, Germany
| | - Michael T Heneka
- Luxembourg Centre for Systems Biomedicine - LCSB, University of Luxembourg, Belvaux, Luxembourg
| | - Daniel Janowitz
- Institute for Stroke and Dementia Research - ISD, University Hospital, LMU Munich, Munich, Germany
| | - Ingo Kilimann
- German Center for Neurodegenerative Diseases - DZNE, Rostock, Germany
- Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
| | - Luca Kleineidam
- German Center for Neurodegenerative Diseases - DZNE, Bonn, Germany
- Department of Neurodegenerative Disease and Geriatric Psychiatry/Psychiatry, University of Bonn Medical Center, Bonn, Germany
| | - Dominik Lammerding
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin-Department of Psychiatry and Neurosciences, Berlin, Germany
| | - Christoph Laske
- German Center for Neurodegenerative Diseases - DZNE, Tübingen, Germany
- Department of Psychiatry and Psychotherapy, Section for Dementia Research, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Matthias H J Munk
- German Center for Neurodegenerative Diseases - DZNE, Tübingen, Germany
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Robert Perneczky
- German Center for Neurodegenerative Diseases - DZNE, Munich, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
- Munich Cluster for Systems Neurology - SyNergy, Munich, Munich, Germany
- Ageing Epidemiology Research Unit - AGE, School of Public Health, Imperial College London, London, UK
| | - Oliver Peters
- German Center for Neurodegenerative Diseases - DZNE, Berlin, Germany
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin-Department of Psychiatry and Neurosciences, Berlin, Germany
| | - Josef Priller
- German Center for Neurodegenerative Diseases - DZNE, Berlin, Germany
- Department of Psychiatry and Psychotherapy, Charité, Charitéplatz 1, Berlin, Germany
- Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich, Germany
- University of Edinburgh and UK DRI, Edinburgh, UK
| | - Boris-Stephan Rauchmann
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
- Sheffield Institute for Translational Neuroscience - SITraN, University of Sheffield, Sheffield, UK
- Department of Neuroradiology, University Hospital LMU, Munich, Germany
| | - Ayda Rostamzadeh
- Department of Psychiatry, University of Cologne, Medical Faculty, Cologne, Germany
| | - Nina Roy-Kluth
- German Center for Neurodegenerative Diseases - DZNE, Bonn, Germany
| | - Ann-Katrin Schild
- Department of Psychiatry, University of Cologne, Medical Faculty, Cologne, Germany
| | - Anja Schneider
- German Center for Neurodegenerative Diseases - DZNE, Bonn, Germany
- Department of Neurodegenerative Disease and Geriatric Psychiatry/Psychiatry, University of Bonn Medical Center, Bonn, Germany
| | - Luisa-Sophie Schneider
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin-Department of Psychiatry and Neurosciences, Berlin, Germany
| | - Annika Spottke
- German Center for Neurodegenerative Diseases - DZNE, Bonn, Germany
- Department of Neurology, University of Bonn, Bonn, Germany
| | - Eike Jakob Spruth
- German Center for Neurodegenerative Diseases - DZNE, Berlin, Germany
- Department of Psychiatry and Psychotherapy, Charité, Charitéplatz 1, Berlin, Germany
| | - Stefan Teipel
- German Center for Neurodegenerative Diseases - DZNE, Rostock, Germany
- Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
| | - Michael Wagner
- German Center for Neurodegenerative Diseases - DZNE, Bonn, Germany
- Department of Neurodegenerative Disease and Geriatric Psychiatry/Psychiatry, University of Bonn Medical Center, Bonn, Germany
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, University of Goettingen, Göttingen, Germany
- German Center for Neurodegenerative Diseases - DZNE, Göttingen, Germany
- Department of Medical Sciences, Neurosciences and Signaling Group, Institute of Biomedicine - iBiMED, University of Aveiro, Aveiro, Portugal
| | - Steffen Wolfsgruber
- German Center for Neurodegenerative Diseases - DZNE, Bonn, Germany
- Department of Neurodegenerative Disease and Geriatric Psychiatry/Psychiatry, University of Bonn Medical Center, Bonn, Germany
| | - Emrah Duezel
- German Center for Neurodegenerative Diseases - DZNE, Magdeburg, Germany
- Institute of Cognitive Neurology and Dementia Research - IKND, Otto-von-Guericke University, Magdeburg, Germany
| | - Frank Jessen
- Department of Psychiatry, University of Cologne, Medical Faculty, Cologne, Germany
- German Center for Neurodegenerative Diseases - DZNE, Bonn, Germany
- Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases - CECAD, University of Cologne, Cologne, Germany
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Stricker NH, Twohy EL, Albertson SM, Karstens AJ, Kremers WK, Machulda MM, Fields JA, Jack CR, Knopman DS, Mielke MM, Petersen RC. Mayo-PACC: A parsimonious preclinical Alzheimer's disease cognitive composite comprised of public-domain measures to facilitate clinical translation. Alzheimers Dement 2023; 19:2575-2584. [PMID: 36565459 PMCID: PMC10272034 DOI: 10.1002/alz.12895] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 11/03/2022] [Accepted: 11/05/2022] [Indexed: 12/25/2022]
Abstract
INTRODUCTION We aimed to define a Mayo Preclinical Alzheimer's disease Cognitive Composite (Mayo-PACC) that prioritizes parsimony and use of public domain measures to facilitate clinical translation. METHODS Cognitively unimpaired participants aged 65 to 85 at baseline with amyloid PET imaging were included, yielding 428 amyloid negative (A-) and 186 amyloid positive (A+) individuals with 7 years mean follow-up. Sensitivity to amyloid-related cognitive decline was examined using slope estimates derived from linear mixed models (difference in annualized change across A+ and A- groups). We compared differences in rates of change between Mayo-PACC and other composites (A+ > A- indicating more significant decline in A+). RESULTS All composites showed sensitivity to amyloid-related longitudinal cognitive decline (A+ > A- annualized change p < 0.05). Comparisons revealed that Mayo-PACC (AVLT sum of trials 1-5+6+delay, Trails B, animal fluency) showed comparable longitudinal sensitivity to other composites. DISCUSSION Mayo-PACC performs similarly to other composites and can be directly translated to the clinic.
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Affiliation(s)
- Nikki H. Stricker
- Division of Neurocognitive Disorders, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
| | - Erin L. Twohy
- Division of Biomedical Statistics and Informatics, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
| | - Sabrina M. Albertson
- Division of Biomedical Statistics and Informatics, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
| | - Aimee J. Karstens
- Division of Neurocognitive Disorders, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
| | - Walter K. Kremers
- Division of Biomedical Statistics and Informatics, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
| | - Mary M. Machulda
- Division of Neurocognitive Disorders, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
| | - Julie A. Fields
- Division of Neurocognitive Disorders, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
| | | | | | - Michelle M. Mielke
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
- Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
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Guevara JE, Kurniadi NE, Duff K. Assessing Longitudinal Cognitive Change in Mild Cognitive Impairment Using Estimated Standardized Regression-Based Formulas. J Alzheimers Dis 2023; 95:509-521. [PMID: 37545235 DOI: 10.3233/jad-230160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
BACKGROUND Cognitive change in mild cognitive impairment (MCI), a likely prodrome to Alzheimer's disease, can be tracked with repeated neuropsychological assessments, but there has been little work quantifying these changes over time. Cognitive change can be statistically examined using standardized regression-based (SRB) formulas, which yield a z-score indicating amount of change compared to a normative group. OBJECTIVE To use SRB z-scores to quantify cognitive change in a sample of patients classified as MCI at baseline, and to compare cognitive change in those who remained MCI on follow-up (MCI-Stable) and those who progressed to dementia (MCI-Decline). METHODS Using 283 MCI patients from a cognitive disorders clinic who were re-assessed after approximately one- and one-half years, SRB z-scores were calculated for each test in a comprehensive neuropsychological battery for each participant. RESULTS There was a significant decline between timepoints across all cognitive tests, with the greatest amount of decline on tests of learning and memory. Group differences were seen on nearly all cognitive tests, with the MCI-Decline group showing more decline (i.e., significantly larger and negative z-scores) than the MCI-Stable participants. Notable cognitive decline was also observed in the MCI-Stable group, with z-scores ranging from -0.01 - -2.24 compared to normative data. CONCLUSION This study highlights the amount of cognitive decline that occurs in MCI, including for those who remain "stable" and those who progress to dementia. It also demonstrates the value of the SRB method in more clearly quantifying cognitive decline, which may help identify individuals most vulnerable to MCI progression.
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Affiliation(s)
- Jasmin E Guevara
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
| | - Natalie E Kurniadi
- Advanced Neurobehavioral Health of Southern California, San Diego, CA, USA
| | - Kevin Duff
- Department of Neurology, Layton Aging and Alzheimer's Disease Center, Oregon Health & Science University, Portland, OR, USA
- Department of Neurology, Center for Alzheimer's Care, Imaging, and Research, University of Utah, Salt Lake City, UT, USA
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