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Aleksic S, Fleysher R, Weiss EF, Tal N, Darby T, Blumen HM, Vazquez J, Ye KQ, Gao T, Siegel SM, Barzilai N, Lipton ML, Milman S. Hypothalamic MRI-derived microstructure is associated with neurocognitive aging in humans. Neurobiol Aging 2024; 141:102-112. [PMID: 38850591 DOI: 10.1016/j.neurobiolaging.2024.05.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 05/17/2024] [Accepted: 05/31/2024] [Indexed: 06/10/2024]
Abstract
The hypothalamus regulates homeostasis across the lifespan and is emerging as a regulator of aging. In murine models, aging-related changes in the hypothalamus, including microinflammation and gliosis, promote accelerated neurocognitive decline. We investigated relationships between hypothalamic microstructure and features of neurocognitive aging, including cortical thickness and cognition, in a cohort of community-dwelling older adults (age range 65-97 years, n=124). Hypothalamic microstructure was evaluated with two magnetic resonance imaging diffusion metrics: mean diffusivity (MD) and fractional anisotropy (FA), using a novel image processing pipeline. Hypothalamic MD was cross-sectionally positively associated with age and it was negatively associated with cortical thickness. Hypothalamic FA, independent of cortical thickness, was cross-sectionally positively associated with neurocognitive scores. An exploratory analysis of longitudinal neurocognitive performance suggested that lower hypothalamic FA may predict cognitive decline. No associations between hypothalamic MD, age, and cortical thickness were identified in a younger control cohort (age range 18-63 years, n=99). To our knowledge, this is the first study to demonstrate that hypothalamic microstructure is associated with features of neurocognitive aging in humans.
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Affiliation(s)
- Sandra Aleksic
- Department of Medicine, Institute for Aging Research, Albert Einstein College of Medicine, Bronx, NY, United States.
| | - Roman Fleysher
- Department of Radiology, Columbia University Irving Medical Center, New York, NY, United States; Department of Radiology, Albert Einstein College of Medicine, Gruss Magnetic Resonance Research Center, Bronx, NY, United States
| | - Erica F Weiss
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Noa Tal
- Department of Medicine, Cedars-Sinai, Los Angeles, CA, United States
| | - Timothy Darby
- Albert Einstein College of Medicine, Bronx, NY, United States
| | - Helena M Blumen
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, United States; Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Juan Vazquez
- Department of Internal Medicine, John Hopkins University, Baltimore, MD, United States
| | - Kenny Q Ye
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States; Department of Systems and Computational Biology, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Tina Gao
- Department of Medicine, Institute for Aging Research, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Shira M Siegel
- Department of Radiology, Columbia University Irving Medical Center, New York, NY, United States
| | - Nir Barzilai
- Department of Medicine, Institute for Aging Research, Albert Einstein College of Medicine, Bronx, NY, United States; Department of Genetics, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Michael L Lipton
- Department of Radiology, Columbia University Irving Medical Center, New York, NY, United States; Department of Biomedical Engineering, Columbia University, New York, NY, United States
| | - Sofiya Milman
- Department of Medicine, Institute for Aging Research, Albert Einstein College of Medicine, Bronx, NY, United States; Department of Genetics, Albert Einstein College of Medicine, Bronx, NY, United States
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Xu Y, Sun Z, Jonaitis E, Deming Y, Lu Q, Johnson SC, Engelman CD. Mid-to-Late Life Healthy Lifestyle Modifies Genetic Risk for Longitudinal Cognitive Aging among Asymptomatic Individuals. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.05.26.24307953. [PMID: 38853902 PMCID: PMC11160812 DOI: 10.1101/2024.05.26.24307953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2024]
Abstract
IMPORTANCE Genetic and lifestyle factors contribute to an individual's risk of developing Alzheimer's disease. However, it is unknown whether and how adherence to healthy lifestyles can mitigate the genetic risk of Alzheimer's. OBJECTIVE The aim of this study is to investigate whether adherence to healthy lifestyles can modify the impact of genetic predisposition to Alzheimer's disease on later-life cognitive decline. DESIGN SETTING AND PARTICIPANTS This prospective cohort study included 891 adults of European ancestry, aged 40 to 65, who were without dementia and had complete healthy-lifestyle and cognition data during the follow-up. Participants joined the Wisconsin Registry for Alzheimer's Prevention (WRAP) beginning in 2001. We conducted replication analyses using a subsample with similar baseline age range from the Health and Retirement Study (HRS). EXPOSURES We assessed participants' exposures using a continuous non-APOE polygenic risk score for Alzheimer's, a binary indicator for APOE-ε4 carrier status, and a weighted healthy-lifestyle score, including factors such as no current smoking, regular physical activity, healthy diet, light to moderate alcohol consumption, and frequent cognitive activities. MAIN OUTCOMES AND MEASURES We z-standardized cognitive scores for global (Preclinical Alzheimer's Cognitive Composite score 3 - PACC3) and domain-specific assessments (delayed recall and immediate learning). RESULTS We followed 891 individuals for up to 10 years (mean [SD] baseline age, 58 [6] years, 31% male, 38% APOE-ε4 carriers). After false discovery rate (FDR) correction, we found statistically significant PRS × lifestyle × age interactions on preclinical cognitive decline but the evidence is stronger among APOE-ε4 carriers. Among APOE-ε4 carriers, PRS-related differences in overall and memory-related domains between people scoring 0-1 and 4-5 regarding healthy lifestyles became evident around age 67 after FDR correction. These findings were robust across several sensitivity analyses and were replicated in the population-based HRS. CONCLUSION A favorable lifestyle can mitigate the genetic risk associated with current known non-APOE genetic variants for longitudinal cognitive decline, and these protective effects are particularly pronounced among APOE-ε4 carriers.
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Affiliation(s)
- Yuexuan Xu
- G.H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University
| | - Zhongxuan Sun
- Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin-Madison
| | - Erin Jonaitis
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison
| | - Yuetiva Deming
- G.H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison
| | - Qiongshi Lu
- Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin-Madison
| | - Sterling C. Johnson
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison
| | - Corinne D. Engelman
- G.H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University
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Quek Y, Fung YL, Bourgeat P, Vogrin SJ, Collins SJ, Bowden SC. Combining neuropsychological assessment and structural neuroimaging to identify early Alzheimer's disease in a memory clinic cohort. Brain Behav 2024; 14:e3505. [PMID: 38688879 PMCID: PMC11061200 DOI: 10.1002/brb3.3505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 04/03/2024] [Accepted: 04/08/2024] [Indexed: 05/02/2024] Open
Abstract
INTRODUCTION The current study examined the contributions of comprehensive neuropsychological assessment and volumetric assessment of selected mesial temporal subregions on structural magnetic resonance imaging (MRI) to identify patients with amnestic mild cognitive impairment (aMCI) and mild probable Alzheimer's disease (AD) dementia in a memory clinic cohort. METHODS Comprehensive neuropsychological assessment and automated entorhinal, transentorhinal, and hippocampal volume measurements were conducted in 40 healthy controls, 38 patients with subjective memory symptoms, 16 patients with aMCI, 16 patients with mild probable AD dementia. Multinomial logistic regression was used to compare the neuropsychological and MRI measures. RESULTS Combining the neuropsychological and MRI measures improved group membership prediction over the MRI measures alone but did not improve group membership prediction over the neuropsychological measures alone. CONCLUSION Comprehensive neuropsychological assessment was an important tool to evaluate cognitive impairment. The mesial temporal volumetric MRI measures contributed no diagnostic value over and above the determinations made through neuropsychological assessment.
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Affiliation(s)
- Yi‐En Quek
- Melbourne School of Psychological SciencesThe University of MelbourneParkvilleVictoriaAustralia
| | - Yi Leng Fung
- Melbourne School of Psychological SciencesThe University of MelbourneParkvilleVictoriaAustralia
| | - Pierrick Bourgeat
- The Australian e‐Health Research CentreCSIRO Health and BiosecurityHerstonQueenslandAustralia
| | - Simon J. Vogrin
- Department of Clinical NeurosciencesSt. Vincent's Hospital MelbourneFitzroyVictoriaAustralia
| | - Steven J. Collins
- Department of Clinical NeurosciencesSt. Vincent's Hospital MelbourneFitzroyVictoriaAustralia
- Department of MedicineThe Royal Melbourne HospitalThe University of MelbourneParkvilleVictoriaAustralia
| | - Stephen C. Bowden
- Melbourne School of Psychological SciencesThe University of MelbourneParkvilleVictoriaAustralia
- Department of Clinical NeurosciencesSt. Vincent's Hospital MelbourneFitzroyVictoriaAustralia
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Jonaitis EM, Hermann BP, Mueller KD, Clark LR, Du L, Betthauser TJ, Cody K, Gleason CE, Christian BT, Asthana S, Chappell RJ, Chin NA, Johnson SC, Langhough RE. Longitudinal normative standards for cognitive tests and composites using harmonized data from two Wisconsin AD-risk-enriched cohorts. Alzheimers Dement 2024; 20:3305-3321. [PMID: 38539269 PMCID: PMC11095443 DOI: 10.1002/alz.13774] [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] [Received: 11/09/2023] [Revised: 02/02/2024] [Accepted: 02/06/2024] [Indexed: 04/06/2024]
Abstract
INTRODUCTION Published norms are typically cross-sectional and often are not sensitive to preclinical cognitive changes due to dementia. We developed and validated demographically adjusted cross-sectional and longitudinal normative standards using harmonized outcomes from two Alzheimer's disease (AD) risk-enriched cohorts. METHODS Data from the Wisconsin Registry for Alzheimer's Prevention and the Wisconsin Alzheimer's Disease Research Center were combined. Quantile regression was used to develop unconditional (cross-sectional) and conditional (longitudinal) normative standards for 18 outcomes using data from cognitively unimpaired participants (N = 1390; mean follow-up = 9.25 years). Validity analyses (N = 2456) examined relationships between percentile scores (centiles), consensus-based cognitive statuses, and AD biomarker levels. RESULTS Unconditional and conditional centiles were lower in those with consensus-based impairment or biomarker positivity. Similarly, quantitative biomarker levels were higher in those whose centiles suggested decline. DISCUSSION This study presents normative standards for cognitive measures sensitive to pre-clinical changes. Future directions will investigate potential clinical applications of longitudinal normative standards. HIGHLIGHTS Quantile regression was used to construct longitudinal norms for cognitive tests. Poorer percentile scores were related to concurrent diagnosis and Alzheimer's disease biomarkers. A ShinyApp was built to display test scores and norms and flag low performance.
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Affiliation(s)
- Erin M. Jonaitis
- Wisconsin Alzheimer's InstituteSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
- Wisconsin Alzheimer's Disease Research CenterSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
| | - Bruce P. Hermann
- Department of NeurologySchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
| | - Kimberly D. Mueller
- Department of Communication Sciences and DisordersUniversity of Wisconsin – MadisonMadisonWisconsinUSA
- Division of GeriatricsUniversity of Wisconsin – MadisonMadisonWisconsinUSA
| | - Lindsay R. Clark
- Division of GeriatricsUniversity of Wisconsin – MadisonMadisonWisconsinUSA
- Geriatric Research Education and Clinical CenterWilliam S. Middleton Memorial Veterans Hospital, MadisonMadisonWisconsinUSA
| | - Lianlian Du
- Wisconsin Alzheimer's InstituteSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
| | - Tobey J. Betthauser
- Wisconsin Alzheimer's Disease Research CenterSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
- Department of MedicineSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
| | - Karly Cody
- Wisconsin Alzheimer's Disease Research CenterSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
| | - Carey E. Gleason
- Wisconsin Alzheimer's Disease Research CenterSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
- Division of GeriatricsUniversity of Wisconsin – MadisonMadisonWisconsinUSA
- Geriatric Research Education and Clinical CenterWilliam S. Middleton Memorial Veterans Hospital, MadisonMadisonWisconsinUSA
- Department of MedicineSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
| | - Bradley T. Christian
- Wisconsin Alzheimer's Disease Research CenterSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
- Waisman CenterUniversity of Wisconsin – MadisonMadisonWisconsinUSA
- Department of Medical PhysicsSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
| | - Sanjay Asthana
- Wisconsin Alzheimer's Disease Research CenterSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
- Department of MedicineSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
| | - Richard J. Chappell
- Department of StatisticsSchool of ComputerData and Information SciencesUniversity of Wisconsin – MadisonMadisonWisconsinUSA
- Department of Biostatistics and Medical InformaticsSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
| | - Nathaniel A. Chin
- Wisconsin Alzheimer's Disease Research CenterSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
- Division of GeriatricsUniversity of Wisconsin – MadisonMadisonWisconsinUSA
| | - Sterling C. Johnson
- Wisconsin Alzheimer's InstituteSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
- Wisconsin Alzheimer's Disease Research CenterSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
- Geriatric Research Education and Clinical CenterWilliam S. Middleton Memorial Veterans Hospital, MadisonMadisonWisconsinUSA
- Department of MedicineSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
| | - Rebecca E. Langhough
- Wisconsin Alzheimer's InstituteSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
- Wisconsin Alzheimer's Disease Research CenterSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
- Department of MedicineSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
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Tang R, Buchholz E, Dale AM, Rissman RA, Fennema-Notestine C, Gillespie NA, Hagler DJ, Lyons MJ, Neale MC, Panizzon MS, Puckett OK, Reynolds CA, Franz CE, Kremen WS, Elman JA. Associations of plasma neurofilament light chain with cognition and neuroimaging measures in community-dwelling early old age men. Alzheimers Res Ther 2024; 16:90. [PMID: 38664843 PMCID: PMC11044425 DOI: 10.1186/s13195-024-01464-1] [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] [Received: 10/31/2023] [Accepted: 04/21/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND Plasma neurofilament light chain (NfL) is a promising biomarker of neurodegeneration with potential clinical utility in monitoring the progression of neurodegenerative diseases. However, the cross-sectional associations of plasma NfL with measures of cognition and brain have been inconsistent in community-dwelling populations. METHODS We examined these associations in a large community-dwelling sample of early old age men (N = 969, mean age = 67.57 years, range = 61-73 years), who are either cognitively unimpaired (CU) or with mild cognitive impairment (MCI). Specifically, we investigated five cognitive domains (executive function, episodic memory, verbal fluency, processing speed, visual-spatial ability), as well as neuroimaging measures of gray and white matter. RESULTS After adjusting for age, health status, and young adult general cognitive ability, plasma NfL level was only significantly associated with processing speed and white matter hyperintensity (WMH) volume, but not with other cognitive or neuroimaging measures. The association with processing speed was driven by individuals with MCI, as it was not detected in CU individuals. CONCLUSIONS These results suggest that in early old age men without dementia, plasma NfL does not appear to be sensitive to cross-sectional individual differences in most domains of cognition or neuroimaging measures of gray and white matter. The revealed plasma NfL associations were limited to WMH for all participants and processing speed only within the MCI cohort. Importantly, considering cognitive status in community-based samples will better inform the interpretation of the relationships of plasma NfL with cognition and brain and may help resolve mixed findings in the literature.
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Affiliation(s)
- Rongxiang Tang
- Department of Psychiatry, University of California San Diego, La Jolla, 92093, USA.
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, 92093, USA.
| | - Erik Buchholz
- Department of Psychiatry, University of California San Diego, La Jolla, 92093, USA
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, 92093, USA
| | - Anders M Dale
- Department of Radiology, University of California San Diego, La Jolla, 92093, USA
- Department of Neurosciences, University of California San Diego, La Jolla, 92093, USA
| | - Robert A Rissman
- Department of Neurosciences, University of California San Diego, La Jolla, 92093, USA
| | - Christine Fennema-Notestine
- Department of Psychiatry, University of California San Diego, La Jolla, 92093, USA
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, 92093, USA
- Department of Radiology, University of California San Diego, La Jolla, 92093, USA
| | - Nathan A Gillespie
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavior Genetics, Virginia Commonwealth University, Richmond, VA, 23284, USA
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Donald J Hagler
- Department of Neurosciences, University of California San Diego, La Jolla, 92093, USA
| | - Michael J Lyons
- Department of Psychological and Brain Sciences, Boston University, Boston, 02215, USA
| | - Michael C Neale
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavior Genetics, Virginia Commonwealth University, Richmond, VA, 23284, USA
| | - Matthew S Panizzon
- Department of Psychiatry, University of California San Diego, La Jolla, 92093, USA
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, 92093, USA
| | - Olivia K Puckett
- Department of Psychiatry, University of California San Diego, La Jolla, 92093, USA
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, 92093, USA
| | - Chandra A Reynolds
- Department of Psychology and Neurosciences, University of Colorado Boulder, Boulder, 80309, USA
| | - Carol E Franz
- Department of Psychiatry, University of California San Diego, La Jolla, 92093, USA
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, 92093, USA
| | - William S Kremen
- Department of Psychiatry, University of California San Diego, La Jolla, 92093, USA
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, 92093, USA
| | - Jeremy A Elman
- Department of Psychiatry, University of California San Diego, La Jolla, 92093, USA
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, 92093, USA
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Hall MG, Wollman SC, Haines ME, Katschke JL, Boyle MA, Richardson HK, Hammers DB. Clinical validation of an aggregate learning ratio from the neuropsychological assessment battery. APPLIED NEUROPSYCHOLOGY. ADULT 2024:1-10. [PMID: 38527375 DOI: 10.1080/23279095.2024.2329974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
Quantifying learning deficits provides valuable information in identifying and diagnosing mild cognitive impairment and dementia. Previous research has found that a learning ratio (LR) metric, derived from the list learning test from the Neuropsychological Assessment Battery (NAB), was able to distinguish between those with normal cognition versus memory impairment. The current study furthers the NAB LR research by validating a NAB story LR, as well as an aggregate LR. The aggregate LR was created by combining the individual list and story LRs. Participants were classified as those with normal cognition (n = 51), those with MCI (n = 39) and those with dementia (n = 35). Results revealed the story LR was able to accurately distinguish normal controls from those with mild cognitive impairment and those with dementia and offers enhanced discriminability beyond the story immediate recall score (sum of trial 1 and trial 2). Further, the aggregate LR provided superior discriminability beyond the individual list and story LRs and accounted for additional variance in diagnostic group classification. The NAB aggregate LR provides improved sensitivity in detecting declines in impaired learning, which may assist clinicians in making diagnoses earlier in a disease process, benefiting the individual through earlier interventions.
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Affiliation(s)
- Matthew G Hall
- PM&R, The University of Toledo - Health Science Campus, Toledo, OH, USA
| | | | - Mary E Haines
- PM&R, The University of Toledo - Health Science Campus, Toledo, OH, USA
| | | | - Mellisa A Boyle
- PM&R, The University of Toledo - Health Science Campus, Toledo, OH, USA
| | | | - Dustin B Hammers
- Neurology, Indiana University School of Medicine, Indianapolis, IN, USA
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Sepe-Forrest L, Bailey AJ, Quinn PD, Carver FW, Hetrick WP, O’Donnell BF. Alcohol consumption's effects on working memory: Examining familial confounding. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2024; 38:153-159. [PMID: 37326533 PMCID: PMC10721736 DOI: 10.1037/adb0000936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
OBJECTIVE The purpose of our study was to provide a more rigorous test of the causal hypothesis that chronic alcohol use impairs working memory performance. METHOD We measured linear associations between a latent factor representing alcohol consumption and accuracy across four working memory tasks before and after accounting for familial confounding using a cotwin control design. Specifically, this study examined accuracy through a latent working memory score, the National Institutes of Health (NIH) Toolbox List Sorting, NIH Toolbox Picture Sequence, Penn Word Memory, and 2-back tasks. The study included data from 158 dizygotic and 278 monozygotic twins (Mage = 29 ± 3 years). RESULTS In our initial sample-wide analysis, we did not detect any statistically significant associations between alcohol use and working memory accuracy. However, our cotwin control analyses showed that twins with greater levels of alcohol use exhibited worse scores on the latent working memory composite measure (B = -.25, CI [-.43, -.08], p < .01), Picture Sequence (B = -.31, CI [-.55, -.08], p < .01), and List Sorting (B = -.28, CI [-.51, -.06 ], p = .01) tasks than did their cotwins. CONCLUSIONS These results are consistent with a potentially causal relationship between alcohol use and working memory performance that can be detected only after accounting for confounding familial factors. This highlights the importance of understanding the mechanisms that may underlie negative associations between alcohol use and cognitive performance, as well as the potential factors that influence both alcohol behaviors and cognition. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Linnea Sepe-Forrest
- Department of Psychological & Brain Sciences, Indiana University
- Program in Neuroscience, Indiana University
| | - Allen J. Bailey
- Department of Psychological & Brain Sciences, Indiana University
| | - Patrick D. Quinn
- Department of Psychological & Brain Sciences, Indiana University
- Program in Neuroscience, Indiana University
- School of Public Health, Indiana University
| | | | - William P. Hetrick
- Department of Psychological & Brain Sciences, Indiana University
- Program in Neuroscience, Indiana University
| | - Brian F. O’Donnell
- Department of Psychological & Brain Sciences, Indiana University
- Program in Neuroscience, Indiana University
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Jauregi Zinkunegi A, Bruno D, Betthauser TJ, Langhough R, Asthana S, Chin NA, Hermann BP, Johnson SC, Mueller KD. A comparison of story-recall metrics to predict hippocampal volume in older adults with and without cognitive impairment. Clin Neuropsychol 2024; 38:453-470. [PMID: 37349970 PMCID: PMC10739621 DOI: 10.1080/13854046.2023.2223389] [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] [Received: 02/06/2023] [Accepted: 06/05/2023] [Indexed: 06/24/2023]
Abstract
Objective: Process-based scores of episodic memory tests, such as the recency ratio (Rr), have been found to compare favourably to, or to be better than, most conventional or "traditional" scores employed to estimate memory ability in older individuals (Bock et al., 2021; Bruno et al., 2019). We explored the relationship between process-based scores and hippocampal volume in older adults, while comparing process-based to traditional story recall-derived scores, to examine potential differences in their predictive abilities. Methods: We analysed data from 355 participants extracted from the WRAP and WADRC databases, who were classified as cognitively unimpaired, or exhibited mild cognitive impairment (MCI) or dementia. Story Recall was measured with the Logical Memory Test (LMT) from the Weschler Memory Scale Revised, collected within twelve months of the magnetic resonance imaging scan. Linear regression analyses were conducted with left or right hippocampal volume (HV) as outcomes separately, and with Rr, Total ratio, Immediate LMT, or Delayed LMT scores as predictors, along with covariates. Results: Higher Rr and Tr scores significantly predicted lower left and right HV, while Tr showed the best model fit of all, as indicated by AIC. Traditional scores, Immediate LMT and Delayed LMT, were significantly associated with left and right HV, but were outperformed by both process-based scores for left HV, and by Tr for right HV. Conclusions: Current findings show the direct relationship between hippocampal volume and all the LMT scores examined here, and that process-based scores outperform traditional scores as markers of hippocampal volume.
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Affiliation(s)
| | - Davide Bruno
- School of Psychology, Liverpool John Moores University, Liverpool, UK
| | - Tobey J Betthauser
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, Madison, WI, USA
- Wisconsin Alzheimer's Disease Research Center, School of Medicine and Public Health, University of Wisconsin, Madison, Madison, WI, USA
| | - Rebecca Langhough
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, Madison, WI, USA
- Wisconsin Alzheimer's Disease Research Center, School of Medicine and Public Health, University of Wisconsin, Madison, Madison, WI, USA
- Wisconsin Alzheimer's Institute, School of Medicine and Public Health, University of Wisconsin, Madison, Madison, WI, USA
| | - Sanjay Asthana
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, Madison, WI, USA
- Wisconsin Alzheimer's Institute, School of Medicine and Public Health, University of Wisconsin, Madison, Madison, WI, USA
- Geriatric Research Education and Clinical Center, William S. Middleton Veterans Hospital, Madison, WI, USA
| | - Nathaniel A Chin
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, Madison, WI, USA
- Wisconsin Alzheimer's Disease Research Center, School of Medicine and Public Health, University of Wisconsin, Madison, Madison, WI, USA
| | - Bruce P Hermann
- Wisconsin Alzheimer's Institute, School of Medicine and Public Health, University of Wisconsin, Madison, Madison, WI, USA
- Department of Neurology, University of Wisconsin, Madison, Madison, WI, USA
| | - Sterling C Johnson
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, Madison, WI, USA
- Wisconsin Alzheimer's Disease Research Center, School of Medicine and Public Health, University of Wisconsin, Madison, Madison, WI, USA
- Wisconsin Alzheimer's Institute, School of Medicine and Public Health, University of Wisconsin, Madison, Madison, WI, USA
- Geriatric Research Education and Clinical Center, William S. Middleton Veterans Hospital, Madison, WI, USA
| | - Kimberly D Mueller
- Wisconsin Alzheimer's Disease Research Center, School of Medicine and Public Health, University of Wisconsin, Madison, Madison, WI, USA
- Wisconsin Alzheimer's Institute, School of Medicine and Public Health, University of Wisconsin, Madison, Madison, WI, USA
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, WI, USA
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Xu Y, Sun Z, Jonaitis E, Deming Y, Lu Q, Johnson SC, Engelman CD. Apolipoprotein E moderates the association between non-APOE polygenic risk score for Alzheimer's disease and aging on preclinical cognitive function. Alzheimers Dement 2024; 20:1063-1075. [PMID: 37858606 PMCID: PMC10916952 DOI: 10.1002/alz.13515] [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] [Received: 06/09/2023] [Revised: 09/01/2023] [Accepted: 09/25/2023] [Indexed: 10/21/2023]
Abstract
INTRODUCTION Variation in preclinical cognitive decline suggests additional genetic factors related to Alzheimer's disease (eg, a non-APOE polygenic risk score [PRS]) may interact with the APOE ε4 allele to influence cognitive decline. METHODS We tested the PRS × APOE ε4 × age interaction on preclinical cognition using longitudinal data from the Wisconsin Registry for Alzheimer's Prevention. All analyses were fitted using a linear mixed-effects model and adjusted for within individual/family correlation among 1190 individuals. RESULTS We found statistically significant PRS × APOE ε4 × age interactions on immediate learning (P = 0.038), delayed recall (P < 0.001), and Preclinical Alzheimer's Cognitive Composite 3 score (P = 0.026). PRS-related differences in overall and memory-related cognitive domains between people with and without APOE ε4 emerge around age 70, with a much stronger adverse PRS effect among APOE ε4 carriers. The findings were replicated in a population-based cohort. DISCUSSIONS APOE ε4 can modify the association between PRS and cognition decline. HIGHLIGHTS APOE ε4 can modify the association between polygenic risk scores (PRSs) and longitudinal cognition decline, with the modifying effects more pronounced when the PRS is constructed using a conservative P threshold (eg, P < 5e-8 ). The adverse genetic effect caused by the combined effect of the currently known genetic variants is more detrimental among APOE ε4 carriers around age 70. Individuals who are APOE ε4 carriers with high PRSs are the most vulnerable to the harmful effects caused by genetic burden.
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Affiliation(s)
- Yuexuan Xu
- Department of Population Health ScienceSchool of Medicine and Public HealthUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - Zhongxuan Sun
- Department of Biostatistics and Medical InformaticsSchool of Medicine and Public HealthUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - Erin Jonaitis
- Wisconsin Alzheimer's InstituteUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - Yuetiva Deming
- Department of Population Health ScienceSchool of Medicine and Public HealthUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
- Department of MedicineSchool of Medicine and Public HealthUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - Qiongshi Lu
- Department of Biostatistics and Medical InformaticsSchool of Medicine and Public HealthUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - Sterling C. Johnson
- Wisconsin Alzheimer's InstituteUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
- Department of MedicineSchool of Medicine and Public HealthUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - Corinne D. Engelman
- Department of Population Health ScienceSchool of Medicine and Public HealthUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
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Bikic A, Dalsgaard S, Pittman B, Leckman JF, Wexler B. Cognitive training for children with ADHD: composite cognitive score outcome in a randomized controlled trial. Nord J Psychiatry 2024; 78:87-91. [PMID: 37905332 DOI: 10.1080/08039488.2023.2270954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 10/04/2023] [Indexed: 11/02/2023]
Abstract
PURPOSE OF THE ARTICLE Cognitive training for Attention Deficit/Hyperactivity Disorder (ADHD) has shown promising, although mixed results. In post-hoc analyses, we evaluate effects of cognitive training using a novel composite cognition score as the outcome for children attending at least 16 sessions of training, dose-response of training and associations between symptoms and cognitive functioning. MATERIALS AND METHODS Children (age 6-13) with ADHD were randomized to intervention (n = 26) or control (n = 34). For the current analysis, we restricted the intervention group to children, who completed at least 16 sessions of cognitive training (n = 26) and examined a dose response within that group. RESULTS Cognition improved significantly in the intervention, but not control group. Amount of the completed training sessions correlated significantly with the amount of cognitive improvement. CONCLUSION Variations in dose and frequency of training may be an important source of the variance in previous studies.
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Affiliation(s)
- Aida Bikic
- Department of Regional Health Research, University of Southern Denmark, Odense C, Denmark
- Child and Adolescent Psychiatric Services Southern Jutland, Aabenraa, Denmark
| | - Søren Dalsgaard
- National Centre for Register-based Research, Business and Social Sciences, Aarhus University, Aarhus, Denmark
- Department of Clinical Medicine, Health and Medical Sciences, University of Copenhagen, Copenhagen N, Denmark
- Center for Child and Adolescent Psychiatry, Mental Health Services of the Capital Region, Glostrup, Denmark
| | - Brian Pittman
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | | | - Bruce Wexler
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
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Bruno D, Gicas KM, Jauregi‐Zinkunegi A, Mueller KD, Lamar M. Delayed primacy recall performance predicts post mortem Alzheimer's disease pathology from unimpaired ante mortem cognitive baseline. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2024; 16:e12524. [PMID: 38239330 PMCID: PMC10795090 DOI: 10.1002/dad2.12524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 10/31/2023] [Accepted: 12/19/2023] [Indexed: 01/22/2024]
Abstract
We propose a novel method to assess delayed primacy in the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) memory test. We then examine whether this measure predicts post mortem Alzheimer's disease (AD) neuropathology in individuals who were clinically unimpaired at baseline. A total of 1096 individuals were selected from the Rush Alzheimer's Disease Center database registry. All participants were clinically unimpaired at baseline, and had subsequently undergone brain autopsy. Average age at baseline was 78.8 (6.92). A Bayesian regression analysis was carried out with global pathology as an outcome; demographic, clinical, and apolipoprotein E (APOE) data as covariates; and cognitive predictors, including delayed primacy. Global AD pathology was best predicted by delayed primacy. Secondary analyses showed that delayed primacy was mostly associated with neuritic plaques, whereas total delayed recall was associated with neurofibrillary tangles. Sex differential associations were observed. We conclude that CERAD-derived delayed primacy is a useful metric for early detection and diagnosis of AD in unimpaired individuals. Highlights We propose a novel method to analyse serial position in the CERAD memory test.We analyse data from 1096 individuals who were cognitively unimpaired at baseline.Delayed primacy predicts post mortem pathology better than traditional metrics.
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Affiliation(s)
- Davide Bruno
- School of PsychologyLiverpool John Moores UniversityLiverpoolUK
| | | | | | - Kimberly D. Mueller
- Wisconsin Alzheimer's InstituteSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
- Wisconsin Alzheimer's Disease Research CenterSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
- Department of Communication Sciences and DisordersUniversity of Wisconsin – MadisonMadisonWisconsinUSA
| | - Melissa Lamar
- Rush Alzheimer's Disease Center and the Department of Psychiatry and Behavioral SciencesRush University Medical CenterChicagoIllinoisUSA
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12
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Choi JJ, Koscik RL, Jonaitis EM, Panyard DJ, Morrow AR, Johnson SC, Engelman CD, Schmitz LL. Assessing the Biological Mechanisms Linking Smoking Behavior and Cognitive Function: A Mediation Analysis of Untargeted Metabolomics. Metabolites 2023; 13:1154. [PMID: 37999250 PMCID: PMC10673384 DOI: 10.3390/metabo13111154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 11/10/2023] [Accepted: 11/11/2023] [Indexed: 11/25/2023] Open
Abstract
(1) Smoking is the most significant preventable health hazard in the modern world. It increases the risk of vascular problems, which are also risk factors for dementia. In addition, toxins in cigarettes increase oxidative stress and inflammation, which have both been linked to the development of Alzheimer's disease and related dementias (ADRD). This study identified potential mechanisms of the smoking-cognitive function relationship using metabolomics data from the longitudinal Wisconsin Registry for Alzheimer's Prevention (WRAP). (2) 1266 WRAP participants were included to assess the association between smoking status and four cognitive composite scores. Next, untargeted metabolomic data were used to assess the relationships between smoking and metabolites. Metabolites significantly associated with smoking were then tested for association with cognitive composite scores. Total effect models and mediation models were used to explore the role of metabolites in smoking-cognitive function pathways. (3) Plasma N-acetylneuraminate was associated with smoking status Preclinical Alzheimer Cognitive Composite 3 (PACC3) and Immediate Learning (IMM). N-acetylneuraminate mediated 12% of the smoking-PACC3 relationship and 13% of the smoking-IMM relationship. (4) These findings provide links between previous studies that can enhance our understanding of potential biological pathways between smoking and cognitive function.
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Affiliation(s)
- Jerome J. Choi
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53726, USA; (J.J.C.); (A.R.M.)
| | - Rebecca L. Koscik
- Wisconsin Alzheimer’s Institute, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53726, USA; (R.L.K.); (E.M.J.)
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison, Madison, WI 53792, USA
| | - Erin M. Jonaitis
- Wisconsin Alzheimer’s Institute, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53726, USA; (R.L.K.); (E.M.J.)
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison, Madison, WI 53792, USA
| | - Daniel J. Panyard
- Department of Genetics, School of Medicine, Stanford University, Palo Alto, CA 94305, USA;
| | - Autumn R. Morrow
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53726, USA; (J.J.C.); (A.R.M.)
| | - Sterling C. Johnson
- Wisconsin Alzheimer’s Institute, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53726, USA; (R.L.K.); (E.M.J.)
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison, Madison, WI 53792, USA
- William S. Middleton Memorial Veterans Hospital, Middleton, WI 53705, USA
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53792, USA
| | - Corinne D. Engelman
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53726, USA; (J.J.C.); (A.R.M.)
| | - Lauren L. Schmitz
- La Follette School of Public Affairs, University of Wisconsin-Madison, Madison, WI 53706, USA;
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Prigatano GP, Russell S. The transition from Mild Cognitive Impairment of the Amnestic Type to early dementia: A phenomenological and neuropsychological case analysis. APPLIED NEUROPSYCHOLOGY. ADULT 2023:1-8. [PMID: 37782952 DOI: 10.1080/23279095.2023.2262068] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
The scientific literature on neuropsychological correlates of Mild Cognitive Impairment of the Amnestic Type (MCI-A) often reports large group findings and employs multivariate statistics to describe domains of cognitive impairment associated with the transition of MCI-A to early dementia, typically of the Alzheimer's Type (AD). Individual patients may vary, however, in terms of specific changes in their neuropsychological test performance as they transition from MCI-A to probable AD. The subjective experiences of individuals during this time of transition can also vary but rarely are reported. Tracking both the patient's subjective experiences and their performance on neuropsychological measures provides a more complete picture of the patient's clinical situation. These combined sets of information help the clinical neuropsychologist provide a more individualized and personally relevant service. We present a phenomenological and neuropsychological case analysis of a 67-year-old woman who transitioned from MCI-A to probable early AD in an attempt to illustrate how such a combined analysis is helpful in their psychological care.
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Affiliation(s)
- George P Prigatano
- Department of Clinical Neuropsychology, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Sydney Russell
- Department of Clinical Neuropsychology, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
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14
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Asher S, Suominen AL, Stephen R, Ngandu T, Koskinen S, Solomon A. Association of tooth count with cognitive decline and dementia in the Finnish adult population. J Clin Periodontol 2023; 50:1154-1166. [PMID: 37461219 DOI: 10.1111/jcpe.13851] [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] [Received: 04/04/2023] [Revised: 06/16/2023] [Accepted: 06/29/2023] [Indexed: 08/18/2023]
Abstract
AIM To evaluate whether tooth loss is associated with cognitive decline and incident dementia. MATERIALS AND METHODS We analysed data from the Finnish population-based Health 2000 and follow-up Health 2011 surveys (participants aged ≥30 years and without dementia at baseline; N = 5506 at baseline and 3426 at 11-year follow-up). Dementia diagnoses until 2015 were ascertained from national registers (N = 5542). Tooth count was dichotomized as adequate (≥20) versus tooth loss (<20). Tooth loss was further stratified into 10-19 teeth, 1-9 teeth and edentulism. Upper and lower jaws were also considered separately. Baseline cognitive test scores were dichotomized by median as high versus low, and 11-year change as decline versus no decline. RESULTS Tooth loss (<20) was associated with lower baseline overall cognition (odds ratio [OR] = 1.21, 95% confidence interval [CI] = 1.03-1.43), 11-year cognitive decline (OR = 1.30, 95% CI = 1.05-1.70) and higher 15-year dementia risk (hazard ratio = 1.52, 95% CI = 1.15-2.02) after adjusting for multiple confounders. After adjustment for dentures, associations became non-significant, except for 10-19 teeth remaining and dementia. Results were similar after considering reverse causality bias; however, 10-19 teeth remaining was significantly associated with 11-year cognitive decline even after adjustment for dentures. No jaw-specific differences were observed. CONCLUSIONS Tooth loss adversely impacts the risk of cognitive decline and dementia. The role of dentures should be further explored.
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Affiliation(s)
- Sam Asher
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
| | - Anna Liisa Suominen
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
- Oral Health Teaching Clinic, Kuopio University Hospital, Kuopio, Finland
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Ruth Stephen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
- Institute of Clinical Medicine/Neurology, University of Eastern Finland, Kuopio, Finland
- Division of Clinical Geriatrics, Center for Alzheimer Research, Karolinska Institute, Stockholm, Sweden
| | - Tiia Ngandu
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
- Division of Clinical Geriatrics, Center for Alzheimer Research, Karolinska Institute, Stockholm, Sweden
| | - Seppo Koskinen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Alina Solomon
- Institute of Clinical Medicine/Neurology, University of Eastern Finland, Kuopio, Finland
- Division of Clinical Geriatrics, Center for Alzheimer Research, Karolinska Institute, Stockholm, Sweden
- Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, UK
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15
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Han JH, Jackson JC, Orun OM, Brown SM, Casey JD, Clark L, Collins SP, Cordero K, Ginde AA, Gong MN, Hough CL, Iwashyna TJ, Kiehl AL, Lauck A, Leither LM, Lindsell CJ, Patel MB, Raman R, Rice TW, Ringwood NJ, Sheppard KL, Semler MW, Thompson BT, Ely EW, Self WH. Modifiable in-hospital factors for 12-month global cognition, post-traumatic stress disorder symptoms, and depression symptoms in adults hospitalized with COVID-19. Influenza Other Respir Viruses 2023; 17:e13197. [PMID: 37752063 PMCID: PMC10522479 DOI: 10.1111/irv.13197] [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] [Received: 11/03/2022] [Revised: 08/22/2023] [Accepted: 08/23/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND We sought to identify potentially modifiable in-hospital factors associated with global cognition, post-traumatic stress disorder (PTSD) symptoms, and depression symptoms at 12 months. METHODS This was a multi-center prospective cohort study in adult hospitalized patients with acute COVID-19. The following in-hospital factors were assessed: delirium; frequency of in-person and virtual visits by friends and family; and hydroxychloroquine, corticosteroid, and remdesivir administration. Twelve-month global cognition was characterized by the MOCA-Blind. Twelve-month PTSD and depression were characterized using the PTSD Checklist for the DSM-V and Hospital Anxiety Depression Scale, respectively. FINDINGS Two hundred three patients completed the 12-month follow-up assessments. Remdesivir use was associated with significantly higher cognition at 12 months based on the MOCA-Blind (adjusted odds ratio [aOR] = 1.98, 95% CI: 1.06, 3.70). Delirium was associated with worsening 12-month PTSD (aOR = 3.44, 95% CI: 1.89, 6.28) and depression (aOR = 2.18, 95% CI: 1.23, 3.84) symptoms. Multiple virtual visits per day during hospitalization was associated with lower 12-month depression symptoms compared to those with less than daily virtual visits (aOR = 0.40, 95% CI: 0.19, 0.85). CONCLUSION Potentially modifiable factors associated with better long-term outcomes included remdesivir use (associated with better cognitive function), avoidance of delirium (associated with less PTSD and depression symptoms), and increased virtual interactions with friends and family (associated with less depression symptoms).
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Affiliation(s)
- Jin H. Han
- Critical Illness, Brain Dysfunction, and Survivorship CenterVanderbilt University Medical CenterNashvilleTennesseeUSA
- Geriatric Research, Education, and Clinical Center (GRECC)Tennessee Valley Healthcare SystemNashvilleTennesseeUSA
- Department of Emergency MedicineVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - James C. Jackson
- Critical Illness, Brain Dysfunction, and Survivorship CenterVanderbilt University Medical CenterNashvilleTennesseeUSA
- Geriatric Research, Education, and Clinical Center (GRECC)Tennessee Valley Healthcare SystemNashvilleTennesseeUSA
- Division of Allergy, Pulmonary, and Critical Care, Department of MedicineVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Onur M. Orun
- Critical Illness, Brain Dysfunction, and Survivorship CenterVanderbilt University Medical CenterNashvilleTennesseeUSA
- Department of BiostatisticsVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Samuel M. Brown
- Division of Pulmonary/Critical Care Medicine, Department of MedicineIntermountain Medical Center and the University of UtahSalt Lake CityUtahUSA
| | - Jonathan D. Casey
- Division of Allergy, Pulmonary, and Critical Care, Department of MedicineVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Lindsay Clark
- Division of Geriatrics and GerontologyUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
- Geriatric Research, Education, and Clinical Center (GRECC)William S Middleton Memorial Veterans HospitalMadisonWisconsinUSA
| | - Sean P. Collins
- Geriatric Research, Education, and Clinical Center (GRECC)Tennessee Valley Healthcare SystemNashvilleTennesseeUSA
- Department of Emergency MedicineVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Kemberlyne Cordero
- Critical Illness, Brain Dysfunction, and Survivorship CenterVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Adit A. Ginde
- Department of Emergency MedicineUniversity of Colorado School of MedicineAuroraColoradoUSA
| | - Michelle N. Gong
- Division of Critical Care, Division of Pulmonary Medicine, Department of MedicineAlbert Einstein College of MedicineBronxNew YorkUSA
| | - Catherine L. Hough
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of MedicineOregon Health & Science UniversityPortlandOregonUSA
| | - Theodore J. Iwashyna
- Division of Pulmonary and Critical Care, Department of MedicineJohns Hopkins UniversityBaltimoreMarylandUSA
- Health Policy & Management in the Bloomberg School of Public HealthJohns Hopkins UniversityBaltimoreMarylandUSA
| | - Amy L. Kiehl
- Critical Illness, Brain Dysfunction, and Survivorship CenterVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Alana Lauck
- Critical Illness, Brain Dysfunction, and Survivorship CenterVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Lindsay M. Leither
- Division of Pulmonary/Critical Care Medicine, Department of MedicineIntermountain Medical Center and the University of UtahSalt Lake CityUtahUSA
| | | | - Mayur B. Patel
- Critical Illness, Brain Dysfunction, and Survivorship CenterVanderbilt University Medical CenterNashvilleTennesseeUSA
- Geriatric Research, Education, and Clinical Center (GRECC)Tennessee Valley Healthcare SystemNashvilleTennesseeUSA
- Division of Acute Care Surgery, Department of Surgery, Section of Surgical SciencesVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Rameela Raman
- Critical Illness, Brain Dysfunction, and Survivorship CenterVanderbilt University Medical CenterNashvilleTennesseeUSA
- Department of BiostatisticsVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Todd W. Rice
- Division of Allergy, Pulmonary, and Critical Care, Department of MedicineVanderbilt University Medical CenterNashvilleTennesseeUSA
- Vanderbilt Institute for Clinical and Translational Research (VICTR)Vanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Nancy J. Ringwood
- Division of Pulmonary and Critical Care MedicineMassachusetts General HospitalBostonMassachusettsUSA
| | - Karen L. Sheppard
- Critical Illness, Brain Dysfunction, and Survivorship CenterVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Matthew W. Semler
- Division of Allergy, Pulmonary, and Critical Care, Department of MedicineVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - B. Taylor Thompson
- Division of Pulmonary and Critical Care MedicineMassachusetts General HospitalBostonMassachusettsUSA
| | - E. Wesley Ely
- Critical Illness, Brain Dysfunction, and Survivorship CenterVanderbilt University Medical CenterNashvilleTennesseeUSA
- Geriatric Research, Education, and Clinical Center (GRECC)Tennessee Valley Healthcare SystemNashvilleTennesseeUSA
- Division of Allergy, Pulmonary, and Critical Care, Department of MedicineVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Wesley H. Self
- Department of Emergency MedicineVanderbilt University Medical CenterNashvilleTennesseeUSA
- Division of Acute Care Surgery, Department of Surgery, Section of Surgical SciencesVanderbilt University Medical CenterNashvilleTennesseeUSA
- Vanderbilt Institute for Clinical and Translational Research (VICTR)Vanderbilt University Medical CenterNashvilleTennesseeUSA
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Arce Rentería M, McClure LA, Callas PW, LaBode-Richman VM, Kroll DS, Manly JJ, Zakai NA, Unverzagt F, Cushman M. Lipoprotein(a) and risk of cognitive impairment in Black and White Americans: the Reasons for Geographic and Racial Differences in Stroke cohort. Res Pract Thromb Haemost 2023; 7:102170. [PMID: 37694266 PMCID: PMC10491800 DOI: 10.1016/j.rpth.2023.102170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 05/16/2023] [Accepted: 06/13/2023] [Indexed: 09/12/2023] Open
Abstract
Background Cognitive impairment has a substantial vascular etiology. Higher lipoprotein(a) [Lp(a)] is associated with cardiovascular disease risk, but its association with cognitive function is uncertain. We hypothesized that Lp(a) is a risk factor for cognitive impairment, a relationship that would be modified by race and sex. Objectives To study the association of Lp(a) with cognitive impairment in a biracial cohort. Methods The Reasons for Geographic and Racial Differences in Stroke (REGARDS) study recruited 30,239 Black and White Americans aged >45 years from 2003 to 2007. After 3.4 years, among participants with normal baseline cognition, baseline Lp(a) was measured in 434 cases of incident cognitive impairment and 557 controls. Cognitive impairment was defined as scores below the sixth percentile based on age, sex, race, and education norms on 2 or 3 components of a 3-test battery administered every 2 years. Results Median Lp(a) was higher in Black than in White individuals. Among Black participants, the adjusted odds ratio (OR) of cognitive impairment per SD higher increment Lp(a) was 1.39 (95% CI: 1.05, 1.84). The OR in White participants was 1.03 (95% CI: 0.87, 1.21; P for race difference = .03). The relationship of Lp(a) with cognitive trajectory differed by sex and race. Elevated Lp(a) was associated with worse baseline memory in Black men and a steeper trajectory of verbal fluency decline in Black men than in White men and women. Conclusion Higher Lp(a) was associated with increased risk of cognitive impairment in Black but not White individuals. Future studies should evaluate the biological and social mechanisms through which race and Lp(a) interact to increase risk of cognitive impairment.
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Affiliation(s)
- Miguel Arce Rentería
- Department of Neurology, Columbia University Medical Center, New York, New York, USA
| | - Leslie A. McClure
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
| | - Peter W. Callas
- Department of Medicine, Larner College of Medicine at the University of Vermont, Burlington, Vermont, USA
| | | | - Danielle S. Kroll
- Department of Neurology, Columbia University Medical Center, New York, New York, USA
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
| | - Jennifer J. Manly
- Department of Neurology, Columbia University Medical Center, New York, New York, USA
| | - Neil A. Zakai
- Department of Medicine, Larner College of Medicine at the University of Vermont, Burlington, Vermont, USA
- Department of Pathology & Laboratory Medicine, Larner College of Medicine at the University of Vermont, Burlington, Vermont, USA
| | - Frederick Unverzagt
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Mary Cushman
- Department of Medicine, Larner College of Medicine at the University of Vermont, Burlington, Vermont, USA
- Department of Pathology & Laboratory Medicine, Larner College of Medicine at the University of Vermont, Burlington, Vermont, USA
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Erickson P, Simrén J, Brum WS, Ennis GE, Kollmorgen G, Suridjan I, Langhough R, Jonaitis EM, Van Hulle CA, Betthauser TJ, Carlsson CM, Asthana S, Ashton NJ, Johnson SC, Shaw LM, Blennow K, Andreasson U, Bendlin BB, Zetterberg H. Prevalence and Clinical Implications of a β-Amyloid-Negative, Tau-Positive Cerebrospinal Fluid Biomarker Profile in Alzheimer Disease. JAMA Neurol 2023; 80:2807607. [PMID: 37523162 PMCID: PMC10391361 DOI: 10.1001/jamaneurol.2023.2338] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 05/05/2023] [Indexed: 08/01/2023]
Abstract
Importance Knowledge is lacking on the prevalence and prognosis of individuals with a β-amyloid-negative, tau-positive (A-T+) cerebrospinal fluid (CSF) biomarker profile. Objective To estimate the prevalence of a CSF A-T+ biomarker profile and investigate its clinical implications. Design, Setting, and Participants This was a retrospective cohort study of the cross-sectional multicenter University of Gothenburg (UGOT) cohort (November 2019-January 2021), the longitudinal multicenter Alzheimer Disease Neuroimaging Initiative (ADNI) cohort (individuals with mild cognitive impairment [MCI] and no cognitive impairment; September 2005-May 2022), and 2 Wisconsin cohorts, Wisconsin Alzheimer Disease Research Center and Wisconsin Registry for Alzheimer Prevention (WISC; individuals without cognitive impairment; February 2007-November 2020). This was a multicenter study, with data collected from referral centers in clinical routine (UGOT) and research settings (ADNI and WISC). Eligible individuals had 1 lumbar puncture (all cohorts), 2 or more cognitive assessments (ADNI and WISC), and imaging (ADNI only) performed on 2 separate occasions. Data were analyzed on August 2022 to April 2023. Exposures Baseline CSF Aβ42/40 and phosphorylated tau (p-tau)181; cognitive tests (ADNI: modified preclinical Alzheimer cognitive composite [mPACC]; WISC: modified 3-test PACC [PACC-3]). Exposures in the ADNI cohort included [18F]-florbetapir amyloid positron emission tomography (PET), magnetic resonance imaging (MRI), [18F]-fluorodeoxyglucose PET (FDG-PET), and cross-sectional tau-PET (ADNI: [18F]-flortaucipir, WISC: [18F]-MK6240). Main Outcomes and Measures Primary outcomes were the prevalence of CSF AT biomarker profiles and continuous longitudinal global cognitive outcome and imaging biomarker trajectories in A-T+ vs A-T- groups. Secondary outcomes included cross-sectional tau-PET. Results A total of 7679 individuals (mean [SD] age, 71.0 [8.4] years; 4101 male [53%]) were included in the UGOT cohort, 970 individuals (mean [SD] age, 73 [7.0] years; 526 male [54%]) were included in the ADNI cohort, and 519 individuals (mean [SD] age, 60 [7.3] years; 346 female [67%]) were included in the WISC cohort. The prevalence of an A-T+ profile in the UGOT cohort was 4.1% (95% CI, 3.7%-4.6%), being less common than the other patterns. Longitudinally, no significant differences in rates of worsening were observed between A-T+ and A-T- profiles for cognition or imaging biomarkers. Cross-sectionally, A-T+ had similar tau-PET uptake to individuals with an A-T- biomarker profile. Conclusion and Relevance Results suggest that the CSF A-T+ biomarker profile was found in approximately 5% of lumbar punctures and was not associated with a higher rate of cognitive decline or biomarker signs of disease progression compared with biomarker-negative individuals.
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Affiliation(s)
- Pontus Erickson
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Joel Simrén
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Wagner S. Brum
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Graduate Program in Biological Sciences: Biochemistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Gilda E. Ennis
- School of Medicine and Public Health, University of Wisconsin-Madison, Madison
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison
| | | | | | - Rebecca Langhough
- School of Medicine and Public Health, University of Wisconsin-Madison, Madison
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison
| | - Erin M. Jonaitis
- School of Medicine and Public Health, University of Wisconsin-Madison, Madison
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison
| | - Carol A. Van Hulle
- School of Medicine and Public Health, University of Wisconsin-Madison, Madison
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison
| | - Tobey J. Betthauser
- School of Medicine and Public Health, University of Wisconsin-Madison, Madison
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison
| | - Cynthia M. Carlsson
- School of Medicine and Public Health, University of Wisconsin-Madison, Madison
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison
- Geriatric Research Education and Clinical Center of the Wm. S. Middleton Memorial Veterans Hospital, Madison, Wisconsin
| | - Sanjay Asthana
- School of Medicine and Public Health, University of Wisconsin-Madison, Madison
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison
- Geriatric Research Education and Clinical Center of the Wm. S. Middleton Memorial Veterans Hospital, Madison, Wisconsin
| | - Nicholas J. Ashton
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Institute of Psychiatry, Psychology and Neuroscience, Maurice Wohl Institute Clinical Neuroscience Institute, King’s College London, London, England
- NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation, London, England
- Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway
| | - Sterling C. Johnson
- School of Medicine and Public Health, University of Wisconsin-Madison, Madison
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison
| | - Leslie M. Shaw
- Department of Pathology and Laboratory Medicine, University of Pennsylvania School of Medicine, Philadelphia
| | - Kaj Blennow
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Ulf Andreasson
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Barbara B. Bendlin
- School of Medicine and Public Health, University of Wisconsin-Madison, Madison
| | - Henrik Zetterberg
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Gothenburg, Sweden
- School of Medicine and Public Health, University of Wisconsin-Madison, Madison
- Institute of Neurology, Department of Neurodegenerative Disease, University College London, London, England
- UK Dementia Research Institute, University College London, London, England
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong, China
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Arce Rentería M, Briceño EM, Chen D, Saenz J, Kobayashi LC, Gonzalez C, Vonk JMJ, Jones RN, Manly JJ, Wong R, Weir D, Langa KM, Gross AL. Memory and language cognitive data harmonization across the United States and Mexico. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2023; 15:e12478. [PMID: 37711154 PMCID: PMC10498430 DOI: 10.1002/dad2.12478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 07/07/2023] [Accepted: 07/31/2023] [Indexed: 09/16/2023]
Abstract
INTRODUCTION We used cultural neuropsychology-informed procedures to derive and validate harmonized scores representing memory and language across population-based studies in the United States and Mexico. METHODS Data were from the Health and Retirement Study Harmonized Cognitive Assessment Protocol (HRS-HCAP) and the Mexican Health and Aging Study (MHAS) Ancillary Study on Cognitive Aging (Mex-Cog). We statistically co-calibrated memory and language domains and performed differential item functioning (DIF) analysis using a cultural neuropsychological approach. We examined relationships among harmonized scores, age, and education. RESULTS We included 3170 participants from the HRS-HCAP (Mage = 76.6 [standard deviation (SD): 7.5], 60% female) and 2042 participants from the Mex-Cog (Mage = 68.1 [SD: 9.0], 59% female). Five of seven memory items and one of twelve language items demonstrated DIF by study. Harmonized memory and language scores showed expected associations with age and education. DISCUSSION A cultural neuropsychological approach to harmonization facilitates the generation of harmonized measures of memory and language function in cross-national studies. HIGHLIGHTS We harmonized memory and language scores across studies in the United States and Mexico.A cultural neuropsychological approach to data harmonization was used.Harmonized scores showed minimal measurement differences between cohorts.Future work can use these harmonized scores for cross-national studies of Alzheimer's disease and related dementias.
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Affiliation(s)
- Miguel Arce Rentería
- Department of NeurologyTaub Institute for Research on Alzheimer's Disease and the Aging BrainColumbia University College of Physicians and SurgeonsNew YorkNew YorkUSA
| | - Emily M. Briceño
- Department of Physical Medicine & RehabilitationUniversity of Michigan Medical SchoolAnn ArborMichiganUSA
| | - Diefei Chen
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
- Johns Hopkins University Center on Aging and HealthBaltimoreMarylandUSA
| | - Joseph Saenz
- Edson College of Nursing and Health Innovation at Arizona State UniversityPhoenixArizonaUSA
| | - Lindsay C. Kobayashi
- Department of EpidemiologyCenter for Social Epidemiology and Population HealthUniversity of Michigan School of Public HealthAnn ArborMichiganUSA
- Survey Research CenterUniversity of Michigan Institute for Social ResearchAnn ArborMichiganUSA
| | | | - Jet M. J. Vonk
- Department of NeurologyMemory and Aging CenterUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Richard N. Jones
- Department of Psychiatry and Human BehaviorWarren Alpert Medical SchoolBrownUniversityProvidence, Rhode IslandUSA
| | - Jennifer J. Manly
- Department of NeurologyTaub Institute for Research on Alzheimer's Disease and the Aging BrainColumbia University College of Physicians and SurgeonsNew YorkNew YorkUSA
| | - Rebeca Wong
- Sealy Center on AgingUniversity of Texas Medical Branch at GalvestonGalvestonTexasUSA
| | - David Weir
- Department of EpidemiologyCenter for Social Epidemiology and Population HealthUniversity of Michigan School of Public HealthAnn ArborMichiganUSA
| | - Kenneth M. Langa
- Department of EpidemiologyCenter for Social Epidemiology and Population HealthUniversity of Michigan School of Public HealthAnn ArborMichiganUSA
- Department of Internal MedicineUniversity of MichiganAnn ArborMichiganUSA
- Veterans Affairs Ann Arbor Center for Clinical Management ResearchAnn ArborMichiganUSA
| | - Alden L. Gross
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
- Johns Hopkins University Center on Aging and HealthBaltimoreMarylandUSA
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19
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Salvadó G, Larsson V, Cody KA, Cullen NC, Jonaitis EM, Stomrud E, Kollmorgen G, Wild N, Palmqvist S, Janelidze S, Mattsson-Carlgren N, Zetterberg H, Blennow K, Johnson SC, Ossenkoppele R, Hansson O. Optimal combinations of CSF biomarkers for predicting cognitive decline and clinical conversion in cognitively unimpaired participants and mild cognitive impairment patients: A multi-cohort study. Alzheimers Dement 2023; 19:2943-2955. [PMID: 36648169 PMCID: PMC10350470 DOI: 10.1002/alz.12907] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 10/30/2022] [Accepted: 11/15/2022] [Indexed: 01/18/2023]
Abstract
INTRODUCTION Our objective was determining the optimal combinations of cerebrospinal fluid (CSF) biomarkers for predicting disease progression in Alzheimer's disease (AD) and other neurodegenerative diseases. METHODS We included 1,983 participants from three different cohorts with longitudinal cognitive and clinical data, and baseline CSF levels of Aβ42, Aβ40, phosphorylated tau at threonine-181 (p-tau), neurofilament light (NfL), neurogranin, α-synuclein, soluble triggering receptor expressed on myeloid cells 2 (sTREM2), glial fibrillary acidic protein (GFAP), YKL-40, S100b, and interleukin 6 (IL-6) (Elecsys NeuroToolKit). RESULTS Change of modified Preclinical Alzheimer's Cognitive Composite (mPACC) in cognitively unimpaired (CU) was best predicted by p-tau/Aβ42 alone (R2 ≥ 0.31) or together with NfL (R2 = 0.25), while p-tau/Aβ42 (R2 ≥ 0.19) was sufficient to accurately predict change of the Mini-Mental State Examination (MMSE) in mild cognitive impairment (MCI) patients. P-tau/Aβ42 (AUC ≥ 0.87) and p-tau/Aβ42 together with NfL (AUC ≥ 0.75) were the best predictors of conversion to AD and all-cause dementia, respectively. DISCUSSION P-tau/Aβ42 is sufficient for predicting progression in AD, with very high accuracy. Adding NfL improves the prediction of all-cause dementia conversion and cognitive decline.
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Affiliation(s)
- Gemma Salvadó
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Victoria Larsson
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Karly A Cody
- Wisconsin Alzheimer’s Disease Research Center University of Wisconsin School of Medicine and Public Health Madison Wisconsin, Madison, Wisconsin, USA
| | - Nicholas C Cullen
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Erin M Jonaitis
- Wisconsin Alzheimer’s Disease Research Center University of Wisconsin School of Medicine and Public Health Madison Wisconsin, Madison, Wisconsin, USA
- Wisconsin Alzheimer’s Institute, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Erik Stomrud
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | | | | | - Sebastian Palmqvist
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Shorena Janelidze
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Niklas Mattsson-Carlgren
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
- Wallenberg Center for Molecular Medicine, Lund University, Lund, Sweden
- Department of Neurology, Skåne University Hospital, Lund, Sweden
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, United Kingdom
- UK Dementia Research Institute at UCL, London, United Kingdom
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong, China
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Sterling C Johnson
- Wisconsin Alzheimer’s Disease Research Center University of Wisconsin School of Medicine and Public Health Madison Wisconsin, Madison, Wisconsin, USA
- Wisconsin Alzheimer’s Institute, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Geriatric Research, Education and Clinical Center at the William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin, USA
| | - Rik Ossenkoppele
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital, Malmö, Sweden
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20
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Vasiljevic E, Koscik RL, Jonaitis E, Betthauser T, Johnson SC, Engelman CD. Cognitive trajectories diverge by genetic risk in a preclinical longitudinal cohort. Alzheimers Dement 2023; 19:3108-3118. [PMID: 36723444 PMCID: PMC10390653 DOI: 10.1002/alz.12920] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 12/06/2022] [Accepted: 12/12/2022] [Indexed: 02/02/2023]
Abstract
INTRODUCTION We sought to characterize the timing of changes in cognitive trajectories related to genetic risk using the apolipoprotein E (APOE) score, a continuous measure of Alzheimer's disease (AD) risk. We also aimed to determine whether that timing was different when genetic risk was measured using an AD polygenic risk score (PRS) that contains APOE. METHODS We analyzed trajectories (N ≈1135) for four neuropsychological composite scores using mixed effects regression for longitudinal change across APOE scores and PRS of participants in the Wisconsin Registry for Alzheimer's Prevention, a longitudinal study of adults aged 40 to 70 at baseline, with a median participant follow-up time of 7.8 years. RESULTS We found a significant non-linear age-by-APOE score interaction in predicting cognitive decline. Cognitive trajectories diverged by APOE score at approximately 65 years of age. A 0.5 standard deviation difference in cognition between extreme percentiles of the PRS was predicted to occur 1 to 2 years before that of the APOE score. DISCUSSION Cognitive decline differs across time and APOE score. Estimates did not substantially shift with the AD PRS. HIGHLIGHTS The apolipoprotein E (APOE) score, a continuous measure, accounts for non-linear genetic risk of Alzheimer's disease. Non-linear age interacts with the APOE score to affect cognition. Cognitive decline starts to differ by APOE score levels at approximately age 65. Cognitive decline timing by polygenic risk (including APOE) is similar to APOE alone.
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Affiliation(s)
- Eva Vasiljevic
- Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, 610 Walnut Dr., Madison, WI 53726, USA
- Center for Demography of Health and Aging, University of Wisconsin-Madison, 1180 Observatory Drive Madison, WI 53706, USA
| | - Rebecca Langhough Koscik
- Wisconsin Alzheimer’s Institute, University of Wisconsin School of Medicine and Public Health, 610 Walnut Street, 9th Floor, Madison, WI 53726, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, MC 2420, Madison, Wisconsin 53792, USA
| | - Erin Jonaitis
- Wisconsin Alzheimer’s Institute, University of Wisconsin School of Medicine and Public Health, 610 Walnut Street, 9th Floor, Madison, WI 53726, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, MC 2420, Madison, Wisconsin 53792, USA
| | - Tobey Betthauser
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, MC 2420, Madison, Wisconsin 53792, USA
- Department of Medicine, University of Wisconsin-Madison, 1685 Highland Avenue, 5158 Medical Foundation Centennial Building, Madison, WI 53705, USA
| | - Sterling C. Johnson
- Wisconsin Alzheimer’s Institute, University of Wisconsin School of Medicine and Public Health, 610 Walnut Street, 9th Floor, Madison, WI 53726, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, MC 2420, Madison, Wisconsin 53792, USA
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, 2500 Overlook Terrace, Madison, WI 53705, USA
| | - Corinne D. Engelman
- Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, 610 Walnut Dr., Madison, WI 53726, USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin School of Medicine and Public Health, 610 Walnut Street, 9th Floor, Madison, WI 53726, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, MC 2420, Madison, Wisconsin 53792, USA
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Giorgio J, Tanna A, Malpetti M, White SR, Wang J, Baker S, Landau S, Tanaka T, Chen C, Rowe JB, O'Brien J, Fripp J, Breakspear M, Jagust W, Kourtzi Z. A robust harmonization approach for cognitive data from multiple aging and dementia cohorts. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2023; 15:e12453. [PMID: 37502020 PMCID: PMC10369372 DOI: 10.1002/dad2.12453] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 05/19/2023] [Accepted: 05/23/2023] [Indexed: 07/29/2023]
Abstract
INTRODUCTION Although many cognitive measures have been developed to assess cognitive decline due to Alzheimer's disease (AD), there is little consensus on optimal measures, leading to varied assessments across research cohorts and clinical trials making it difficult to pool cognitive measures across studies. METHODS We used a two-stage approach to harmonize cognitive data across cohorts and derive a cross-cohort score of cognitive impairment due to AD. First, we pool and harmonize cognitive data from international cohorts of varying size and ethnic diversity. Next, we derived cognitive composites that leverage maximal data from the harmonized dataset. RESULTS We show that our cognitive composites are robust across cohorts and achieve greater or comparable sensitivity to AD-related cognitive decline compared to the Mini-Mental State Examination and Preclinical Alzheimer Cognitive Composite. Finally, we used an independent cohort validating both our harmonization approach and composite measures. DISCUSSION Our easy to implement and readily available pipeline offers an approach for researchers to harmonize their cognitive data with large publicly available cohorts, providing a simple way to pool data for the development or validation of findings related to cognitive decline due to AD.
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Affiliation(s)
- Joseph Giorgio
- Helen Wills Neuroscience InstituteUniversity of California BerkeleyBerkeleyCaliforniaUSA
- School of Psychological SciencesCollege of Engineering, Science and the EnvironmentUniversity of NewcastleNewcastleNew South WalesAustralia
| | - Ankeet Tanna
- Department of PsychologyUniversity of CambridgeCambridgeUK
| | - Maura Malpetti
- Department of Clinical NeurosciencesUniversity of CambridgeCambridgeUK
| | - Simon R. White
- Department of PsychiatryUniversity of CambridgeCambridgeUK
- MRC Biostatistics UnitUniversity of CambridgeshireCambridgeUK
| | - Jingshen Wang
- Division of BiostatisticsUniversity of California BerkeleyBerkeleyCaliforniaUSA
| | - Suzanne Baker
- Molecular Biophysics & Integrated BioimagingLawrence Berkeley National LaboratoryBerkeleyCaliforniaUSA
| | - Susan Landau
- Helen Wills Neuroscience InstituteUniversity of California BerkeleyBerkeleyCaliforniaUSA
| | - Tomotaka Tanaka
- Department of PharmacologyYong Loo Lin School of MedicineNational University of SingaporeKent RidgeSingapore
| | - Christopher Chen
- Department of PharmacologyYong Loo Lin School of MedicineNational University of SingaporeKent RidgeSingapore
| | - James B. Rowe
- Department of Clinical NeurosciencesUniversity of CambridgeCambridgeUK
- Cambridge University Hospitals NHS Foundation TrustCambridgeUK
| | - John O'Brien
- Department of PsychiatryUniversity of CambridgeCambridgeUK
- Cambridge University Hospitals NHS Foundation TrustCambridgeUK
| | - Jurgen Fripp
- The Australian eHealth Research CentreCSIRO Health and BiosecurityBrisbaneQueenslandAustralia
| | - Michael Breakspear
- School of Psychological SciencesCollege of Engineering, Science and the EnvironmentUniversity of NewcastleNewcastleNew South WalesAustralia
| | - William Jagust
- Helen Wills Neuroscience InstituteUniversity of California BerkeleyBerkeleyCaliforniaUSA
- Molecular Biophysics & Integrated BioimagingLawrence Berkeley National LaboratoryBerkeleyCaliforniaUSA
| | - Zoe Kourtzi
- Department of PsychologyUniversity of CambridgeCambridgeUK
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Bruno D, Gicas KM, Jauregi Zinkunegi A, Mueller KD, Lamar M. Delayed primacy recall performance predicts post mortem Alzheimer's disease pathology from unimpaired ante mortem cognitive baseline. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.06.26.546225. [PMID: 37425732 PMCID: PMC10327046 DOI: 10.1101/2023.06.26.546225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
INTRODUCTION We propose a novel method to assess delayed primacy in the CERAD memory test. We then examine whether this measure predicts post mortem Alzheimer's disease (AD) neuropathology in individuals who were clinically unimpaired at baseline. METHODS A total of 1096 individuals were selected from the Rush Alzheimer's Disease Center database registry. All participants were clinically unimpaired at baseline, and had subsequently undergone brain autopsy. Average age at baseline was 78.8 (6.92). A Bayesian regression analysis was carried out with global pathology as outcome; demographic, clinical and APOE data as covariates; and cognitive predictors, including delayed primacy. RESULTS Global AD pathology was best predicted by delayed primacy. Secondary analyses showed that delayed primacy was mostly associated with neuritic plaques, whereas total delayed recall was associated with neurofibrillary tangles. DISCUSSION We conclude that CERAD-derived delayed primacy is a useful metric for early detection and diagnosis of AD in unimpaired individuals.
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Affiliation(s)
- Davide Bruno
- School of Psychology, Liverpool John Moores University, UK
| | | | | | - Kimberly D. Mueller
- Wisconsin Alzheimer’s Institute, School of Medicine and Public Health, University of Wisconsin – Madison, Madison, WI, USA
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin – Madison, Madison, WI, USA
- Department of Communication Sciences and Disorders, University of Wisconsin – Madison, Madison, WI, USA
| | - Melissa Lamar
- Rush Alzheimer’s Disease Center and the Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
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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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Coughlan GT, Betthauser TJ, Boyle R, Koscik RL, Klinger HM, Chibnik LB, Jonaitis EM, Yau WYW, Wenzel A, Christian BT, Gleason CE, Saelzler UG, Properzi MJ, Schultz AP, Hanseeuw BJ, Manson JE, Rentz DM, Johnson KA, Sperling R, Johnson SC, Buckley RF. Association of Age at Menopause and Hormone Therapy Use With Tau and β-Amyloid Positron Emission Tomography. JAMA Neurol 2023; 80:462-473. [PMID: 37010830 PMCID: PMC10071399 DOI: 10.1001/jamaneurol.2023.0455] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 12/16/2022] [Indexed: 04/04/2023]
Abstract
Importance Postmenopausal females represent around 70% of all individuals with Alzheimer disease. Previous literature shows elevated levels of tau in cognitively unimpaired postmenopausal females compared with age-matched males, particularly in the setting of high β-amyloid (Aβ). The biological mechanisms associated with higher tau deposition in female individuals remain elusive. Objective To examine the extent to which sex, age at menopause, and hormone therapy (HT) use are associated with regional tau at a given level of Aβ, both measured with positron emission tomography (PET). Design, Setting, and Participants This cross-sectional study included participants enrolled in the Wisconsin Registry for Alzheimer Prevention. Cognitively unimpaired males and females with at least 1 18F-MK-6240 and 11C-Pittsburgh compound B PET scan were analyzed. Data were collected between November 2006 and May 2021. Exposures Premature menopause (menopause at younger than 40 years), early menopause (menopause at age 40-45 years), and regular menopause (menopause at older than 45 years) and HT user (current/past use) and HT nonuser (no current/past use). Exposures were self-reported. Main Outcomes and Measures Seven tau PET regions that show sex differences across temporal, parietal, and occipital lobes. Primary analyses examined the interaction of sex, age at menopause or HT, and Aβ PET on regional tau PET in a series of linear regressions. Secondary analyses investigated the influence of HT timing in association with age at menopause on regional tau PET. Results Of 292 cognitively unimpaired individuals, there were 193 females (66.1%) and 99 males (33.9%). The mean (range) age at tau scan was 67 (49-80) years, 52 (19%) had abnormal Aβ, and 106 (36.3%) were APOEε4 carriers. There were 98 female HT users (52.2%) (past/current). Female sex (standardized β = -0.41; 95% CI, -0.97 to -0.32; P < .001), earlier age at menopause (standardized β = -0.38; 95% CI, -0.14 to -0.09; P < .001), and HT use (standardized β = 0.31; 95% CI, 0.40-1.20; P = .008) were associated with higher regional tau PET in individuals with elevated Aβ compared with male sex, later age at menopause, and HT nonuse. Affected regions included medial and lateral regions of the temporal and occipital lobes. Late initiation of HT (>5 years following age at menopause) was associated with higher tau PET compared with early initiation (β = 0.49; 95% CI, 0.27-0.43; P = .001). Conclusions and Relevance In this study, females exhibited higher tau compared with age-matched males, particularly in the setting of elevated Aβ. In females, earlier age at menopause and late initiation of HT were associated with increased tau vulnerability especially when neocortical Aβ elevated. These observational findings suggest that subgroups of female individuals may be at higher risk of pathological burden.
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Affiliation(s)
- Gillian T. Coughlan
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Tobey J. Betthauser
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin, School of Medicine and Public Health, Madison
- Department of Medicine, University of Wisconsin–Madison, Madison
| | - Rory Boyle
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Rebecca L. Koscik
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin, School of Medicine and Public Health, Madison
- Department of Medicine, University of Wisconsin–Madison, Madison
| | - Hannah M. Klinger
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Lori B. Chibnik
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, and the Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Erin M. Jonaitis
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin, School of Medicine and Public Health, Madison
- Department of Medicine, University of Wisconsin–Madison, Madison
| | - Wai-Ying Wendy Yau
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Allen Wenzel
- Department of Medicine, University of Wisconsin–Madison, Madison
| | - Bradley T. Christian
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin, School of Medicine and Public Health, Madison
| | - Carey E. Gleason
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin, School of Medicine and Public Health, Madison
| | - Ursula G. Saelzler
- Department of Psychiatry, University of California, San Diego, San Diego
| | - Michael J. Properzi
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Aaron P. Schultz
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston
- Center for Alzheimer Research and Treatment, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Bernard J. Hanseeuw
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston
- Center for Alzheimer Research and Treatment, Brigham and Women’s Hospital, Boston, Massachusetts
- Department of Neurology, Cliniques Universitaires Saint-Luc, Woluwe-Saint-Lambert, Belgium
- Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston
- Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium
| | - JoAnn E. Manson
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, and the Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Dorene M. Rentz
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston
- Center for Alzheimer Research and Treatment, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Keith A. Johnson
- Center for Alzheimer Research and Treatment, Brigham and Women’s Hospital, Boston, Massachusetts
- Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Reisa Sperling
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston
- Center for Alzheimer Research and Treatment, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Sterling C. Johnson
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin, School of Medicine and Public Health, Madison
- Department of Medicine, University of Wisconsin–Madison, Madison
| | - Rachel F. Buckley
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston
- Center for Alzheimer Research and Treatment, Brigham and Women’s Hospital, Boston, Massachusetts
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
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25
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Dong R, Denier-Fields DN, Van Hulle CA, Kollmorgen G, Suridjan I, Wild N, Lu Q, Anderson RM, Zetterberg H, Blennow K, Carlsson CM, Johnson SC, Engelman CD. Identification of plasma metabolites associated with modifiable risk factors and endophenotypes reflecting Alzheimer's disease pathology. Eur J Epidemiol 2023; 38:559-571. [PMID: 36964431 PMCID: PMC11070200 DOI: 10.1007/s10654-023-00988-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 03/05/2023] [Indexed: 03/26/2023]
Abstract
Modifiable factors can influence the risk for Alzheimer's disease (AD) and serve as targets for intervention; however, the biological mechanisms linking these factors to AD are unknown. This study aims to identify plasma metabolites associated with modifiable factors for AD, including MIND diet, physical activity, smoking, and caffeine intake, and test their association with AD endophenotypes to identify their potential roles in pathophysiological mechanisms. The association between each of the 757 plasma metabolites and four modifiable factors was tested in the wisconsin registry for Alzheimer's prevention cohort of initially cognitively unimpaired, asymptomatic middle-aged adults. After Bonferroni correction, the significant plasma metabolites were tested for association with each of the AD endophenotypes, including twelve cerebrospinal fluid (CSF) biomarkers, reflecting key pathophysiologies for AD, and four cognitive composite scores. Finally, causal mediation analyses were conducted to evaluate possible mediation effects. Analyses were performed using linear mixed-effects regression. A total of 27, 3, 23, and 24 metabolites were associated with MIND diet, physical activity, smoking, and caffeine intake, respectively. Potential mediation effects include beta-cryptoxanthin in the association between MIND diet and preclinical Alzheimer cognitive composite score, hippurate between MIND diet and immediate learning, glutamate between physical activity and CSF neurofilament light, and beta-cryptoxanthin between smoking and immediate learning. Our study identified several plasma metabolites that are associated with modifiable factors. These metabolites can be employed as biomarkers for tracking these factors, and they provide a potential biological pathway of how modifiable factors influence the human body and AD risk.
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Affiliation(s)
- Ruocheng Dong
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, 53726, USA
| | - Diandra N Denier-Fields
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, 53726, USA
- Department of Nutrition Science, University of Wisconsin-Madison, Madison, WI, 53706, USA
| | - Carol A Van Hulle
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, 53792, USA
- Wisconsin Alzheimer's Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, 53792, USA
| | | | | | - Norbert Wild
- Roche Diagnostics GmbH, 82377, Penzberg, Germany
| | - Qiongshi Lu
- Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, 53792, USA
| | - Rozalyn M Anderson
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, 53792, USA
- Geriatric Research Education and Clinical Center, William. S. Middleton Memorial Veterans Hospital, Madison, WI, 53705, USA
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, S-43180, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, S-43180, Mölndal, Sweden
- UK Dementia Research Institute at UCL, London, WC1E 6BT, UK
- Department of Neurodegenerative Disease, UCL Institute of Neurology, London, WC1H 0AL, UK
- Hong Kong Center for Neurodegenerative Diseases, Clear Water Bay, Hong Kong, China
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, S-43180, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, S-43180, Mölndal, Sweden
| | - Cynthia M Carlsson
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, 53792, USA
- Wisconsin Alzheimer's Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, 53792, USA
- Geriatric Research Education and Clinical Center, William. S. Middleton Memorial Veterans Hospital, Madison, WI, 53705, USA
| | - Sterling C Johnson
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, 53792, USA
- Wisconsin Alzheimer's Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, 53792, USA
- Geriatric Research Education and Clinical Center, William. S. Middleton Memorial Veterans Hospital, Madison, WI, 53705, USA
- Wisconsin Alzheimer's Institute, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, 53719, USA
| | - Corinne D Engelman
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, 53726, USA.
- Wisconsin Alzheimer's Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, 53792, USA.
- Wisconsin Alzheimer's Institute, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, 53719, USA.
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26
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Downs TL, Whiteside EJ, Foot G, Mills DE, Bliss ES. Differences in total cognition and cerebrovascular function in female breast cancer survivors and cancer-free women. Breast 2023; 69:358-365. [PMID: 37018967 PMCID: PMC10122006 DOI: 10.1016/j.breast.2023.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/24/2023] [Accepted: 03/30/2023] [Indexed: 04/03/2023] Open
Abstract
Reduced cognition is often reported by breast cancer patients and survivors, but the mechanisms for this decline are yet to be determined. We compared the differences in cerebrovascular function and cognition in breast cancer survivors (n = 15) and cancer-free women (n = 15) matched by age and body mass index. Participants undertook anthropometric, mood, cardiovascular, exercise performance, strength, cerebrovascular, and cognitive measurements. Transcranial Doppler ultrasound was used to measure the cerebrovascular responsiveness (CVR) to physiological (hypercapnia; 5% carbon dioxide) and psychological stimuli. Breast cancer survivors had a lower CVR to hypercapnia (21.5 ± 12.8 vs 66.0 ± 20.9%, P < 0.001), CVR to cognitive stimuli (15.1 ± 1.5 vs 23.7 ± 9.0%, P < 0.001) and total composite cognitive score (100 ± 12 vs. 113 ± 7, P = 0.003) than cancer-free women. These parameters remained statistically different between the groups following adjustments for covariates using an analysis of co-variance. We observed significant correlations between multiple measures and exercise capacity the only variable positively correlated to all primary measures (CVR to hypercapnia, r = 0.492, P = 0.007; CVR to cognitive stimuli r = 0.555, P = 0.003; and total composite cognitive score, r = 0.625, P < 0.001). In this study, breast cancer survivors had lower cerebrovascular and cognitive function than age-matched cancer-free women, which may be attributable to the effects of cancer and cancer treatment on brain health.
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27
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Du L, Langhough R, Hermann BP, Jonaitis E, Betthauser TJ, Cody KA, Mueller K, Zuelsdorff M, Chin N, Ennis GE, Bendlin BB, Gleason CE, Christian BT, Plante DT, Chappell R, Johnson SC. Associations between self-reported sleep patterns and health, cognition and amyloid measures: results from the Wisconsin Registry for Alzheimer's Prevention. Brain Commun 2023; 5:fcad039. [PMID: 36910417 PMCID: PMC9999364 DOI: 10.1093/braincomms/fcad039] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 12/09/2022] [Accepted: 02/22/2023] [Indexed: 02/25/2023] Open
Abstract
Previous studies suggest associations between self-reported sleep problems and poorer health, cognition, Alzheimer's disease pathology and dementia-related outcomes. It is important to develop a deeper understanding of the relationship between these complications and sleep disturbance, a modifiable risk factor, in late midlife, a time when Alzheimer's disease pathology may be accruing. The objectives of this study included application of unsupervised machine learning procedures to identify distinct subgroups of persons with problematic sleep and the association of these subgroups with concurrent measures of mental and physical health, cognition and PET-identified amyloid. Dementia-free participants from the Wisconsin Registry for Alzheimer's Prevention (n = 619) completed sleep questionnaires including the Insomnia Severity Index, Epworth Sleepiness Scale and Medical Outcomes Study Sleep Scale. K-means clustering analysis identified discrete sleep problem groups who were then compared across concurrent health outcomes (e.g. depression, self-rated health and insulin resistance), cognitive composite indices including episodic memory and executive function and, in a subset, Pittsburgh Compound B PET imaging to assess amyloid burden. Significant omnibus tests (P < 0.05) were followed with pairwise comparisons. Mean (SD) sample baseline sleep assessment age was 62.6 (6.7). Cluster analysis identified three groups: healthy sleepers [n = 262 (42.3%)], intermediate sleepers [n = 229 (37.0%)] and poor sleepers [n = 128 (20.7%)]. All omnibus tests comparing demographics and health measures across sleep groups were significant except for age, sex and apolipoprotein E e4 carriers; the poor sleepers group was worse than one or both of the other groups on all other measures, including measures of depression, self-reported health and memory complaints. The poor sleepers group had higher average body mass index, waist-hip ratio and homeostatic model assessment of insulin resistance. After adjusting for covariates, the poor sleepers group also performed worse on all concurrent cognitive composites except working memory. There were no differences between sleep groups on PET-based measures of amyloid. Sensitivity analyses indicated that while different clustering approaches resulted in different group assignments for some (predominantly the intermediate group), between-group patterns in outcomes were consistent. In conclusion, distinct sleep characteristics groups were identified with a sizable minority (20.7%) exhibiting poor sleep characteristics, and this group also exhibited the poorest concurrent mental and physical health and cognition, indicating substantial multi-morbidity; sleep group was not associated with amyloid PET estimates. Precision-based management of sleep and related factors may provide an opportunity for early intervention that could serve to delay or prevent clinical impairment.
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Affiliation(s)
- Lianlian Du
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53726, USA
- Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53792, USA
| | - Rebecca Langhough
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53726, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53726, USA
| | - Bruce P Hermann
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53726, USA
- Department of Neurology, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53726, USA
| | - Erin Jonaitis
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53726, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53726, USA
| | - Tobey J Betthauser
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53726, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53726, USA
| | - Karly Alex Cody
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53726, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53726, USA
| | - Kimberly Mueller
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53726, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53726, USA
| | - Megan Zuelsdorff
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
- University of Wisconsin-Madison School of Nursing, Madison, WI 53705, USA
| | - Nathaniel Chin
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53726, USA
| | - Gilda E Ennis
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53726, USA
| | - Barbara B Bendlin
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53726, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53726, USA
- Madison VA GRECC, William S. Middleton Memorial Hospital, Madison, WI 53705, USA
| | - Carey E Gleason
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53726, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
- Madison VA GRECC, William S. Middleton Memorial Hospital, Madison, WI 53705, USA
| | - Bradley T Christian
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
- Department of Medical Physics, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53705, USA
| | - David T Plante
- Department of Psychiatry, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53719, USA
| | - Rick Chappell
- Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53792, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
| | - Sterling C Johnson
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53726, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53726, USA
- Madison VA GRECC, William S. Middleton Memorial Hospital, Madison, WI 53705, USA
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28
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Jutten RJ, Papp KV, Hendrix S, Ellison N, Langbaum JB, Donohue MC, Hassenstab J, Maruff P, Rentz DM, Harrison J, Cummings J, Scheltens P, Sikkes SAM. Why a clinical trial is as good as its outcome measure: A framework for the selection and use of cognitive outcome measures for clinical trials of Alzheimer's disease. Alzheimers Dement 2023; 19:708-720. [PMID: 36086926 PMCID: PMC9931632 DOI: 10.1002/alz.12773] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 06/29/2022] [Accepted: 07/22/2022] [Indexed: 11/11/2022]
Abstract
A crucial aspect of any clinical trial is using the right outcome measure to assess treatment efficacy. Compared to the rapidly evolved understanding and measurement of pathophysiology in preclinical and early symptomatic stages of Alzheimer's disease (AD), relatively less progress has been made in the evolution of clinical outcome assessments (COAs) for those stages. The current paper aims to provide a benchmark for the design and evaluation of COAs for use in early AD trials. We discuss lessons learned on capturing cognitive changes in predementia stages of AD, including challenges when validating novel COAs for those early stages and necessary evidence for their implementation in clinical trials. Moving forward, we propose a multi-step framework to advance the use of more effective COAs to assess clinically meaningful changes in early AD, which will hopefully contribute to the much-needed consensus around more appropriate outcome measures to assess clinical efficacy of putative treatments. HIGHLIGHTS: We discuss lessons learned on capturing cognitive changes in predementia stages of AD. We propose a framework for the design and evaluation of performance based cognitive tests for use in early AD trials. We provide recommendations to facilitate the implementation of more effective cognitive outcome measures in AD trials.
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Affiliation(s)
- Roos J. Jutten
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Kathryn V. Papp
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | | | | | | | - Michael C. Donohue
- Alzheimer’s Therapeutic Research Institute, Keck School of Medicine, University of Southern California, San Diego, California, USA
| | - Jason Hassenstab
- Knight Alzheimer Disease Research Center, Department of Neurology, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Paul Maruff
- Cogstate Ltd., Melbourne, Victoria, Australia
- The Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia
| | - Dorene M. Rentz
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - John Harrison
- Metis Cognition Ltd., Kilmington, UK
- Department of Psychiatry, Psychology & Neuroscience, King’s College London, UK
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam UMC, location VUmc, VU University, Amsterdam, The Netherlands
| | - Jeffrey Cummings
- Chambers-Grundy Center for Transformative Neuroscience, Department of Brain Health, School of Integrated Health Sciences, University of Nevada Las Vegas (UNLV), Las Vegas, Nevada, USA
| | - Philip Scheltens
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam UMC, location VUmc, VU University, Amsterdam, The Netherlands
| | - Sietske A. M. Sikkes
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam UMC, location VUmc, VU University, Amsterdam, The Netherlands
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Movement and Behavioral Sciences, VU University, Amsterdam, The Netherlands
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29
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Johnson SC, Suárez-Calvet M, Suridjan I, Minguillón C, Gispert JD, Jonaitis E, Michna A, Carboni M, Bittner T, Rabe C, Kollmorgen G, Zetterberg H, Blennow K. Identifying clinically useful biomarkers in neurodegenerative disease through a collaborative approach: the NeuroToolKit. Alzheimers Res Ther 2023; 15:25. [PMID: 36709293 PMCID: PMC9883877 DOI: 10.1186/s13195-023-01168-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 01/15/2023] [Indexed: 01/30/2023]
Abstract
BACKGROUND Alzheimer's disease (AD) is a complex and heterogeneous disease, which requires reliable biomarkers for diagnosis and monitoring disease activity. Preanalytical protocol and technical variability associated with biomarker immunoassays makes comparability of biomarker data across multiple cohorts difficult. This study aimed to compare cerebrospinal fluid (CSF) biomarker results across independent cohorts, including participants spanning the AD continuum. METHODS Measured on the NeuroToolKit (NTK) prototype panel of immunoassays, 12 CSF biomarkers were evaluated from three cohorts (ALFA+, Wisconsin, and Abby/Blaze). A correction factor was applied to biomarkers found to be affected by preanalytical procedures (amyloid-β1-42, amyloid-β1-40, and alpha-synuclein), and results between cohorts for each disease stage were compared. The relationship between CSF biomarker concentration and cognitive scores was evaluated. RESULTS Biomarker distributions were comparable across cohorts following correction. Correlations of biomarker values were consistent across cohorts, regardless of disease stage. Disease stage differentiation was highest for neurofilament light (NfL), phosphorylated tau, and total tau, regardless of the cohort. Correlation between biomarker concentration and cognitive scores was comparable across cohorts, and strongest for NfL, chitinase-3-like protein-1 (YKL40), and glial fibrillary acidic protein. DISCUSSION The precision of the NTK enables merging of biomarker datasets, after correction for preanalytical confounders. Assessment of multiple cohorts is crucial to increase power in future studies into AD pathogenesis.
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Affiliation(s)
- Sterling C Johnson
- University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
- Geriatric Research Education and Clinical Center of the William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
| | - Marc Suárez-Calvet
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08005, Barcelona, Spain.
- Centre for Biomedical Research Network on Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain.
- Neurology Service, Hospital del Mar, Barcelona, Spain.
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
| | | | - Carolina Minguillón
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08005, Barcelona, Spain
- Centre for Biomedical Research Network on Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Juan Domingo Gispert
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08005, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Centre for Biomedical Research in Network Bioengineering, Biomaterials and Nanomedicine, Instituto de Salud Carlos III, Madrid, Spain
| | - Erin Jonaitis
- University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | | | | | - Tobias Bittner
- F. Hoffmann-La Roche AG, Basel, Switzerland
- Genentech, A Member of the Roche Group, San Francisco, CA, USA
| | - Christina Rabe
- Genentech, A Member of the Roche Group, San Francisco, CA, USA
| | | | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, UK
- UK Dementia Research Institute at UCL, London, UK
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong, China
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
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Wilkerson GB, Colston MA, Acocello SN, Hogg JA, Carlson LM. Subtle impairments of perceptual-motor function and well-being are detectable among military cadets and college athletes with self-reported history of concussion. Front Sports Act Living 2023; 5:1046572. [PMID: 36761780 PMCID: PMC9905443 DOI: 10.3389/fspor.2023.1046572] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 01/03/2023] [Indexed: 01/26/2023] Open
Abstract
Introduction A lack of obvious long-term effects of concussion on standard clinical measures of behavioral performance capabilities does not preclude the existence of subtle neural processing impairments that appear to be linked to elevated risk for subsequent concussion occurrence, and which may be associated with greater susceptibility to progressive neurodegenerative processes. The purpose of this observational cohort study was to assess virtual reality motor response variability and survey responses as possible indicators of suboptimal brain function among military cadets and college athletes with self-reported history of concussion (HxC). Methods The cohort comprised 75 college students (20.7 ± 2.1 years): 39 Reserve Officer Training Corp (ROTC) military cadets (10 female), 16 football players, and 20 wrestlers; HxC self-reported by 20 (29.2 ± 27.1 months prior, range: 3-96). A virtual reality (VR) test involving 40 lunging/reaching responses to horizontally moving dots (filled/congruent: same direction; open/incongruent: opposite direction) was administered, along with the Sport Fitness and Wellness Index (SFWI) survey. VR Dispersion (standard deviation of 12 T-scores for neck, upper extremity, and lower extremity responses to congruent vs. incongruent stimuli originating from central vs. peripheral locations) and SFWI response patterns were the primary outcomes of interest. Results Logistic regression modeling of VR Dispersion (range: 1.5-21.8), SFWI (range: 44-100), and an interaction between them provided 81% HxC classification accuracy (Model χ 2[2] = 26.03, p < .001; Hosmer & Lemeshow χ 2[8] = 1.86, p = .967; Nagelkerke R 2 = .427; Area Under Curve = .841, 95% CI: .734, .948). Binary modeling that included VR Dispersion ≥3.2 and SFWI ≤86 demonstrated 75% sensitivity and 86% specificity with both factors positive (Odds Ratio = 17.6, 95% CI: 5.0, 62.1). Discussion/Conclusion Detection of subtle indicators of altered brain processes that might otherwise remain unrecognized is clearly important for both short-term and long-term clinical management of concussion. Inconsistency among neck, upper extremity, and lower extremity responses to different types of moving visual stimuli, along with survey responses suggesting suboptimal well-being, merit further investigation as possible clinical indicators of persisting effects of concussion that might prove to be modifiable.
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Affiliation(s)
- Gary B Wilkerson
- Department of Health and Human Performance, University of Tennessee at Chattanooga, Chattanooga, TN, United States
| | - Marisa A Colston
- Department of Health and Human Performance, University of Tennessee at Chattanooga, Chattanooga, TN, United States
| | - Shellie N Acocello
- Department of Health and Human Performance, University of Tennessee at Chattanooga, Chattanooga, TN, United States
| | - Jennifer A Hogg
- Department of Health and Human Performance, University of Tennessee at Chattanooga, Chattanooga, TN, United States
| | - Lynette M Carlson
- Department of Health and Human Performance, University of Tennessee at Chattanooga, Chattanooga, TN, United States
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Peplow P, Martinez B. MicroRNAs as potential biomarkers in temporal lobe epilepsy and mesial temporal lobe epilepsy. Neural Regen Res 2023; 18:716-726. [DOI: 10.4103/1673-5374.354510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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32
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Xu Y, Vasiljevic E, Deming YK, Jonaitis EM, Koscik RL, Van Hulle CA, Lu Q, Carboni M, Kollmorgen G, Wild N, Carlsson CM, Johnson SC, Zetterberg H, Blennow K, Engelman CD. Effect of Pathway-Specific Polygenic Risk Scores for Alzheimer's Disease (AD) on Rate of Change in Cognitive Function and AD-Related Biomarkers Among Asymptomatic Individuals. J Alzheimers Dis 2023; 94:1587-1605. [PMID: 37482996 PMCID: PMC10468904 DOI: 10.3233/jad-230097] [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: 07/25/2023]
Abstract
BACKGROUND Genetic scores for late-onset Alzheimer's disease (LOAD) have been associated with preclinical cognitive decline and biomarker variations. Compared with an overall polygenic risk score (PRS), a pathway-specific PRS (p-PRS) may be more appropriate in predicting a specific biomarker or cognitive component underlying LOAD pathology earlier in the lifespan. OBJECTIVE In this study, we leveraged longitudinal data from the Wisconsin Registry for Alzheimer's Prevention and explored changing patterns in cognition and biomarkers at various age points along six biological pathways. METHODS PRS and p-PRSs with and without APOE were constructed separately based on the significant SNPs associated with LOAD in a recent genome-wide association study meta-analysis and compared to APOE alone. We used a linear mixed-effects model to assess the association between PRS/p-PRSs and cognitive trajectories among 1,175 individuals. We also applied the model to the outcomes of cerebrospinal fluid biomarkers in a subset. Replication analyses were performed in an independent sample. RESULTS We found p-PRSs and the overall PRS can predict preclinical changes in cognition and biomarkers. The effects of PRS/p-PRSs on rate of change in cognition, amyloid-β, and tau outcomes are dependent on age and appear earlier in the lifespan when APOE is included in these risk scores compared to when APOE is excluded. CONCLUSION In addition to APOE, the p-PRSs can predict age-dependent changes in amyloid-β, tau, and cognition. Once validated, they could be used to identify individuals with an elevated genetic risk of accumulating amyloid-β and tau, long before the onset of clinical symptoms.
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Affiliation(s)
- Yuexuan Xu
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, WI, USA
| | - Eva Vasiljevic
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, WI, USA
- Center for Demography of Health and Aging, University of Wisconsin-Madison, WI, USA
| | - Yuetiva K. Deming
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, WI, USA
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, WI, USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison, WI, USA
| | - Erin M. Jonaitis
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison, WI, USA
| | - Rebecca L. Koscik
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, WI, USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison, WI, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison, WI, USA
| | - Carol A. Van Hulle
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, WI, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison, WI, USA
| | - Qiongshi Lu
- Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin-Madison, WI, USA
| | | | | | | | - Cynthia M. Carlsson
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, WI, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison, WI, USA
- Geriatric Research Education and Clinical Center, Wm. S. Middleton Memorial VA Hospital, Madison, WI, USA
| | - Sterling C. Johnson
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, WI, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison, WI, USA
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- UK Dementia Research Institute at UCL, London, UK
- Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong, China
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Corinne D. Engelman
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, WI, USA
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Ashton NJ, Janelidze S, Mattsson-Carlgren N, Binette AP, Strandberg O, Brum WS, Karikari TK, González-Ortiz F, Di Molfetta G, Meda FJ, Jonaitis EM, Koscik RL, Cody K, Betthauser TJ, Li Y, Vanmechelen E, Palmqvist S, Stomrud E, Bateman RJ, Zetterberg H, Johnson SC, Blennow K, Hansson O. Differential roles of Aβ42/40, p-tau231 and p-tau217 for Alzheimer's trial selection and disease monitoring. Nat Med 2022; 28:2555-2562. [PMID: 36456833 PMCID: PMC9800279 DOI: 10.1038/s41591-022-02074-w] [Citation(s) in RCA: 110] [Impact Index Per Article: 55.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 10/03/2022] [Indexed: 12/03/2022]
Abstract
Blood biomarkers indicative of Alzheimer's disease (AD) pathology are altered in both preclinical and symptomatic stages of the disease. Distinctive biomarkers may be optimal for the identification of AD pathology or monitoring of disease progression. Blood biomarkers that correlate with changes in cognition and atrophy during the course of the disease could be used in clinical trials to identify successful interventions and thereby accelerate the development of efficient therapies. When disease-modifying treatments become approved for use, efficient blood-based biomarkers might also inform on treatment implementation and management in clinical practice. In the BioFINDER-1 cohort, plasma phosphorylated (p)-tau231 and amyloid-β42/40 ratio were more changed at lower thresholds of amyloid pathology. Longitudinally, however, only p-tau217 demonstrated marked amyloid-dependent changes over 4-6 years in both preclinical and symptomatic stages of the disease, with no such changes observed in p-tau231, p-tau181, amyloid-β42/40, glial acidic fibrillary protein or neurofilament light. Only longitudinal increases of p-tau217 were also associated with clinical deterioration and brain atrophy in preclinical AD. The selective longitudinal increase of p-tau217 and its associations with cognitive decline and atrophy was confirmed in an independent cohort (Wisconsin Registry for Alzheimer's Prevention). These findings support the differential association of plasma biomarkers with disease development and strongly highlight p-tau217 as a surrogate marker of disease progression in preclinical and prodromal AD, with impact for the development of new disease-modifying treatments.
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Affiliation(s)
- Nicholas J Ashton
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Maurice Wohl Institute Clinical Neuroscience Institute, London, UK
- NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation, London, UK
- Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway
| | - Shorena Janelidze
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, Sweden
| | - Niklas Mattsson-Carlgren
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, Sweden
- Department of Neurology, Skåne University Hospital, Lund University, Lund, Sweden
- Wallenberg Center for Molecular Medicine, Lund University, Lund, Sweden
| | - Alexa Pichet Binette
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, Sweden
| | - Olof Strandberg
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, Sweden
| | - Wagner S Brum
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Graduate Program in Biological Sciences: Biochemistry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Thomas K Karikari
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Fernándo González-Ortiz
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Guglielmo Di Molfetta
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Francisco J Meda
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Erin M Jonaitis
- Wisconsin Alzheimer's Institute, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
- Wisconsin Alzheimer's Disease Research Center, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Rebecca Langhough Koscik
- Wisconsin Alzheimer's Institute, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
- Wisconsin Alzheimer's Disease Research Center, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Karly Cody
- Wisconsin Alzheimer's Institute, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
- Wisconsin Alzheimer's Disease Research Center, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Tobey J Betthauser
- Wisconsin Alzheimer's Institute, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
- Wisconsin Alzheimer's Disease Research Center, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Yan Li
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
- SILQ Center, Washington University School of Medicine, St. Louis, MO, USA
| | | | - Sebastian Palmqvist
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Erik Stomrud
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Randall J Bateman
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
- SILQ Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, UK
- UK Dementia Research Institute at UCL, London, UK
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong, China
| | - Sterling C Johnson
- Wisconsin Alzheimer's Institute, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
- Wisconsin Alzheimer's Disease Research Center, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.
- ADx NeuroSciences, Technologiepark 94, Ghent, Belgium.
| | - Oskar Hansson
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, Sweden.
- Memory Clinic, Skåne University Hospital, Malmö, Sweden.
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Tarumi T, Patel NR, Tomoto T, Pasha E, Khan AM, Kostroske K, Riley J, Tinajero CD, Wang C, Hynan LS, Rodrigue KM, Kennedy KM, Park DC, Zhang R. Aerobic exercise training and neurocognitive function in cognitively normal older adults: A one-year randomized controlled trial. J Intern Med 2022; 292:788-803. [PMID: 35713933 PMCID: PMC9588521 DOI: 10.1111/joim.13534] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Current evidence is inconsistent on the benefits of aerobic exercise training for preventing or attenuating age-related cognitive decline in older adults. OBJECTIVE To investigate the effects of a 1-year progressive, moderate-to-high intensity aerobic exercise intervention on cognitive function, brain volume, and cortical thickness in sedentary but otherwise healthy older adults. METHODS We randomized 73 older adults to a 1-year aerobic exercise or stretching-and-toning (active control) program. The primary outcome was a cognitive composite score calculated from eight neuropsychological tests encompassing inductive reasoning, long-term and working memory, executive function, and processing speed. Secondary outcomes were brain volume and cortical thickness assessed by MRI, and cardiorespiratory fitness measured by peak oxygen uptake (VO2 ). RESULTS One-year aerobic exercise increased peak VO2 by ∼10% (p < 0.001) while it did not change with stretching (p = 0.241). Cognitive composite scores increased in both the aerobic and stretching groups (p < 0.001 for time effect), although no group difference was observed. Total brain volume (p < 0.001) and mean cortical thickness (p = 0.001) decreased in both groups over time, while the reduction in hippocampal volume was smaller in the stretching group compared with the aerobic group (p = 0.040 for interaction). Across all participants, improvement in peak VO2 was positively correlated with increases in cognitive composite score (r = 0.282, p = 0.042) and regional cortical thickness at the inferior parietal lobe (p = 0.016). CONCLUSIONS One-year aerobic exercise and stretching interventions improved cognitive performance but did not prevent age-related brain volume loss in sedentary healthy older adults. Cardiorespiratory fitness gain was positively correlated with cognitive performance and regional cortical thickness.
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Affiliation(s)
- Takashi Tarumi
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas, USA
- Human Informatics and Interaction Research Institute, National Institute of Advanced Industrial Science and Technology, Tsukuba, Japan
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Neena R. Patel
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas, USA
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Tsubasa Tomoto
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas, USA
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Evan Pasha
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas, USA
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Ayaz M. Khan
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas, USA
- Department of Diagnostic Imaging, St. Jude Children Research Hospital, Memphis, TN, USA
| | - Kayla Kostroske
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas, USA
| | - Jonathan Riley
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas, USA
| | - Cynthia D. Tinajero
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas, USA
| | - Ciwen Wang
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas, USA
| | - Linda S. Hynan
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Karen M. Rodrigue
- Center for Vital Longevity, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Dallas, Texas, USA
| | - Kristen M. Kennedy
- Center for Vital Longevity, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Dallas, Texas, USA
| | - Denise C. Park
- Center for Vital Longevity, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Dallas, Texas, USA
| | - Rong Zhang
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas, USA
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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Skirrow C, Meszaros M, Meepegama U, Lenain R, Papp KV, Weston J, Fristed E. Validation of a Remote and Fully Automated Story Recall Task to Assess for Early Cognitive Impairment in Older Adults: Longitudinal Case-Control Observational Study. JMIR Aging 2022; 5:e37090. [PMID: 36178715 PMCID: PMC9568813 DOI: 10.2196/37090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 07/07/2022] [Accepted: 07/13/2022] [Indexed: 01/23/2023] Open
Abstract
Background Story recall is a simple and sensitive cognitive test that is commonly used to measure changes in episodic memory function in early Alzheimer disease (AD). Recent advances in digital technology and natural language processing methods make this test a candidate for automated administration and scoring. Multiple parallel test stimuli are required for higher-frequency disease monitoring. Objective This study aims to develop and validate a remote and fully automated story recall task, suitable for longitudinal assessment, in a population of older adults with and without mild cognitive impairment (MCI) or mild AD. Methods The “Amyloid Prediction in Early Stage Alzheimer’s disease” (AMYPRED) studies recruited participants in the United Kingdom (AMYPRED-UK: NCT04828122) and the United States (AMYPRED-US: NCT04928976). Participants were asked to complete optional daily self-administered assessments remotely on their smart devices over 7 to 8 days. Assessments included immediate and delayed recall of 3 stories from the Automatic Story Recall Task (ASRT), a test with multiple parallel stimuli (18 short stories and 18 long stories) balanced for key linguistic and discourse metrics. Verbal responses were recorded and securely transferred from participants’ personal devices and automatically transcribed and scored using text similarity metrics between the source text and retelling to derive a generalized match score. Group differences in adherence and task performance were examined using logistic and linear mixed models, respectively. Correlational analysis examined parallel-forms reliability of ASRTs and convergent validity with cognitive tests (Logical Memory Test and Preclinical Alzheimer’s Cognitive Composite with semantic processing). Acceptability and usability data were obtained using a remotely administered questionnaire. Results Of the 200 participants recruited in the AMYPRED studies, 151 (75.5%)—78 cognitively unimpaired (CU) and 73 MCI or mild AD—engaged in optional remote assessments. Adherence to daily assessment was moderate and did not decline over time but was higher in CU participants (ASRTs were completed each day by 73/106, 68.9% participants with MCI or mild AD and 78/94, 83% CU participants). Participants reported favorable task usability: infrequent technical problems, easy use of the app, and a broad interest in the tasks. Task performance improved modestly across the week and was better for immediate recall. The generalized match scores were lower in participants with MCI or mild AD (Cohen d=1.54). Parallel-forms reliability of ASRT stories was moderate to strong for immediate recall (mean rho 0.73, range 0.56-0.88) and delayed recall (mean rho=0.73, range=0.54-0.86). The ASRTs showed moderate convergent validity with established cognitive tests. Conclusions The unsupervised, self-administered ASRT task is sensitive to cognitive impairments in MCI and mild AD. The task showed good usability, high parallel-forms reliability, and high convergent validity with established cognitive tests. Remote, low-cost, low-burden, and automatically scored speech assessments could support diagnostic screening, health care, and treatment monitoring.
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Affiliation(s)
| | | | | | | | - Kathryn V Papp
- Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States.,Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
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Cody KA, Koscik RL, Erickson CM, Berman SE, Jonaitis EM, Williams VJ, Mueller KD, Christian BT, Chin NA, Clark LR, Betthauser TJ, Johnson SC. Associations of the Lifestyle for Brain Health index with longitudinal cognition and brain amyloid beta in clinically unimpaired older adults: Findings from the Wisconsin Registry for Alzheimer's Prevention. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2022; 14:e12351. [PMID: 36110432 PMCID: PMC9464997 DOI: 10.1002/dad2.12351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 07/13/2022] [Accepted: 07/20/2022] [Indexed: 01/25/2023]
Abstract
Introduction Modifiable health and lifestyle factors increase risk of dementia, but whether modifiable factors, when measured in late-midlife, impact the emergence or progression of Alzheimer's disease (AD) pathophysiologic or cognitive changes remains unresolved. Methods In initially cognitively unimpaired, late middle-aged participants (N = 1215; baseline age, M [standard deviation] = 59.3 [6.7] years) from the Wisconsin Registry for Alzheimer's Prevention (WRAP), we investigated the influence of the Lifestyle for Brain Health (LIBRA) index, a lifestyle-based dementia risk score, on AD-related cognitive trajectories and amyloid beta (Aβ) plaque accumulation. Results Overall, lower baseline LIBRA, denoting healthier lifestyle and lower dementia risk, was related to better overall cognitive performance, but did not moderate apolipoprotein E ε4 or Aβ-related longitudinal cognitive trajectories. LIBRA was not significantly associated with Aβ accumulation or estimated age of Aβ onset. Discussion In WRAP, late-midlife LIBRA scores were related to overall cognitive performance, but not AD-related cognitive decline or Aβ accumulation in the preclinical timeframe. Highlights The Lifestyle for Brain Health (LIBRA) index was associated with cognitive performance in late-midlife.LIBRA did not moderate apolipoprotein E ε4 or amyloid-related cognitive decline.LIBRA was not associated with the onset or accumulation of amyloid plaques.
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Affiliation(s)
- Karly A. Cody
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Department of MedicineUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Rebecca L. Koscik
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Department of MedicineUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Wisconsin Alzheimer's InstituteUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Claire M. Erickson
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Department of MedicineUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Sara E. Berman
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Department of MedicineUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Erin M. Jonaitis
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Department of MedicineUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Wisconsin Alzheimer's InstituteUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Victoria J. Williams
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Department of MedicineUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Kimberly D. Mueller
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Department of MedicineUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Wisconsin Alzheimer's InstituteUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Department of Communication Sciences & DisordersUniversity of Wisconsin–MadisonMadisonWisconsinUSA
| | - Bradley T. Christian
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Waisman Laboratory for Brain Imaging and BehaviorUniversity of Wisconsin–MadisonMadisonWisconsinUSA,Department of Medical PhysicsUniversity of Wisconsin–MadisonMadisonWisconsinUSA
| | - Nathanial A. Chin
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Lindsay R. Clark
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Department of MedicineUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Geriatric Research Education and Clinical CenterWilliam S. Middleton Veterans HospitalMadisonWisconsinUSA
| | - Tobey J. Betthauser
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Department of MedicineUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Sterling C. Johnson
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Department of MedicineUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Wisconsin Alzheimer's InstituteUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Geriatric Research Education and Clinical CenterWilliam S. Middleton Veterans HospitalMadisonWisconsinUSA
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Milà-Alomà M, Ashton NJ, Shekari M, Salvadó G, Ortiz-Romero P, Montoliu-Gaya L, Benedet AL, Karikari TK, Lantero-Rodriguez J, Vanmechelen E, Day TA, González-Escalante A, Sánchez-Benavides G, Minguillon C, Fauria K, Molinuevo JL, Dage JL, Zetterberg H, Gispert JD, Suárez-Calvet M, Blennow K. Plasma p-tau231 and p-tau217 as state markers of amyloid-β pathology in preclinical Alzheimer's disease. Nat Med 2022; 28:1797-1801. [PMID: 35953717 PMCID: PMC9499867 DOI: 10.1038/s41591-022-01925-w] [Citation(s) in RCA: 70] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 06/29/2022] [Indexed: 01/07/2023]
Abstract
Blood biomarkers indicating elevated amyloid-β (Aβ) pathology in preclinical Alzheimer’s disease are needed to facilitate the initial screening process of participants in disease-modifying trials. Previous biofluid data suggest that phosphorylated tau231 (p-tau231) could indicate incipient Aβ pathology, but a comprehensive comparison with other putative blood biomarkers is lacking. In the ALFA+ cohort, all tested plasma biomarkers (p-tau181, p-tau217, p-tau231, GFAP, NfL and Aβ42/40) were significantly changed in preclinical Alzheimer’s disease. However, plasma p-tau231 reached abnormal levels with the lowest Aβ burden. Plasma p-tau231 and p-tau217 had the strongest association with Aβ positron emission tomography (PET) retention in early accumulating regions and associated with longitudinal increases in Aβ PET uptake in individuals without overt Aβ pathology at baseline. In summary, plasma p-tau231 and p-tau217 better capture the earliest cerebral Aβ changes, before overt Aβ plaque pathology is present, and are promising blood biomarkers to enrich a preclinical population for Alzheimer’s disease clinical trials. A comprehensive comparison of Alzheimer’s disease blood biomarkers in cognitively unimpaired individuals reveals that plasma p-tau231 and p-tau217 capture very early Aβ changes, showing promise as markers to enrich a preclinical population for Alzheimer’s disease clinical trials
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Affiliation(s)
- Marta Milà-Alomà
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable, Instituto de Salud Carlos III, Madrid, Spain.,Universitat Pompeu Fabra, Barcelona, Spain
| | - Nicholas J Ashton
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden.,Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden.,King's College London, Institute of Psychiatry, Psychology & Neuroscience, Maurice Wohl Clinical Neuroscience Institute, London, UK.,NIHR Biomedical Research Centre for Mental Health & Biomedical Research Unit for Dementia at South London & Maudsley NHS Foundation, London, UK
| | - Mahnaz Shekari
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable, Instituto de Salud Carlos III, Madrid, Spain.,Universitat Pompeu Fabra, Barcelona, Spain
| | - Gemma Salvadó
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable, Instituto de Salud Carlos III, Madrid, Spain
| | - Paula Ortiz-Romero
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Laia Montoliu-Gaya
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden
| | - Andrea L Benedet
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden.,Translational Neuroimaging Laboratory, McGill Centre for Studies in Aging, McGill University, Montreal, Quebec, Canada
| | - Thomas K Karikari
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden.,Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Juan Lantero-Rodriguez
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden
| | | | - Theresa A Day
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN, USA
| | - Armand González-Escalante
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Gonzalo Sánchez-Benavides
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable, Instituto de Salud Carlos III, Madrid, Spain
| | - Carolina Minguillon
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable, Instituto de Salud Carlos III, Madrid, Spain
| | - Karine Fauria
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable, Instituto de Salud Carlos III, Madrid, Spain
| | - José Luis Molinuevo
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
| | - Jeffrey L Dage
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN, USA.,Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK.,UK Dementia Research Institute at UCL, London, UK
| | - Juan Domingo Gispert
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable, Instituto de Salud Carlos III, Madrid, Spain.,Centro de Investigación Biomédica en Red Bioingeniería, Biomateriales y Nanomedicina, Madrid, Spain
| | - Marc Suárez-Calvet
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain. .,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain. .,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable, Instituto de Salud Carlos III, Madrid, Spain. .,Servei de Neurologia, Hospital del Mar, Barcelona, Spain.
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden. .,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.
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Vesperman CJ, Wang R, Schultz SA, Law LL, Dougherty RJ, Ma Y, Oh JM, Edwards DF, Gallagher CL, Chin NA, Asthana S, Hermann BP, Sager MA, Johnson SC, Cook DB, Okonkwo OC. Cardiorespiratory fitness and cognition in persons at risk for Alzheimer's disease. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2022; 14:e12330. [PMID: 35845261 PMCID: PMC9270660 DOI: 10.1002/dad2.12330] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 05/02/2022] [Accepted: 05/10/2022] [Indexed: 01/25/2023]
Abstract
Introduction This study examined the relationship between cardiorespiratory fitness (CRF) and longitudinal cognitive functioning in a cohort enriched with risk factors for Alzheimer's disease (AD). Methods A total of 155 enrollees in the Wisconsin Registry for Alzheimer's Prevention completed repeat comprehensive neuropsychological evaluations that assessed six cognitive domains. Peak oxygen consumption (VO2peak) was the primary measure of CRF. Random effects regression was used to investigate the effect of CRF on cognitive trajectories. Results Higher CRF was associated with slower decline in the cognitive domains of verbal learning and memory (P < .01) and visual learning and memory (P < .042). Secondary analyses indicated that these effects were stronger among men than women, and for noncarriers of the apolipoprotein E ε4 allele. Discussion Higher CRF was associated with a slower rate of the decline in episodic memory that occurs as a natural consequence of aging in a cohort enriched with risk factors for AD.
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Affiliation(s)
- Clayton J. Vesperman
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Rui Wang
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
- The Swedish School of Sport and Health SciencesGIHStockholmSweden
- Department of NeurobiologyCare Sciences and SocietyKarolinska InstitutetStockholmSweden
| | - Stephanie A. Schultz
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
- Department of RadiologyUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
- Department of RadiologyWashington University in St. Louis School of MedicineSt. LouisMissouriUSA
| | - Lena L. Law
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Ryan J. Dougherty
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
- Department of KinesiologyUniversity of Wisconsin School of EducationMadisonWisconsinUSA
| | - Yue Ma
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Jennifer M. Oh
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Dorothy F. Edwards
- Department of KinesiologyUniversity of Wisconsin School of EducationMadisonWisconsinUSA
| | - Catherine L. Gallagher
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
- Department of NeurologyUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Nathaniel A. Chin
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Sanjay Asthana
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
- Geriatric Research Education and Clinical CenterWilliam S. Middleton Memorial Veterans HospitalMadisonWisconsinUSA
| | - Bruce P. Hermann
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
- Department of NeurologyUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Mark A. Sager
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
- Wisconsin Alzheimer's InstituteUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Sterling C. Johnson
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
- Geriatric Research Education and Clinical CenterWilliam S. Middleton Memorial Veterans HospitalMadisonWisconsinUSA
- Wisconsin Alzheimer's InstituteUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Dane B. Cook
- Department of KinesiologyUniversity of Wisconsin School of EducationMadisonWisconsinUSA
- Research ServiceWilliam S. Middleton Memorial Veterans HospitalMadisonWisconsinUSA
| | - Ozioma C. Okonkwo
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
- Geriatric Research Education and Clinical CenterWilliam S. Middleton Memorial Veterans HospitalMadisonWisconsinUSA
- Wisconsin Alzheimer's InstituteUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
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Nair AK, Van Hulle CA, Bendlin BB, Zetterberg H, Blennow K, Wild N, Kollmorgen G, Suridjan I, Busse WW, Rosenkranz MA. Asthma amplifies dementia risk: Evidence from CSF biomarkers and cognitive decline. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2022; 8:e12315. [PMID: 35846157 PMCID: PMC9270636 DOI: 10.1002/trc2.12315] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 04/28/2022] [Accepted: 05/09/2022] [Indexed: 11/09/2022]
Abstract
Introduction Evidence from epidemiology, neuroimaging, and animal models indicates that asthma adversely affects the brain, but the nature and extent of neuropathophysiological impact remain unclear. Methods We tested the hypothesis that asthma is a risk factor for dementia by comparing cognitive performance and cerebrospinal fluid biomarkers of glial activation/neuroinflammation, neurodegeneration, and Alzheimer's disease (AD) pathology in 60 participants with asthma to 315 non-asthma age-matched control participants (45-93 years), in a sample enriched for AD risk. Results Participants with severe asthma had higher neurogranin concentrations compared to controls and those with mild asthma. Positive relationships between cardiovascular risk and concentrations of neurogranin and α-synuclein were amplified in severe asthma. Severe asthma also amplified the deleterious associations that apolipoprotein E ε4 carrier status, cardiovascular risk, and phosphorylated tau181/amyloid beta42 have with rate of cognitive decline. Discussion Our data suggest that severe asthma is associated with synaptic degeneration and may compound risk for dementia posed by cardiovascular disease and genetic predisposition. Highlights Those with severe asthma showed evidence of higher dementia risk than controls evidenced by: higher levels of the synaptic degeneration biomarker neurogranin regardless of cognitive status, cardiovascular or genetic risk, and controlling for demographics.steeper increase in levels of synaptic degeneration biomarkers neurogranin and α-synuclein with increasing cardiovascular risk.accelerated cognitive decline with higher cardiovascular risk, genetic predisposition, or pathological tau.
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Affiliation(s)
- Ajay Kumar Nair
- Center for Healthy MindsUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - Carol A. Van Hulle
- Wisconsin Alzheimer's Disease Research CenterSchool of Medicine and Public HealthUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
- Department of MedicineSchool of Medicine and Public HealthUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - Barbara B. Bendlin
- Wisconsin Alzheimer's Disease Research CenterSchool of Medicine and Public HealthUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
- Department of MedicineSchool of Medicine and Public HealthUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
- Wisconsin Alzheimer's InstituteSchool of Medicine and Public HealthUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - Henrik Zetterberg
- Department of Psychiatry and NeurochemistryInstitute of Neuroscience and PhysiologyThe Sahlgrenska Academy at The University of GothenburgMölndalSweden
- Clinical Neurochemistry LaboratorySahlgrenska University HospitalMölndalSweden
- Department of Neurodegenerative DiseaseUCL Institute of NeurologyLondonUK
- UK Dementia Research Institute at UCLLondonUK
- Hong Kong Center for Neurodegenerative DiseasesHong KongPeople's Republic of China
| | - Kaj Blennow
- Department of Psychiatry and NeurochemistryInstitute of Neuroscience and PhysiologyThe Sahlgrenska Academy at The University of GothenburgMölndalSweden
- Clinical Neurochemistry LaboratorySahlgrenska University HospitalMölndalSweden
| | | | | | | | - William W. Busse
- Department of MedicineSchool of Medicine and Public HealthUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - Melissa A. Rosenkranz
- Center for Healthy MindsUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
- Department of PsychiatryUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
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Johansson M, Stomrud E, Johansson PM, Svenningsson A, Palmqvist S, Janelidze S, van Westen D, Mattsson-Carlgren N, Hansson O. Development of Apathy, Anxiety, and Depression in Cognitively Unimpaired Older Adults: Effects of Alzheimer's Disease Pathology and Cognitive Decline. Biol Psychiatry 2022; 92:34-43. [PMID: 35346458 DOI: 10.1016/j.biopsych.2022.01.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 01/12/2022] [Accepted: 01/16/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND The impact of Alzheimer's disease (AD) pathology and cognitive deficits on longitudinal neuropsychiatric symptoms is unclear, especially in early disease stages. METHODS Cognitively unimpaired older adults (N = 356) enrolled in the prospective Swedish BioFINDER study were examined. Neuropsychiatric assessments encompassed the Apathy Evaluation Scale and the Hospital Anxiety and Depression Scale, performed biennially (together with tests of global cognition) for up to 8 years. Biomarkers were measured in cerebrospinal fluid or plasma at baseline. Magnetic resonance imaging quantified white matter lesions. We used linear mixed-effect models to test associations between baseline AD biomarkers (for amyloid-β [Aβ], tau, and neurodegeneration) and white matter lesions with longitudinal neuropsychiatric symptoms (apathy, anxiety, and depressive symptoms). We also tested associations between changes in cognition and changes in neuropsychiatric symptoms. Finally, we tested if change in cognition mediated the effects of different brain pathologies on neuropsychiatric symptoms. RESULTS Aβ pathology at baseline was associated with increasing levels of apathy (β = -0.284, p = .005) and anxiety (β = -0.060, p = .011) longitudinally. More rapid decline of cognition over time was related to increasing levels of apathy. The effects of baseline Aβ pathology on longitudinal apathy were partly mediated by changes in cognitive performance (proportion mediated 23%). CONCLUSIONS Aβ pathology may drive the development of both apathy and anxiety in very early stages of AD, largely independent of cognitive change. The effect of Aβ on apathy is only partially conveyed by worse cognition. Together, these findings highlight certain neuropsychiatric symptoms as early manifestations of AD.
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Affiliation(s)
- Maurits Johansson
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden; Division of Clinical Sciences Helsingborg, Department of Clinical Sciences Lund, Lund University, Helsingborg, Sweden; Clinical Department of Psychiatry, Helsingborg Hospital, Helsingborg, Sweden.
| | - Erik Stomrud
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden; Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Per Mårten Johansson
- Division of Clinical Sciences Helsingborg, Department of Clinical Sciences Lund, Lund University, Helsingborg, Sweden; Department of Internal Medicine, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - Anna Svenningsson
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden; Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Sebastian Palmqvist
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden; Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Shorena Janelidze
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Danielle van Westen
- Diagnostic Radiology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden; Image and Function, Skåne University Hospital Lund, Lund, Sweden
| | - Niklas Mattsson-Carlgren
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden; Wallenberg Center for Molecular Medicine, Lund University, Lund, Sweden; Department of Neurology, Skåne University Hospital Lund, Lund, Sweden
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden; Memory Clinic, Skåne University Hospital, Malmö, Sweden.
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Mueller KD, Du L, Bruno D, Betthauser T, Christian B, Johnson S, Hermann B, Koscik RL. Item-Level Story Recall Predictors of Amyloid-Beta in Late Middle-Aged Adults at Increased Risk for Alzheimer's Disease. Front Psychol 2022; 13:908651. [PMID: 35832924 PMCID: PMC9271832 DOI: 10.3389/fpsyg.2022.908651] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 05/31/2022] [Indexed: 11/13/2022] Open
Abstract
Background Story recall (SR) tests have shown variable sensitivity to rate of cognitive decline in individuals with Alzheimer's disease (AD) biomarkers. Although SR tasks are typically scored by obtaining a sum of items recalled, item-level analyses may provide additional sensitivity to change and AD processes. Here, we examined the difficulty and discrimination indices of each item from the Logical Memory (LM) SR task, and determined if these metrics differed by recall conditions, story version (A vs. B), lexical categories, serial position, and amyloid status. Methods n = 1,141 participants from the Wisconsin Registry for Alzheimer's Prevention longitudinal study who had item-level data were included in these analyses, as well as a subset of n = 338 who also had amyloid positron emission tomography (PET) imaging. LM data were categorized into four lexical categories (proper names, verbs, numbers, and "other"), and by serial position (primacy, middle, and recency). We calculated difficulty and discriminability/memorability by item, category, and serial position and ran separate repeated measures ANOVAs for each recall condition, lexical category, and serial position. For the subset with amyloid imaging, we used a two-sample t-test to examine whether amyloid positive (Aβ+) and amyloid negative (Aβ-) groups differed in difficulty or discrimination for the same summary metrics. Results In the larger sample, items were more difficult (less memorable) in the delayed recall condition across both story A and story B. Item discrimination was higher at delayed than immediate recall, and proper names had better discrimination than any of the other lexical categories or serial position groups. In the subsample with amyloid PET imaging, proper names were more difficult for Aβ+ than Aβ-; items in the verb and "other" lexical categories and all serial positions from delayed recall were more discriminate for the Aβ+ group compared to the Aβ- group. Conclusion This study provides empirical evidence that both LM stories are effective at discriminating ability levels and amyloid status, and that individual items vary in difficulty and discrimination by amyloid status, while total scores do not. These results can be informative for the future development of sensitive tasks or composite scores for early detection of cognitive decline.
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Affiliation(s)
- Kimberly D. Mueller
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, WI, United States
- Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Lianlian Du
- Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Davide Bruno
- School of Psychology, Liverpool John Moores University, Liverpool, United Kingdom
| | - Tobey Betthauser
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Bradley Christian
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
- Waisman Laboratory for Brain Imaging and Behavior, University of Wisconsin-Madison, Madison, WI, United States
- Department of Medical Physics, University of Wisconsin-Madison, Madison, WI, United States
| | - Sterling Johnson
- Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
- Geriatric Research Education and Clinical Center, William S. Middleton Veterans Hospital, Madison, WI, United States
| | - Bruce Hermann
- Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
- Department of Neurology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Rebecca Langhough Koscik
- Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
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Kagerer SM, Schroeder C, van Bergen JMG, Schreiner SJ, Meyer R, Steininger SC, Vionnet L, Gietl AF, Treyer V, Buck A, Pruessmann KP, Hock C, Unschuld PG. Low Subicular Volume as an Indicator of Dementia-Risk Susceptibility in Old Age. Front Aging Neurosci 2022; 14:811146. [PMID: 35309894 PMCID: PMC8926841 DOI: 10.3389/fnagi.2022.811146] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 01/31/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Hippocampal atrophy is an established Alzheimer’s Disease (AD) biomarker. Volume loss in specific subregions as measurable with ultra-high field magnetic resonance imaging (MRI) may reflect earliest pathological alterations. Methods Data from positron emission tomography (PET) for estimation of cortical amyloid β (Aβ) and high-resolution 7 Tesla T1 MRI for assessment of hippocampal subfield volumes were analyzed in 61 non-demented elderly individuals who were divided into risk-categories as defined by high levels of cortical Aβ and low performance in standardized episodic memory tasks. Results High cortical Aβ and low episodic memory interactively predicted subicular volume [F(3,57) = 5.90, p = 0.018]. The combination of high cortical Aβ and low episodic memory was associated with significantly lower subicular volumes, when compared to participants with high episodic memory (p = 0.004). Discussion Our results suggest that low subicular volume is linked to established indicators of AD risk, such as increased cortical Aβ and low episodic memory. Our data support subicular volume as a marker of dementia-risk susceptibility in old-aged non-demented persons.
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Affiliation(s)
- Sonja M. Kagerer
- Institute for Regenerative Medicine, University of Zurich, Zurich, Switzerland
- Psychogeriatric Medicine, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Clemens Schroeder
- Institute for Regenerative Medicine, University of Zurich, Zurich, Switzerland
| | | | - Simon J. Schreiner
- Institute for Regenerative Medicine, University of Zurich, Zurich, Switzerland
| | - Rafael Meyer
- Institute for Regenerative Medicine, University of Zurich, Zurich, Switzerland
| | - Stefanie C. Steininger
- Psychogeriatric Medicine, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Laetitia Vionnet
- Institute for Biomedical Engineering, University of Zurich and ETH Zürich, Zurich, Switzerland
| | - Anton F. Gietl
- Institute for Regenerative Medicine, University of Zurich, Zurich, Switzerland
- Psychogeriatric Medicine, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Valerie Treyer
- Institute for Regenerative Medicine, University of Zurich, Zurich, Switzerland
- Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Alfred Buck
- Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Klaas P. Pruessmann
- Institute for Biomedical Engineering, University of Zurich and ETH Zürich, Zurich, Switzerland
| | - Christoph Hock
- Institute for Regenerative Medicine, University of Zurich, Zurich, Switzerland
- Neurimmune, Schlieren, Switzerland
| | - Paul G. Unschuld
- Institute for Regenerative Medicine, University of Zurich, Zurich, Switzerland
- Psychogeriatric Medicine, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Institute for Biomedical Engineering, University of Zurich and ETH Zürich, Zurich, Switzerland
- Geriatric Psychiatry, Department of Psychiatry, University Hospitals of Geneva, University of Geneva, Geneva, Switzerland
- *Correspondence: Paul G. Unschuld,
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Du L, Koscik RL, Chin NA, Bratzke LC, Cody K, Erickson CM, Jonaitis E, Mueller KD, Hermann BP, Johnson SC. Prescription Medications and Co-Morbidities in Late Middle-Age are Associated with Greater Cognitive Declines: Results from WRAP. FRONTIERS IN AGING 2022; 2:759695. [PMID: 35822000 PMCID: PMC9261362 DOI: 10.3389/fragi.2021.759695] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 12/02/2021] [Indexed: 11/13/2022]
Abstract
The present study investigated: 1) sex differences in polypharmacy, comorbidities, self-rated current health (SRH), and cognitive performance, 2) associations between comorbidities, polypharmacy, SRH, and objective measures of health, and 3) associations of these factors with longitudinal cognitive performance. Analyses included 1039 eligible Wisconsin Registry for Alzheimer’s Prevention (WRAP) participants who were cognitively unimpaired at baseline and had ≥2 visits with cognitive composites, self-reported health history, and concurrent medication records. Repeated measures correlation (rmcorr) examined the associations between medications, co-morbidities, SRH, and objective measures of health (including LIfestyle for BRAin Health Index (LIBRA), and depression). Linear mixed-effect models examined associations between medications, co-morbidities, and cognitive change over time using a preclinical Alzheimer’s cognitive composite (PACC3) and cognitive domain z-scores (executive function, working memory, immediate learning, and delayed recall). In secondary analyses, we also examined whether the number of medications interacted with co-morbidities and whether they modified age-related cognitive trajectories. The number of prescribed medications was associated with worse SRH and a higher number of self-reported co-morbidities. More prescribed medications were associated with a faster decline in executive function, and more comorbidities were associated with faster PACC3 decline. Those with a non-elevated number of co-morbidities and medications performed an average of 0.26 SD higher (better) in executive function and an average of 0.18 SD higher on PACC3 than those elevated on both. Associations between medications, co-morbidities, and executive function, and PACC3 suggest that persons with more co-morbidities and medications may be at increased risk of reaching clinical levels of impairment earlier than healthier, less medicated peers.
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Affiliation(s)
- Lianlian Du
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States
- Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Rebecca Langhough Koscik
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States
- Wisconsin Alzheimer’s Disease Research Center, Madison, WI, United States
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States
- *Correspondence: Rebecca Langhough Koscik,
| | - Nathaniel A. Chin
- Wisconsin Alzheimer’s Disease Research Center, Madison, WI, United States
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States
| | - Lisa C. Bratzke
- School of Nursing, University of Wisconsin—Madison, Madison, WI, United States
| | - Karly Cody
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States
- Wisconsin Alzheimer’s Disease Research Center, Madison, WI, United States
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States
| | - Claire M. Erickson
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States
- Wisconsin Alzheimer’s Disease Research Center, Madison, WI, United States
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States
| | - Erin Jonaitis
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States
- Wisconsin Alzheimer’s Disease Research Center, Madison, WI, United States
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States
| | - Kimberly D. Mueller
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States
- Wisconsin Alzheimer’s Disease Research Center, Madison, WI, United States
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States
- Department of Communication Sciences & Disorders, University of Wisconsin—Madison, Madison, WI, United States
| | - Bruce P. Hermann
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States
- Department of Neurology, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States
| | - Sterling C. Johnson
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States
- Wisconsin Alzheimer’s Disease Research Center, Madison, WI, United States
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States
- Madison VA GRECC, William S. Middleton Memorial Hospital, Madison, WI, United States
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Kim YJ, Hahn A, Park YH, Na DL, Chin J, Seo SW. Longitudinal Amyloid Cognitive Composite in Preclinical Alzheimer's Disease. Eur J Neurol 2021; 29:980-989. [PMID: 34972256 DOI: 10.1111/ene.15241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 12/16/2021] [Accepted: 12/23/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Previous studies have developed several cognitive composites in preclinical AD. However, more sensitive measures to track cognitive changes and therapeutic efficacy in preclinical Alzheimer's disease (AD) are needed considering diverse sociocultural and linguistic backgrounds. This study developed a composite score that can sensitively detect the Aβ-related cognitive trajectory of preclinical AD using Korean data. METHODS A total of 196 cognitively normal (CN) participants who underwent amyloid positron emission tomography were followed-up with neuropsychological assessments. We developed the Longitudinal Amyloid cognitive Composite in Preclinical AD (LACPA) using the linear mixed-effects model (LMM) and z-scores. The LMM was also used to investigate the longitudinal sensitivity of LACPA and the association between time-varying brain atrophy and LACPA. RESULTS Considering the group-time interaction effects of each subtest, the Seoul Verbal Learning Test-Elderly's version (SVLT-E) immediate recall/delayed recall/recognition, the Korean Trail Making Test B time, and the Korean Mini-Mental State Examination were selected as components of LACPA. LACPA exhibited a significant group-time interaction effect between the Aβ+ and Aβ- groups (t = -3.288, p = 0.001). Associations between time-varying LACPA and brain atrophy were found in the bilateral medial temporal, right lateral parietal, and right lateral frontal regions, and hippocampal volume. CONCLUSION LACPA may contribute to reduction in time and financial burden when monitoring Aβ-related cognitive decline and therapeutic efficacy of the disease-modifying agents specifically targeting Aβ in secondary prevention trials.
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Affiliation(s)
- Young Ju Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea.,Neuroscience Center, Samsung Medical Center, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Alice Hahn
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea.,Neuroscience Center, Samsung Medical Center, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Yu Hyun Park
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea.,Neuroscience Center, Samsung Medical Center, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Duk L Na
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea.,Neuroscience Center, Samsung Medical Center, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea.,Stem Cell & Regenerative Medicine Institute
| | - Juhee Chin
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea.,Neuroscience Center, Samsung Medical Center, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Sang Won Seo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea.,Neuroscience Center, Samsung Medical Center, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea.,Samsung Alzheimer Research Center.,Center for Clinical Epidemiology, Samsung Medical Center, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea.,Department of Health Sciences and Technology.,Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
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Levin F, Jelistratova I, Betthauser TJ, Okonkwo O, Johnson SC, Teipel SJ, Grothe MJ. In vivo staging of regional amyloid progression in healthy middle-aged to older people at risk of Alzheimer's disease. Alzheimers Res Ther 2021; 13:178. [PMID: 34674764 PMCID: PMC8532333 DOI: 10.1186/s13195-021-00918-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 10/11/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND We investigated regional amyloid staging characteristics in 11C-PiB-PET data from middle-aged to older participants at elevated risk for AD enrolled in the Wisconsin Registry for Alzheimer's Prevention. METHODS We analyzed partial volume effect-corrected 11C-PiB-PET distribution volume ratio maps from 220 participants (mean age = 61.4 years, range 46.9-76.8 years). Regional amyloid positivity was established using region-specific thresholds. We used four stages from the frequency-based staging of amyloid positivity to characterize individual amyloid deposition. Longitudinal PET data was used to assess the temporal progression of stages and to evaluate the emergence of regional amyloid positivity in participants who were amyloid-negative at baseline. We also assessed the effect of amyloid stage on longitudinal cognitive trajectories. RESULTS The staging model suggested progressive accumulation of amyloid from associative to primary neocortex and gradually involving subcortical regions. Longitudinal PET measurements supported the cross-sectionally estimated amyloid progression. In mixed-effects longitudinal analysis of cognitive follow-up data obtained over an average period of 6.5 years following the baseline PET measurement, amyloid stage II showed a faster decline in executive function, and advanced amyloid stages (III and IV) showed a faster decline across multiple cognitive domains compared to stage 0. CONCLUSIONS Overall, the 11C-PiB-PET-based staging model was generally consistent with previously derived models from 18F-labeled amyloid PET scans and a longitudinal course of amyloid accumulation. Differences in longitudinal cognitive decline support the potential clinical utility of in vivo amyloid staging for risk stratification of the preclinical phase of AD even in middle-aged to older individuals at risk for AD.
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Affiliation(s)
- Fedor Levin
- German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Rostock, Germany
| | - Irina Jelistratova
- German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Rostock, Germany
| | - Tobey J Betthauser
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Ozioma Okonkwo
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Sterling C Johnson
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
- Wisconsin Alzheimer's Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
| | - Stefan J Teipel
- German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Rostock, Germany
- Department of Psychosomatic Medicine, University of Rostock, Rostock, Germany
| | - Michel J Grothe
- German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Rostock, Germany.
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, s/n, 41013, Seville, Spain.
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Ennis GE, Koscik RL, Ma Y, Jonaitis EM, Van Hulle CA, Betthauser TJ, Randall AM, Chin N, Engelman CD, Anderson R, Suridjan I, Kollmorgen G, Christian BT, Carlsson CM, Asthana S, Johnson SC, Zetterberg H, Blennow K, Bendlin BB. Insulin resistance is related to cognitive decline but not change in CSF biomarkers of Alzheimer's disease in non-demented adults. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2021; 13:e12220. [PMID: 34337133 PMCID: PMC8319658 DOI: 10.1002/dad2.12220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 05/10/2021] [Accepted: 06/04/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION We investigated whether insulin resistance (IR) was associated with longitudinal age-related change in cognition and biomarkers of Alzheimer's disease (AD) pathology and neurodegeneration in middle-aged and older adults who were non-demented at baseline. METHODS IR was measured with homeostatic model assessment of insulin resistance (HOMA2-IR). Core AD-related cerebrospinal fluid (CSF) biomarkers and cognition were assessed, respectively, on n = 212 (1 to 5 visits) and n = 1299 (1 to 6 visits). Linear mixed models tested whether HOMA2-IR moderated age-related change in CSF biomarkers and cognition. Linear regressions tested whether HOMA2-IR x apolipoprotein E ε4 allele (APOE ε4) carrier status predicted amyloid beta [Aβ] chronicity (estimated duration of amyloid positron emission tomography [PET] positivity) (n = 253). RESULTS Higher HOMA2-IR was associated with greater cognitive decline but not with changes in CSF biomarkers. HOMA2-IR x APOE4 was not related to Aβ chronicity but was significantly associated with CSF phosphorylated tau (P-tau)181/Aβ42 level. DISCUSSION In non-demented adults IR may not be directly associated with age-related change in AD biomarkers. Additional research is needed to determine mechanisms linking IR to cognitive decline.
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Affiliation(s)
- Gilda E Ennis
- Wisconsin Alzheimer's Disease Research Center University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA
| | - Rebecca L Koscik
- Wisconsin Alzheimer's Disease Research Center University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA
- Wisconsin Alzheimer's Institute University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA
| | - Yue Ma
- Wisconsin Alzheimer's Disease Research Center University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA
| | - Erin M Jonaitis
- Wisconsin Alzheimer's Institute University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA
| | - Carol A Van Hulle
- Wisconsin Alzheimer's Disease Research Center University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA
| | - Tobey J Betthauser
- Wisconsin Alzheimer's Disease Research Center University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA
- Division of Geriatrics and Gerontology Department of Medicine University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA
| | - Allison M Randall
- Wisconsin Alzheimer's Disease Research Center University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA
| | - Nathaniel Chin
- Wisconsin Alzheimer's Disease Research Center University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA
- Division of Geriatrics and Gerontology Department of Medicine University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA
| | - Corinne D Engelman
- Department of Population Health Sciences University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA
| | - Rozalyn Anderson
- Division of Geriatrics and Gerontology Department of Medicine University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA
- Geriatric Research Education and Clinical Center William S. Middleton Hospital Department of Veterans Affairs Madison Wisconsin USA
| | | | | | - Bradley T Christian
- Wisconsin Alzheimer's Disease Research Center University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA
- Waisman Laboratory for Brain Imaging and Behavior University of Wisconsin-Madison Madison Wisconsin USA
- Department of Medical Physics University of Wisconsin-Madison Madison Wisconsin USA
| | - Cynthia M Carlsson
- Wisconsin Alzheimer's Disease Research Center University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA
- Wisconsin Alzheimer's Institute University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA
- Division of Geriatrics and Gerontology Department of Medicine University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA
- Geriatric Research Education and Clinical Center William S. Middleton Hospital Department of Veterans Affairs Madison Wisconsin USA
| | - Sanjay Asthana
- Wisconsin Alzheimer's Disease Research Center University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA
- Wisconsin Alzheimer's Institute University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA
- Division of Geriatrics and Gerontology Department of Medicine University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA
- Geriatric Research Education and Clinical Center William S. Middleton Hospital Department of Veterans Affairs Madison Wisconsin USA
| | - Sterling C Johnson
- Wisconsin Alzheimer's Disease Research Center University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA
- Wisconsin Alzheimer's Institute University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA
- Division of Geriatrics and Gerontology Department of Medicine University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA
- Geriatric Research Education and Clinical Center William S. Middleton Hospital Department of Veterans Affairs Madison Wisconsin USA
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry Institute of Neuroscience and Physiology The Sahlgrenska Academy at the University of Gothenburg Gothenburg Sweden
- Clinical Neurochemistry Laboratory Sahlgrenska University Hospital Mölndal Sweden
- UK Dementia Research Institute at UCL London UK
- Department of Neurodegenerative Disease UCL Institute of Neurology London UK
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry Institute of Neuroscience and Physiology The Sahlgrenska Academy at the University of Gothenburg Gothenburg Sweden
- Clinical Neurochemistry Laboratory Sahlgrenska University Hospital Mölndal Sweden
| | - Barbara B Bendlin
- Wisconsin Alzheimer's Disease Research Center University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA
- Wisconsin Alzheimer's Institute University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA
- Division of Geriatrics and Gerontology Department of Medicine University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA
- Geriatric Research Education and Clinical Center William S. Middleton Hospital Department of Veterans Affairs Madison Wisconsin USA
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Langhough Koscik R, Hermann BP, Allison S, Clark LR, Jonaitis EM, Mueller KD, Betthauser TJ, Christian BT, Du L, Okonkwo O, Birdsill A, Chin N, Gleason C, Johnson SC. Validity Evidence for the Research Category, "Cognitively Unimpaired - Declining," as a Risk Marker for Mild Cognitive Impairment and Alzheimer's Disease. Front Aging Neurosci 2021; 13:688478. [PMID: 34381351 PMCID: PMC8350058 DOI: 10.3389/fnagi.2021.688478] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 06/16/2021] [Indexed: 12/11/2022] Open
Abstract
While clinically significant cognitive impairment is the key feature of the symptomatic stages of the Alzheimer's disease (AD) continuum, subtle cognitive decline is now known to occur years before a clinical diagnosis of mild cognitive impairment (MCI) or dementia due to AD is made. The primary aim of this study was to examine criterion validity evidence for an operational definition of "cognitively unimpaired-declining" (CU-D) in the Wisconsin Registry for Alzheimer's Prevention (WRAP), a longitudinal cohort study following cognition and risk factors from mid-life and on. Cognitive status was determined for each visit using a consensus review process that incorporated internal norms and published norms; a multi-disciplinary panel reviewed cases first to determine whether MCI or dementia was present, and subsequently whether CU-D was present, The CU-D group differed from CU-stable (CU-S) and MCI on concurrent measures of cognition, demonstrating concurrent validity. Participants who changed from CU-S to CU-D at the next study visit demonstrated greater declines than those who stayed CU-S. In addition, those who were CU-D were more likely to progress to MCI or dementia than those who were CU-S (predictive validity). In a subsample with positron emission tomography (PET) imaging, the CU-D group also differed from the CU-S and MCI/Dementia groups on measures of amyloid and tau burden, indicating that biomarker evidence of AD was elevated in those showing sub-clinical (CU-D) decline. Together, the results corroborate other studies showing that cognitive decline begins long before a dementia diagnosis and indicate that operational criteria can detect subclinical decline that may signal AD or other dementia risk.
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Affiliation(s)
- Rebecca Langhough Koscik
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States
- Wisconsin Alzheimer's Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States
- Wisconsin Alzheimer's Disease Research Center, Madison, WI, United States
| | - Bruce P Hermann
- Wisconsin Alzheimer's Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States
- Wisconsin Alzheimer's Disease Research Center, Madison, WI, United States
- Department of Neurology, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States
| | - Samantha Allison
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States
- Wisconsin Alzheimer's Disease Research Center, Madison, WI, United States
- Madison VA GRECC, William S. Middleton Memorial Hospital, Madison, WI, United States
| | - Lindsay R Clark
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States
- Wisconsin Alzheimer's Disease Research Center, Madison, WI, United States
- Madison VA GRECC, William S. Middleton Memorial Hospital, Madison, WI, United States
| | - Erin M Jonaitis
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States
- Wisconsin Alzheimer's Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States
- Wisconsin Alzheimer's Disease Research Center, Madison, WI, United States
| | - Kimberly D Mueller
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States
- Wisconsin Alzheimer's Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States
- Wisconsin Alzheimer's Disease Research Center, Madison, WI, United States
- Department of Communication Sciences and Disorders, University of Wisconsin, Madison, WI, United States
| | - Tobey J Betthauser
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States
- Wisconsin Alzheimer's Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States
- Wisconsin Alzheimer's Disease Research Center, Madison, WI, United States
| | - Bradley T Christian
- Wisconsin Alzheimer's Disease Research Center, Madison, WI, United States
- Department of Medical Physics, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States
| | - Lianlian Du
- Wisconsin Alzheimer's Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States
| | - Ozioma Okonkwo
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States
- Wisconsin Alzheimer's Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States
- Wisconsin Alzheimer's Disease Research Center, Madison, WI, United States
| | - Alex Birdsill
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States
- Wisconsin Alzheimer's Disease Research Center, Madison, WI, United States
- Madison VA GRECC, William S. Middleton Memorial Hospital, Madison, WI, United States
| | - Nathaniel Chin
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States
- Wisconsin Alzheimer's Disease Research Center, Madison, WI, United States
| | - Carey Gleason
- Wisconsin Alzheimer's Disease Research Center, Madison, WI, United States
- Madison VA GRECC, William S. Middleton Memorial Hospital, Madison, WI, United States
- Department of Geriatrics, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States
| | - Sterling C Johnson
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States
- Wisconsin Alzheimer's Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States
- Wisconsin Alzheimer's Disease Research Center, Madison, WI, United States
- Madison VA GRECC, William S. Middleton Memorial Hospital, Madison, WI, United States
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Dougherty RJ, Jonaitis EM, Gaitán JM, Lose SR, Mergen BM, Johnson SC, Okonkwo OC, Cook DB. Cardiorespiratory fitness mitigates brain atrophy and cognitive decline in adults at risk for Alzheimer's disease. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2021; 13:e12212. [PMID: 34268447 PMCID: PMC8274307 DOI: 10.1002/dad2.12212] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 05/03/2021] [Accepted: 05/19/2021] [Indexed: 12/02/2022]
Abstract
INTRODUCTION Cardiorespiratory fitness (CRF) may mitigate Alzheimer's disease (AD) progression. This study examined the longitudinal associations of CRF with brain atrophy and cognitive decline in a late-middle-aged cohort of adults at risk for AD. METHODS One hundred ten cognitively unimpaired adults (66% female, mean age at baseline 64.2 ± 5.7 years) completed a baseline graded treadmill exercise test, two brain magnetic resonance imaging scans (over 4.67 ± 1.17 years), and two to three cognitive assessments (over 3.26 ± 1.02 years). Linear mixed effects models examined the longitudinal associations adjusted for covariates. RESULTS Participants with higher baseline CRF had slower annual decline in total gray matter volume (P = .013) and cognitive function (P = .048), but not hippocampal volume (P = .426). Exploratory analyses suggested these effects may be stronger among apolipoprotein E ε4 carriers. DISCUSSION CRF is a modifiable physiological attribute that may be targeted during the preclinical phase of AD in effort to delay disease progression, perhaps most effectively among those with genetic risk.
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Affiliation(s)
- Ryan J. Dougherty
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Erin M. Jonaitis
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
- Wisconsin Alzheimer's InstituteUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Julian M. Gaitán
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Sarah R. Lose
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Brandon M. Mergen
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Sterling C. Johnson
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
- Wisconsin Alzheimer's InstituteUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
- William S. Middleton Memorial Veterans HospitalMadisonWisconsinUSA
- Geriatric Research Education and Clinical CenterWilliam S. Middleton Memorial Veterans HospitalMadisonWisconsinUSA
| | - Ozioma C. Okonkwo
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
- Wisconsin Alzheimer's InstituteUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
- Geriatric Research Education and Clinical CenterWilliam S. Middleton Memorial Veterans HospitalMadisonWisconsinUSA
| | - Dane B. Cook
- William S. Middleton Memorial Veterans HospitalMadisonWisconsinUSA
- Department of KinesiologyUniversity of Wisconsin School of EducationMadisonWisconsinUSA
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Marseglia A, Darin-Mattsson A, Skoog J, Rydén L, Hadarsson-Bodin T, Kern S, Rydberg Sterner T, Shang Y, Zettergren A, Westman E, Skoog I. Metabolic syndrome is associated with poor cognition: a population-based study of 70-year-olds without dementia. J Gerontol A Biol Sci Med Sci 2021; 76:2275-2283. [PMID: 34228116 PMCID: PMC8599084 DOI: 10.1093/gerona/glab195] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Indexed: 12/12/2022] Open
Abstract
Background Individual conditions of metabolic syndrome (MetS) have been related to dementia; however, their combined impact on the preclinical stage is unknown. We investigated the associations between MetS and domain-specific cognitive function as well as the role of sociodemographic, cardiovascular, and genetic factors. Methods Within the Gothenburg H70 Birth Cohort Study-Birth cohort 1944, 1131 dementia-free participants (aged 70 years) were examined during 2014–2016. MetS (central obesity plus at least 2 factors [reduced HDL-cholesterol, elevated triglycerides, blood pressure, or blood glucose]) was identified according to the International Diabetes Federation criteria. Five cognitive domains (memory, attention/perceptual speed, executive function, verbal fluency, visuospatial abilities) were generated after z-standardizing raw scores from 10 neuropsychological tests. Education, heart disease, claudication (indicating peripheral atherosclerosis), and apolipoprotein genotype were ascertained by trained staff. Data were analyzed with linear regression models. Results Overall, 618 participants (55%) had MetS. In multiadjusted linear regressions, MetS was related to poorer performance in attention/perceptual speed (β −0.14 [95% CI −0.25, −0.02]), executive function (β −0.12 [95% CI −0.23, −0.01]), and verbal fluency (β −0.19 [95% CI −0.30, −0.08]). These associations were present only among individuals who did not carry any APOE-ε4 allele or were highly educated. However, among those with MetS, high education was related to better cognitive performance. MetS together with comorbid heart disease or claudication was associated with even worse cognitive performance than each alone. Conclusions MetS is associated with poor attention/perceptual speed, executive function, and verbal fluency performance. Education, apolipoprotein E-ε4 allele, and comorbid cardiovascular disease influenced the observed associations.
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Affiliation(s)
- Anna Marseglia
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Alexander Darin-Mattsson
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Johan Skoog
- Centre for Ageing and Health (AgeCap) at the University of Gothenburg, Sweden.,Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Department of Psychology, University of Gothenburg, Gothenburg, Sweden
| | - Lina Rydén
- Centre for Ageing and Health (AgeCap) at the University of Gothenburg, Sweden.,Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Department of Psychiatry Cognition and Old Age Psychiatry, Sahlgrenska University Hospital, Region Västra Götaland, Mölndal, Sweden
| | - Timothy Hadarsson-Bodin
- Centre for Ageing and Health (AgeCap) at the University of Gothenburg, Sweden.,Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Silke Kern
- Centre for Ageing and Health (AgeCap) at the University of Gothenburg, Sweden.,Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Therese Rydberg Sterner
- Centre for Ageing and Health (AgeCap) at the University of Gothenburg, Sweden.,Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Ying Shang
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Anna Zettergren
- Centre for Ageing and Health (AgeCap) at the University of Gothenburg, Sweden.,Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Eric Westman
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Ingmar Skoog
- Centre for Ageing and Health (AgeCap) at the University of Gothenburg, Sweden.,Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Department of Psychiatry Cognition and Old Age Psychiatry, Sahlgrenska University Hospital, Region Västra Götaland, Mölndal, Sweden
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50
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Ingala S, De Boer C, Masselink LA, Vergari I, Lorenzini L, Blennow K, Chételat G, Di Perri C, Ewers M, van der Flier WM, Fox NC, Gispert JD, Haller S, Molinuevo JL, Muniz‐Terrera G, Mutsaerts HJMM, Ritchie CW, Ritchie K, Schmidt M, Schwarz AJ, Vermunt L, Waldman AD, Wardlaw J, Wink AM, Wolz R, Wottschel V, Scheltens P, Visser PJ, Barkhof F. Application of the ATN classification scheme in a population without dementia: Findings from the EPAD cohort. Alzheimers Dement 2021; 17:1189-1204. [PMID: 33811742 PMCID: PMC8359976 DOI: 10.1002/alz.12292] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 11/11/2020] [Accepted: 12/22/2020] [Indexed: 01/18/2023]
Abstract
BACKGROUND We classified non-demented European Prevention of Alzheimer's Dementia (EPAD) participants through the amyloid/tau/neurodegeneration (ATN) scheme and assessed their neuropsychological and imaging profiles. MATERIALS AND METHODS From 1500 EPAD participants, 312 were excluded. Cerebrospinal fluid cut-offs of 1000 pg/mL for amyloid beta (Aß)1-42 and 27 pg/mL for p-tau181 were validated using Gaussian mixture models. Given strong correlation of p-tau and t-tau (R2 = 0.98, P < 0.001), neurodegeneration was defined by age-adjusted hippocampal volume. Multinomial regressions were used to test whether neuropsychological tests and regional brain volumes could distinguish ATN stages. RESULTS Age was 65 ± 7 years, with 58% females and 38% apolipoprotein E (APOE) ε4 carriers; 57.1% were A-T-N-, 32.5% were in the Alzheimer's disease (AD) continuum, and 10.4% suspected non-Alzheimer's pathology. Age and cerebrovascular burden progressed with biomarker positivity (P < 0.001). Cognitive dysfunction appeared with T+. Paradoxically higher regional gray matter volumes were observed in A+T-N- compared to A-T-N- (P < 0.001). DISCUSSION In non-demented individuals along the AD continuum, p-tau drives cognitive dysfunction. Memory and language domains are affected in the earliest stages.
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Affiliation(s)
- Silvia Ingala
- Department of Radiology and Nuclear MedicineAmsterdam UMC Location VUmcVrije Universiteit Amsterdam, Amsterdam NeuroscienceAmsterdamthe Netherlands
- Alzheimer Center AmsterdamDepartment of NeurologyAmsterdam UMC Location VUmcVrije Universiteit Amsterdam, Amsterdam NeuroscienceAmsterdamthe Netherlands
| | - Casper De Boer
- Alzheimer Center AmsterdamDepartment of NeurologyAmsterdam UMC Location VUmcVrije Universiteit Amsterdam, Amsterdam NeuroscienceAmsterdamthe Netherlands
| | - Larissa A Masselink
- Alzheimer Center AmsterdamDepartment of NeurologyAmsterdam UMC Location VUmcVrije Universiteit Amsterdam, Amsterdam NeuroscienceAmsterdamthe Netherlands
| | - Ilaria Vergari
- Department of Radiology and Nuclear MedicineAmsterdam UMC Location VUmcVrije Universiteit Amsterdam, Amsterdam NeuroscienceAmsterdamthe Netherlands
- Alzheimer Center AmsterdamDepartment of NeurologyAmsterdam UMC Location VUmcVrije Universiteit Amsterdam, Amsterdam NeuroscienceAmsterdamthe Netherlands
| | - Luigi Lorenzini
- Department of Radiology and Nuclear MedicineAmsterdam UMC Location VUmcVrije Universiteit Amsterdam, Amsterdam NeuroscienceAmsterdamthe Netherlands
| | - Kaj Blennow
- Department of Psychiatry and NeurochemistryInstitute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of GothenburgMölndalSweden
- Clinical Neurochemistry LaboratorySahlgrenska University HospitalMölndalSweden
| | - Gaël Chételat
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND “Physiopathology and Imaging of Neurological Disorders,”Institut Blood and Brain @ Caen‐NormandieCyceronCaenFrance
| | - Carol Di Perri
- Centre for Dementia PreventionEdinburgh Imaging, UK Dementia Research Institute at The University of EdinburghEdinburghUK
| | - Michael Ewers
- Institute for Stroke and Dementia ResearchKlinikum der Universitat MünchenLudwig‐Maximilians‐Universitat LMUMunichGermany
| | - Wiesje M van der Flier
- Alzheimer Center AmsterdamDepartment of NeurologyAmsterdam UMC Location VUmcVrije Universiteit Amsterdam, Amsterdam NeuroscienceAmsterdamthe Netherlands
| | - Nick C Fox
- Dementia Research CentreDepartment of Neurodegenerative Disease & UK Dementia Research InstituteInstitute of NeurologyUniversity College LondonLondonUK
| | - Juan Domingo Gispert
- Barcelonaβeta Brain Research Center (BBRC)Pasqual Maragall FoundationBarcelonaSpain
- CIBER Fragilidad y Envejecimiento Saludable (CIBERFES)MadridSpain
- Universitat Pompeu FabraBarcelonaSpain
| | - Sven Haller
- CIRD Centre d'Imagerie Rive DroiteGenevaSwitzerland
| | - José Luís Molinuevo
- Barcelonaβeta Brain Research Center (BBRC)Pasqual Maragall FoundationBarcelonaSpain
- Hopsital Clínic‐IDIBAPSAlzheimer's Disease & Other Cognitive Disorders UnitBarcelonaSpain
| | - Graciela Muniz‐Terrera
- Centre for Dementia PreventionEdinburgh Imaging, UK Dementia Research Institute at The University of EdinburghEdinburghUK
| | - Henri JMM Mutsaerts
- Department of Radiology and Nuclear MedicineAmsterdam UMC Location VUmcVrije Universiteit Amsterdam, Amsterdam NeuroscienceAmsterdamthe Netherlands
- Ghent Institute for Functional and Metabolic Imaging (GIfMI)Ghent UniversityGhentBelgium
| | - Craig W Ritchie
- Centre for Clinical Brain SciencesUniversity of EdinburghEdinburghUK
| | - Karen Ritchie
- Centre for Clinical Brain SciencesUniversity of EdinburghEdinburghUK
| | | | - Adam J Schwarz
- Takeda Pharmaceutical Company LtdCambridgeMassachusettsUSA
| | - Lisa Vermunt
- Alzheimer Center AmsterdamDepartment of NeurologyAmsterdam UMC Location VUmcVrije Universiteit Amsterdam, Amsterdam NeuroscienceAmsterdamthe Netherlands
| | - Adam D Waldman
- Centre for Dementia PreventionEdinburgh Imaging, UK Dementia Research Institute at The University of EdinburghEdinburghUK
- Centre for Clinical Brain SciencesUniversity of EdinburghEdinburghUK
| | - Joanna Wardlaw
- Centre for Dementia PreventionEdinburgh Imaging, UK Dementia Research Institute at The University of EdinburghEdinburghUK
- Centre for Clinical Brain SciencesUniversity of EdinburghEdinburghUK
| | - Alle Meije Wink
- Department of Radiology and Nuclear MedicineAmsterdam UMC Location VUmcVrije Universiteit Amsterdam, Amsterdam NeuroscienceAmsterdamthe Netherlands
| | | | - Viktor Wottschel
- Department of Radiology and Nuclear MedicineAmsterdam UMC Location VUmcVrije Universiteit Amsterdam, Amsterdam NeuroscienceAmsterdamthe Netherlands
| | - Philip Scheltens
- Alzheimer Center AmsterdamDepartment of NeurologyAmsterdam UMC Location VUmcVrije Universiteit Amsterdam, Amsterdam NeuroscienceAmsterdamthe Netherlands
| | - Pieter Jelle Visser
- Alzheimer Center AmsterdamDepartment of NeurologyAmsterdam UMC Location VUmcVrije Universiteit Amsterdam, Amsterdam NeuroscienceAmsterdamthe Netherlands
- Department of Psychiatry & NeuropsychologySchool for Mental Health and NeuroscienceMaastricht UniversityMaastrichtthe Netherlands
| | - Frederik Barkhof
- Department of Radiology and Nuclear MedicineAmsterdam UMC Location VUmcVrije Universiteit Amsterdam, Amsterdam NeuroscienceAmsterdamthe Netherlands
- Institutes of Neurology and Healthcare EngineeringUniversity College LondonLondonUK
| | - the EPAD consortium
- Department of Radiology and Nuclear MedicineAmsterdam UMC Location VUmcVrije Universiteit Amsterdam, Amsterdam NeuroscienceAmsterdamthe Netherlands
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