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Shao K, Hu X, Kleineidam L, Stark M, Altenstein S, Amthauer H, Boecker H, Buchert R, Buerger K, Butryn M, Cai Y, Cai Y, Cosma NC, Chen G, Chen Z, Daamen M, Drzezga A, Düzel E, Essler M, Ewers M, Fliessbach K, Gaertner FC, Glanz W, Guo T, Hansen N, He B, Janowitz D, Kilimann I, Krause BJ, Lan G, Lange C, Laske C, Li Y, Li R, Liu L, Lu J, Meng F, Munk MH, Peters O, Perneczky R, Priller J, Ramirez A, Rauchmann BS, Reimold M, Rominger A, Rostamzadeh A, Roy-Kluth N, Schneider A, Spottke A, Spruth EJ, Sun P, Teipel S, Wang X, Wei M, Wei Y, Wiltfang J, Yan S, Yang J, Yu X, Zhang M, Zhang L, Wagner M, Jessen F, Han Y, Kuhn E. Amyloid and SCD jointly predict cognitive decline across Chinese and German cohorts. Alzheimers Dement 2024. [PMID: 39072956 DOI: 10.1002/alz.14119] [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: 11/17/2023] [Revised: 04/10/2024] [Accepted: 05/11/2024] [Indexed: 07/30/2024]
Abstract
INTRODUCTION Subjective cognitive decline (SCD) in amyloid-positive (Aβ+) individuals was proposed as a clinical indicator of Stage 2 in the Alzheimer's disease (AD) continuum, but this requires further validation across cultures, measures, and recruitment strategies. METHODS Eight hundred twenty-one participants from SILCODE and DELCODE cohorts, including normal controls (NC) and individuals with SCD recruited from the community or from memory clinics, underwent neuropsychological assessments over up to 6 years. Amyloid positivity was derived from positron emission tomography or plasma biomarkers. Global cognitive change was analyzed using linear mixed-effects models. RESULTS In the combined and stratified cohorts, Aβ+ participants with SCD showed steeper cognitive decline or diminished practice effects compared with NC or Aβ- participants with SCD. These findings were confirmed using different operationalizations of SCD and amyloid positivity, and across different SCD recruitment settings. DISCUSSION Aβ+ individuals with SCD in German and Chinese populations showed greater global cognitive decline and could be targeted for interventional trials. HIGHLIGHTS SCD in amyloid-positive (Aβ+) participants predicts a steeper cognitive decline. This finding does not rely on specific SCD or amyloid operationalization. This finding is not specific to SCD patients recruited from memory clinics. This finding is valid in both German and Chinese populations. Aβ+ older adults with SCD could be a target population for interventional trials.
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Affiliation(s)
- Kai Shao
- Department of Neurology, XuanWu Hospital of Capital Medical University, Beijing, China
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Department of Psychiatry, Medical Faculty, University of Cologne, Cologne, Germany
| | - Xiaochen Hu
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Department of Psychiatry, Medical Faculty, University of Cologne, Cologne, Germany
| | - Luca Kleineidam
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Department of Old Age Psychiatry and Cognitive Disorders, University of Bonn Medical Center, Bonn, Germany
| | - Melina Stark
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Department of Old Age Psychiatry and Cognitive Disorders, University of Bonn Medical Center, Bonn, Germany
| | - Slawek Altenstein
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany
- Department of Psychiatry and Psychotherapy, Charité, Berlin, Germany
| | - Holger Amthauer
- Department of Nuclear Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Henning Boecker
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Clinical Functional Imaging Group, Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn, Germany
| | - Ralph Buchert
- Department of Nuclear Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, and Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Katharina Buerger
- German Center for Neurodegenerative Diseases (DZNE, Munich), Munich, Germany
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Michaela Butryn
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
- Institute of Cognitive Neurology and Dementia Research (IKND), Otto-von-Guericke University, Magdeburg, Germany
| | - Yanning Cai
- Department of clinical biobank, XuanWu Hospital of Capital Medical University, Beijing, China
| | - Yue Cai
- Institute of Biomedical Engineering, Shenzhen Bay Laboratory, Shenzhen, China
| | - Nicoleta Carmen Cosma
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Guanqun Chen
- Department of Neurology, Beijing ChaoYang Hospital of Capital Medical University, Beijing, China
| | - Zhigeng Chen
- Department of Radiology and Nuclear Medicine, XuanWu Hospital of Capital Medical University, Beijing, China
| | - Marcel Daamen
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Alexander Drzezga
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Institute of Neuroscience and Medicine (INM-2), Molecular Organization of the Brain, Forschungszentrum Jülich, Jülich, Germany
| | - Emrah Düzel
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
- Institute of Cognitive Neurology and Dementia Research (IKND), Otto-von-Guericke University, Magdeburg, Germany
| | - Markus Essler
- Department of Nuclear Medicine, University Hospital Bonn, Bonn, Germany
| | - Michael Ewers
- German Center for Neurodegenerative Diseases (DZNE, Munich), Munich, Germany
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Klaus Fliessbach
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Department of Old Age Psychiatry and Cognitive Disorders, University of Bonn Medical Center, Bonn, Germany
| | | | - Wenzel Glanz
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
- Institute of Cognitive Neurology and Dementia Research (IKND), Otto-von-Guericke University, Magdeburg, Germany
| | - Tengfei Guo
- Institute of Biomedical Engineering, Shenzhen Bay Laboratory, Shenzhen, China
| | - Niels Hansen
- Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, University of Goettingen, Goettingen, Germany
| | - Beiqi He
- School of Information and Communication Engineering, Hainan University, Haikou, China
| | - Daniel Janowitz
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Ingo Kilimann
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany
- Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
| | - Bernd J Krause
- Department of Nuclear Medicine, Rostock University Medical Centre, Rostock, Germany
| | - Guoyu Lan
- Institute of Biomedical Engineering, Shenzhen Bay Laboratory, Shenzhen, China
- Tsinghua Shenzhen International Graduate School (SIGS), Tsinghua University, Shenzhen, China
| | - Catharina Lange
- Department of Nuclear Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Christoph Laske
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
- Section for Dementia Research, Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Yuxia Li
- Department of Neurology, Tangshan Central Hospital, Tanshan, China
| | - Ruixian Li
- Department of Neurology, XuanWu Hospital of Capital Medical University, Beijing, China
| | - Lin Liu
- Institute of Biomedical Engineering, Shenzhen Bay Laboratory, Shenzhen, China
- Tsinghua Shenzhen International Graduate School (SIGS), Tsinghua University, Shenzhen, China
| | - Jie Lu
- Department of Radiology and Nuclear Medicine, XuanWu Hospital of Capital Medical University, Beijing, China
| | - Fansheng Meng
- Medical Imaging Department of Hainan Cancer Hospital, Haikou, China
| | - Matthias H Munk
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Oliver Peters
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Robert Perneczky
- German Center for Neurodegenerative Diseases (DZNE, Munich), Munich, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy) Munich, Munich, Germany
- Ageing Epidemiology Research Unit (AGE), School of Public Health, Imperial College London, London, UK
| | - Josef Priller
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany
- Department of Psychiatry and Psychotherapy, Charité, Berlin, Germany
- University of Edinburgh and UK DRI, Edinburgh, UK
- School of Medicine, Department of Psychiatry and Psychotherapy, Technical University of Munich, Munich, Germany
| | - Alfredo Ramirez
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Department of Old Age Psychiatry and Cognitive Disorders, University of Bonn Medical Center, Bonn, Germany
- Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Köln, Germany
- Division of Neurogenetics and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Köln, Germany
- Department of Psychiatry & Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, San Antonio, Texas, USA
| | - Boris-Stephan Rauchmann
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
- Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield, Sheffield, UK
- Department of Neuroradiology, University Hospital LMU, Munich, Germany
| | - Matthias Reimold
- Department of Nuclear Medicine and Clinical Molecular Imaging, Eberhard-Karls-University, Tuebingen, Germany
| | - Axel Rominger
- Department of Nuclear Medicine, Ludwig-Maximilian-University Munich, Munich, Germany
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Ayda Rostamzadeh
- Department of Psychiatry, Medical Faculty, University of Cologne, Cologne, Germany
| | - Nina Roy-Kluth
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Anja Schneider
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Department of Old Age Psychiatry and Cognitive Disorders, University of Bonn Medical Center, Bonn, Germany
| | - Annika Spottke
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Department of Neurology, University of Bonn, Bonn, Germany
| | - Eike Jakob Spruth
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany
- Department of Psychiatry and Psychotherapy, Charité, Berlin, Germany
| | - Pan Sun
- Institute of Biomedical Engineering, Shenzhen Bay Laboratory, Shenzhen, China
- Tsinghua Shenzhen International Graduate School (SIGS), Tsinghua University, Shenzhen, China
| | - Stefan Teipel
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany
- Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
| | - Xiao Wang
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Min Wei
- Department of Neurology, XuanWu Hospital of Capital Medical University, Beijing, China
| | - Yongzhe Wei
- Department of Neurology, XuanWu Hospital of Capital Medical University, Beijing, China
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, University of Goettingen, Goettingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), Goettingen, Germany
- Neurosciences and Signaling Group, Institute of Biomedicine (iBiMED), Department of Medical Sciences, University of Aveiro, Aveiro, Portugal
| | - Shaozhen Yan
- Department of Radiology and Nuclear Medicine, XuanWu Hospital of Capital Medical University, Beijing, China
- Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Jie Yang
- Department of Neurology, XuanWu Hospital of Capital Medical University, Beijing, China
| | - Xianfeng Yu
- Department of Neurology, XuanWu Hospital of Capital Medical University, Beijing, China
| | - Mingkai Zhang
- Department of Neurology, XuanWu Hospital of Capital Medical University, Beijing, China
| | - Liang Zhang
- School of Information and Communication Engineering, Hainan University, Haikou, China
| | - Michael Wagner
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Department of Old Age Psychiatry and Cognitive Disorders, University of Bonn Medical Center, Bonn, Germany
| | - Frank Jessen
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Department of Psychiatry, Medical Faculty, University of Cologne, Cologne, Germany
- Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Köln, Germany
| | - Ying Han
- Department of Neurology, XuanWu Hospital of Capital Medical University, Beijing, China
- Institute of Biomedical Engineering, Shenzhen Bay Laboratory, Shenzhen, China
- School of Biomedical Engineering, Hainan University, Haikou, China
- Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, China
- National Clinical Research Center for Geriatric Disorders, Beijing, China
- The Central Hospital of Karamay, Xinjiang, China
| | - Elizabeth Kuhn
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Department of Old Age Psychiatry and Cognitive Disorders, University of Bonn Medical Center, Bonn, Germany
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Cappa SF, Ribaldi F, Chicherio C, Frisoni GB. Subjective cognitive decline: Memory complaints, cognitive awareness, and metacognition. Alzheimers Dement 2024. [PMID: 39051174 DOI: 10.1002/alz.13905] [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: 06/07/2023] [Revised: 03/20/2024] [Accepted: 04/20/2024] [Indexed: 07/27/2024]
Abstract
Cognitive complaints are common in elderly subjects and are a frequent reason for referral to memory clinics. If the complaints are not associated with objective cognitive impairment, the condition is labelled subjective cognitive decline (SCD). SCD is often considered as a stage antedating objective impairment, and an at-risk condition for subsequent dementia. Recent large-scale studies indicate that a significantly increased risk of clinical progression in subjects with SCD is associated with positivity for Alzheimer's disease (AD) biomarkers, a finding supporting the notion that SCD can be due to different mechanisms not associated with neurodegeneration, including functional cognitive disorders. In this paper we present a selective review of research on the relations among SCD, cognitive awareness, and metacognitive abilities. We propose that longitudinal studies of metacognitive efficiency in SCD may provide useful cues about the risk of progression to dementia and the possible presence of a functional cognitive disorder, with different implications for the management of this prevalent aging-related condition. HIGHLIGHTS: Subjective cognitive decline (SCD), a common cause of referral to memory clinics, can be due to multiple conditions. The predictive value of SCD for progression to Alzheimer's disease (AD) dementia is high in association with AD biomarker positivity. The awareness of cognitive decline is the mechanism responsible for the emergence of SCD and metacognition is the underlying neuropsychological function. The awareness of cognitive decline in clinical patients is usually assessed comparing an informant rating to the patient self-assessment, a method that can be affected by informant bias. While there is strong evidence that awareness starts to decline with the onset of objective cognitive impairment, progressively leading to the anosognosia of AD, the status of metacognitive efficiency in SCD needs to be further investigated. Quantitative, performance-based indexes of metacognitive efficiency may contribute both to the assessment of progression risk and to the management of subjects with functional cognitive disorders.
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Affiliation(s)
- Stefano F Cappa
- University Institute of Advanced Studies and IRCCS Mondino Foundation Pavia, Pavia, Italy
| | - Federica Ribaldi
- Laboratory of Neuroimaging of Aging (LANVIE), University of Geneva, Geneva, Switzerland
- Geneva Memory Center, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland
| | - Christian Chicherio
- Geneva Memory Center, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland
- Center for Interdisciplinary Study of Gerontology and Vulnerability (CIGEV), University of Geneva, Geneva, Switzerland
| | - Giovanni B Frisoni
- Laboratory of Neuroimaging of Aging (LANVIE), University of Geneva, Geneva, Switzerland
- Geneva Memory Center, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland
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3
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Baumeister H, Vogel JW, Insel PS, Kleineidam L, Wolfsgruber S, Stark M, Gellersen HM, Yakupov R, Schmid MC, Lüsebrink F, Brosseron F, Ziegler G, Freiesleben SD, Preis L, Schneider LS, Spruth EJ, Altenstein S, Lohse A, Fliessbach K, Vogt IR, Bartels C, Schott BH, Rostamzadeh A, Glanz W, Incesoy EI, Butryn M, Janowitz D, Rauchmann BS, Kilimann I, Goerss D, Munk MH, Hetzer S, Dechent P, Ewers M, Scheffler K, Wuestefeld A, Strandberg O, van Westen D, Mattsson-Carlgren N, Janelidze S, Stomrud E, Palmqvist S, Spottke A, Laske C, Teipel S, Perneczky R, Buerger K, Schneider A, Priller J, Peters O, Ramirez A, Wiltfang J, Heneka MT, Wagner M, Düzel E, Jessen F, Hansson O, Berron D. A generalizable data-driven model of atrophy heterogeneity and progression in memory clinic settings. Brain 2024; 147:2400-2413. [PMID: 38654513 PMCID: PMC11224599 DOI: 10.1093/brain/awae118] [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: 09/07/2023] [Revised: 02/02/2024] [Accepted: 03/03/2024] [Indexed: 04/26/2024] Open
Abstract
Memory clinic patients are a heterogeneous population representing various aetiologies of pathological ageing. It is not known whether divergent spatiotemporal progression patterns of brain atrophy, as previously described in Alzheimer's disease patients, are prevalent and clinically meaningful in this group of older adults. To uncover distinct atrophy subtypes, we applied the Subtype and Stage Inference (SuStaIn) algorithm to baseline structural MRI data from 813 participants enrolled in the DELCODE cohort (mean ± standard deviation, age = 70.67 ± 6.07 years, 52% females). Participants were cognitively unimpaired (n = 285) or fulfilled diagnostic criteria for subjective cognitive decline (n = 342), mild cognitive impairment (n = 118) or dementia of the Alzheimer's type (n = 68). Atrophy subtypes were compared in baseline demographics, fluid Alzheimer's disease biomarker levels, the Preclinical Alzheimer Cognitive Composite (PACC-5) as well as episodic memory and executive functioning. PACC-5 trajectories over up to 240 weeks were examined. To test whether baseline atrophy subtype and stage predicted clinical trajectories before manifest cognitive impairment, we analysed PACC-5 trajectories and mild cognitive impairment conversion rates of cognitively unimpaired participants and those with subjective cognitive decline. Limbic-predominant and hippocampal-sparing atrophy subtypes were identified. Limbic-predominant atrophy initially affected the medial temporal lobes, followed by further temporal regions and, finally, the remaining cortical regions. At baseline, this subtype was related to older age, more pathological Alzheimer's disease biomarker levels, APOE ε4 carriership and an amnestic cognitive impairment. Hippocampal-sparing atrophy initially occurred outside the temporal lobe, with the medial temporal lobe spared up to advanced atrophy stages. This atrophy pattern also affected individuals with positive Alzheimer's disease biomarkers and was associated with more generalized cognitive impairment. Limbic-predominant atrophy, in all participants and in only unimpaired participants, was linked to more negative longitudinal PACC-5 slopes than observed in participants without or with hippocampal-sparing atrophy and increased the risk of mild cognitive impairment conversion. SuStaIn modelling was repeated in a sample from the Swedish BioFINDER-2 cohort. Highly similar atrophy progression patterns and associated cognitive profiles were identified. Cross-cohort model generalizability, at both the subject and the group level, was excellent, indicating reliable performance in previously unseen data. The proposed model is a promising tool for capturing heterogeneity among older adults at early at-risk states for Alzheimer's disease in applied settings. The implementation of atrophy subtype- and stage-specific end points might increase the statistical power of pharmacological trials targeting early Alzheimer's disease.
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Affiliation(s)
- Hannah Baumeister
- German Center for Neurodegenerative Diseases (DZNE), 39120 Magdeburg, Germany
| | - Jacob W Vogel
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, 222 42 Lund, Sweden
| | - Philip S Insel
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Luca Kleineidam
- German Center for Neurodegenerative Diseases (DZNE), 53127 Bonn, Germany
- Department of Neurodegenerative Disease and Geriatric Psychiatry, University of Bonn Medical Center, 53127 Bonn, Germany
| | - Steffen Wolfsgruber
- German Center for Neurodegenerative Diseases (DZNE), 53127 Bonn, Germany
- Department of Neurodegenerative Disease and Geriatric Psychiatry, University of Bonn Medical Center, 53127 Bonn, Germany
| | - Melina Stark
- Department of Neurodegenerative Disease and Geriatric Psychiatry, University of Bonn Medical Center, 53127 Bonn, Germany
| | - Helena M Gellersen
- German Center for Neurodegenerative Diseases (DZNE), 39120 Magdeburg, Germany
| | - Renat Yakupov
- German Center for Neurodegenerative Diseases (DZNE), 39120 Magdeburg, Germany
- Institute of Cognitive Neurology and Dementia Research (IKND), Otto-von-Guericke University, 39120 Magdeburg, Germany
| | - Matthias C Schmid
- German Center for Neurodegenerative Diseases (DZNE), 53127 Bonn, Germany
- Institute for Medical Biometry, University Hospital Bonn, 53127 Bonn, Germany
| | - Falk Lüsebrink
- German Center for Neurodegenerative Diseases (DZNE), 39120 Magdeburg, Germany
| | - Frederic Brosseron
- German Center for Neurodegenerative Diseases (DZNE), 53127 Bonn, Germany
| | - Gabriel Ziegler
- Institute of Cognitive Neurology and Dementia Research (IKND), Otto-von-Guericke University, 39120 Magdeburg, Germany
| | - Silka D Freiesleben
- German Center for Neurodegenerative Diseases (DZNE), 10117 Berlin, Germany
- Department of Psychiatry and Neurosciences, Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Lukas Preis
- Department of Psychiatry and Neurosciences, Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Luisa-Sophie Schneider
- Department of Psychiatry and Neurosciences, Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Eike J Spruth
- German Center for Neurodegenerative Diseases (DZNE), 10117 Berlin, Germany
- Department of Psychiatry and Neurosciences, Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Slawek Altenstein
- German Center for Neurodegenerative Diseases (DZNE), 10117 Berlin, Germany
- Department of Psychiatry and Neurosciences, Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Andrea Lohse
- Department of Psychiatry and Neurosciences, Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Klaus Fliessbach
- German Center for Neurodegenerative Diseases (DZNE), 53127 Bonn, Germany
- Department of Neurodegenerative Disease and Geriatric Psychiatry, University of Bonn Medical Center, 53127 Bonn, Germany
| | - Ina R Vogt
- German Center for Neurodegenerative Diseases (DZNE), 53127 Bonn, Germany
| | - Claudia Bartels
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, 37075 Göttingen, Germany
| | - Björn H Schott
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, 37075 Göttingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), 37075 Göttingen, Germany
- Leibniz Institute for Neurobiology, 39118 Magdeburg, Germany
| | - Ayda Rostamzadeh
- Department of Psychiatry, Medical Faculty, University of Cologne, 50937 Cologne, Germany
| | - Wenzel Glanz
- German Center for Neurodegenerative Diseases (DZNE), 39120 Magdeburg, Germany
| | - Enise I Incesoy
- German Center for Neurodegenerative Diseases (DZNE), 39120 Magdeburg, Germany
- Institute of Cognitive Neurology and Dementia Research (IKND), Otto-von-Guericke University, 39120 Magdeburg, Germany
- Department of Psychiatry and Psychotherapy, Otto-von-Guericke University, 39120 Magdeburg, Germany
| | - Michaela Butryn
- German Center for Neurodegenerative Diseases (DZNE), 39120 Magdeburg, Germany
| | - Daniel Janowitz
- Institute for Stroke and Dementia Research (ISD), Ludwig-Maximilians-Universität, 81377 Munich, Germany
| | - Boris-Stephan Rauchmann
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-Universität, 80336 Munich, Germany
- Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield, Sheffield S10 2HQ, UK
- Department of Neuroradiology, Ludwig-Maximilians-Universität, 81377 Munich, Germany
| | - Ingo Kilimann
- German Center for Neurodegenerative Diseases (DZNE), 18147 Rostock, Germany
- Department of Psychosomatic Medicine, Rostock University Medical Center, 18147 Rostock, Germany
| | - Doreen Goerss
- German Center for Neurodegenerative Diseases (DZNE), 18147 Rostock, Germany
- Department of Psychosomatic Medicine, Rostock University Medical Center, 18147 Rostock, Germany
| | - Matthias H Munk
- German Center for Neurodegenerative Diseases (DZNE), 72076 Tübingen, Germany
- Department of Psychiatry and Psychotherapy, University of Tübingen, 72076 Tübingen, Germany
| | - Stefan Hetzer
- Berlin Center for Advanced Neuroimaging, Charité—Universitätsmedizin Berlin, 10117 Berlin, Germany
| | - Peter Dechent
- MR-Research in Neurosciences, Department of Cognitive Neurology, Georg-August-University Göttingen, 37075 Göttingen, Germany
| | - Michael Ewers
- Institute for Stroke and Dementia Research (ISD), Ludwig-Maximilians-Universität, 81377 Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), 81377 Munich, Germany
| | - Klaus Scheffler
- Department for Biomedical Magnetic Resonance, University of Tübingen, 72076 Tübingen, Germany
| | - Anika Wuestefeld
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, 222 42 Lund, Sweden
| | - Olof Strandberg
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, 222 42 Lund, Sweden
| | - Danielle van Westen
- Diagnostic Radiology, Institution of Clinical Sciences Lund, Lund University, 211 84 Lund, Sweden
- Image and Function, Skåne University Hospital, 211 84 Lund, Sweden
| | - Niklas Mattsson-Carlgren
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, 222 42 Lund, Sweden
- Department of Neurology, Skåne University Hospital, Lund University, 211 84 Lund, Sweden
- Wallenberg Center for Molecular Medicine, Lund University, 22184 Lund, Sweden
| | - Shorena Janelidze
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, 222 42 Lund, Sweden
| | - Erik Stomrud
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, 222 42 Lund, Sweden
- Memory Clinic, Skåne University Hospital, 205 02 Malmö, Sweden
| | - Sebastian Palmqvist
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, 222 42 Lund, Sweden
- Memory Clinic, Skåne University Hospital, 205 02 Malmö, Sweden
| | - Annika Spottke
- German Center for Neurodegenerative Diseases (DZNE), 53127 Bonn, Germany
- Department of Neurology, University of Bonn, 53127 Bonn, Germany
| | - Christoph Laske
- German Center for Neurodegenerative Diseases (DZNE), 72076 Tübingen, Germany
- Department of Psychiatry and Psychotherapy, University of Tübingen, 72076 Tübingen, Germany
- Section for Dementia Research, Hertie Institute for Clinical Brain Research, 72076 Tübingen, Germany
| | - Stefan Teipel
- German Center for Neurodegenerative Diseases (DZNE), 18147 Rostock, Germany
- Department of Psychosomatic Medicine, Rostock University Medical Center, 18147 Rostock, Germany
| | - Robert Perneczky
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-Universität, 80336 Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), 81377 Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), 81377 Munich, Germany
- Ageing Epidemiology Research Unit (AGE), School of Public Health, Imperial College London, London SW7 2AZ, UK
| | - Katharina Buerger
- Institute for Stroke and Dementia Research (ISD), Ludwig-Maximilians-Universität, 81377 Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), 81377 Munich, Germany
| | - Anja Schneider
- German Center for Neurodegenerative Diseases (DZNE), 53127 Bonn, Germany
- Department of Neurodegenerative Disease and Geriatric Psychiatry, University of Bonn Medical Center, 53127 Bonn, Germany
| | - Josef Priller
- German Center for Neurodegenerative Diseases (DZNE), 10117 Berlin, Germany
- Department of Psychiatry and Neurosciences, Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
- Department of Psychiatry and Psychotherapy, Technical University of Munich, 81675 Munich, Germany
- Centre for Clinical Brain Sciences, University of Edinburgh and UK DRI, Edinburgh EH16 4SB, UK
| | - Oliver Peters
- German Center for Neurodegenerative Diseases (DZNE), 10117 Berlin, Germany
- Department of Psychiatry and Neurosciences, Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Alfredo Ramirez
- German Center for Neurodegenerative Diseases (DZNE), 53127 Bonn, Germany
- Department of Neurodegenerative Disease and Geriatric Psychiatry, University of Bonn Medical Center, 53127 Bonn, Germany
- Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, 50931 Cologne, Germany
- Division of Neurogenetics and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, University of Cologne, 50931 Cologne, Germany
- Department of Psychiatry & Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases, The University of Texas at San Antonio, San Antonio, TX 78229, USA
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, 37075 Göttingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), 37075 Göttingen, Germany
- Institute of Biomedicine (iBiMED), Department of Medical Sciences, University of Aveiro, 3810-193 Aveiro, Portugal
| | - Michael T Heneka
- Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg, 4362, Belvaux, Luxembourg
| | - Michael Wagner
- German Center for Neurodegenerative Diseases (DZNE), 53127 Bonn, Germany
- Department of Neurodegenerative Disease and Geriatric Psychiatry, University of Bonn Medical Center, 53127 Bonn, Germany
| | - Emrah Düzel
- German Center for Neurodegenerative Diseases (DZNE), 39120 Magdeburg, Germany
- Institute of Cognitive Neurology and Dementia Research (IKND), Otto-von-Guericke University, 39120 Magdeburg, Germany
- Center for Behavioral Brain Sciences (CBBS), Otto-von-Guericke University Magdeburg, 39106 Magdeburg, Germany
| | - Frank Jessen
- German Center for Neurodegenerative Diseases (DZNE), 53127 Bonn, Germany
- Department of Psychiatry, Medical Faculty, University of Cologne, 50937 Cologne, Germany
- Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, 50931 Cologne, Germany
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, 222 42 Lund, Sweden
- Memory Clinic, Skåne University Hospital, 205 02 Malmö, Sweden
| | - David Berron
- German Center for Neurodegenerative Diseases (DZNE), 39120 Magdeburg, Germany
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, 222 42 Lund, Sweden
- Center for Behavioral Brain Sciences (CBBS), Otto-von-Guericke University Magdeburg, 39106 Magdeburg, Germany
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Whitfield T, Chouliaras L, Morrell R, Rubio D, Radford D, Marchant NL, Walker Z. The criteria used to rule out mild cognitive impairment impact dementia incidence rates in subjective cognitive decline. Alzheimers Res Ther 2024; 16:142. [PMID: 38943160 PMCID: PMC11212190 DOI: 10.1186/s13195-024-01516-6] [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: 04/16/2024] [Accepted: 06/23/2024] [Indexed: 07/01/2024]
Abstract
BACKGROUND The research criteria for subjective cognitive decline (SCD) exclude mild cognitive impairment (MCI), but do not stipulate the use of specific MCI criteria. This study compared different approaches to defining (i.e., excluding) MCI during the ascertainment of SCD, focusing on the impact on dementia incidence rates in SCD. METHODS This cohort study utilized routine healthcare data collected in the Essex Memory Clinic from 1999 to 2023. Two different operationalizations of the SCD criteria were used to categorize the cohort into two SCD patient samples. One sample was based on local clinical practice - MCI was excluded according to the Winblad criteria (this sample was termed SCDWinblad). The other sample was created via the retrospective application of the Jak/Bondi criteria for the exclusion of MCI (termed SCDJak/Bondi). Only patients aged ≥ 55 years at baseline with ≥ 12 months follow-up were considered for inclusion. The initial clinical/demographic characteristics of the samples were compared. Rates of incident dementia were calculated for each sample, and unadjusted and Mantel-Haenszel-adjusted incidence rate ratios were calculated to compare dementia incidence between the SCD samples. RESULTS The Essex Memory Clinic database included 2,233 patients in total. The SCD and study eligibility criteria were used to select SCDWinblad (n = 86) and SCDJak/Bondi (n = 185) samples from the database. Median follow-up (3 years) did not differ between the two samples. The SCDJak/Bondi sample was significantly older than the SCDWinblad at first assessment (median age: 74 versus 70 years) and had poorer scores on tests of global cognition, immediate and delayed verbal recall, and category fluency. Following adjustment for age, the dementia incidence rate ratio [95% confidence interval] was 3.7 [1.5 to 9.3], indicating a significantly greater rate of progression to dementia in SCDJak/Bondi. CONCLUSIONS This study highlights that the approach used to ascertain SCD has important implications for both SCD phenotypes and prognosis. This underscores the importance of how MCI is operationalized within SCD studies. More broadly, the findings add to a growing body of work indicating that objective cognition should not be overlooked in SCD, and offer a potential explanation for the heterogeneity across the SCD prognostic literature.
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Affiliation(s)
- Tim Whitfield
- Division of Psychiatry, University College London, London, UK.
| | - Leonidas Chouliaras
- Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Specialist Dementia and Frailty Service, Essex Partnership University NHS Foundation Trust, St Margaret's Hospital, Epping, UK
| | - Rachel Morrell
- Division of Psychiatry, University College London, London, UK
| | - David Rubio
- Specialist Dementia and Frailty Service, Essex Partnership University NHS Foundation Trust, St Margaret's Hospital, Epping, UK
| | - Darren Radford
- Specialist Dementia and Frailty Service, Essex Partnership University NHS Foundation Trust, St Margaret's Hospital, Epping, UK
| | | | - Zuzana Walker
- Division of Psychiatry, University College London, London, UK
- Specialist Dementia and Frailty Service, Essex Partnership University NHS Foundation Trust, St Margaret's Hospital, Epping, UK
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5
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Berron D, Glanz W, Clark L, Basche K, Grande X, Güsten J, Billette OV, Hempen I, Naveed MH, Diersch N, Butryn M, Spottke A, Buerger K, Perneczky R, Schneider A, Teipel S, Wiltfang J, Johnson S, Wagner M, Jessen F, Düzel E. A remote digital memory composite to detect cognitive impairment in memory clinic samples in unsupervised settings using mobile devices. NPJ Digit Med 2024; 7:79. [PMID: 38532080 DOI: 10.1038/s41746-024-00999-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 01/03/2024] [Indexed: 03/28/2024] Open
Abstract
Remote monitoring of cognition holds the promise to facilitate case-finding in clinical care and the individual detection of cognitive impairment in clinical and research settings. In the context of Alzheimer's disease, this is particularly relevant for patients who seek medical advice due to memory problems. Here, we develop a remote digital memory composite (RDMC) score from an unsupervised remote cognitive assessment battery focused on episodic memory and long-term recall and assess its construct validity, retest reliability, and diagnostic accuracy when predicting MCI-grade impairment in a memory clinic sample and healthy controls. A total of 199 participants were recruited from three cohorts and included as healthy controls (n = 97), individuals with subjective cognitive decline (n = 59), or patients with mild cognitive impairment (n = 43). Participants performed cognitive assessments in a fully remote and unsupervised setting via a smartphone app. The derived RDMC score is significantly correlated with the PACC5 score across participants and demonstrates good retest reliability. Diagnostic accuracy for discriminating memory impairment from no impairment is high (cross-validated AUC = 0.83, 95% CI [0.66, 0.99]) with a sensitivity of 0.82 and a specificity of 0.72. Thus, unsupervised remote cognitive assessments implemented in the neotiv digital platform show good discrimination between cognitively impaired and unimpaired individuals, further demonstrating that it is feasible to complement the neuropsychological assessment of episodic memory with unsupervised and remote assessments on mobile devices. This contributes to recent efforts to implement remote assessment of episodic memory for case-finding and monitoring in large research studies and clinical care.
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Affiliation(s)
- David Berron
- German Center for Neurodegenerative Diseases, Magdeburg, Germany.
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden.
- neotiv GmbH, Magdeburg, Germany.
| | - Wenzel Glanz
- German Center for Neurodegenerative Diseases, Magdeburg, Germany
- Institute for Cognitive Neurology and Dementia Research, Otto-von-Guericke University, Magdeburg, Germany
| | - Lindsay Clark
- Department of Medicine, Division of Geriatrics and Gerontology, University of Wisconsin, School of Medicine and Public Health, Madison, Wisconsin, US
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin, USA
| | - Kristin Basche
- Department of Medicine, Division of Geriatrics and Gerontology, University of Wisconsin, School of Medicine and Public Health, Madison, Wisconsin, US
| | - Xenia Grande
- German Center for Neurodegenerative Diseases, Magdeburg, Germany
- Institute for Cognitive Neurology and Dementia Research, Otto-von-Guericke University, Magdeburg, Germany
| | - Jeremie Güsten
- German Center for Neurodegenerative Diseases, Magdeburg, Germany
- Institute for Cognitive Neurology and Dementia Research, Otto-von-Guericke University, Magdeburg, Germany
| | | | | | | | | | - Michaela Butryn
- German Center for Neurodegenerative Diseases, Magdeburg, Germany
- Institute for Cognitive Neurology and Dementia Research, Otto-von-Guericke University, Magdeburg, Germany
| | - Annika Spottke
- German Center for Neurodegenerative Diseases, Bonn, Germany
| | - Katharina Buerger
- German Center for Neurodegenerative Diseases, Munich, Germany
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Robert Perneczky
- German Center for Neurodegenerative Diseases, Munich, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- Ageing Epidemiology Research Unit (AGE), Imperial College London, London, UK
| | - Anja Schneider
- German Center for Neurodegenerative Diseases, Bonn, Germany
- Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
| | - Stefan Teipel
- Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
- German Center for Neurodegenerative Diseases, Rostock, Germany
| | - Jens Wiltfang
- German Center for Neurodegenerative Diseases, Göttingen, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, University of Göttingen, Göttingen, Germany
| | - Sterling Johnson
- Department of Medicine, Division of Geriatrics and Gerontology, University of Wisconsin, School of Medicine and Public Health, Madison, Wisconsin, US
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin, USA
| | - Michael Wagner
- German Center for Neurodegenerative Diseases, Bonn, Germany
- Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
| | - Frank Jessen
- German Center for Neurodegenerative Diseases, Cologne, Germany
| | - Emrah Düzel
- German Center for Neurodegenerative Diseases, Magdeburg, Germany.
- neotiv GmbH, Magdeburg, Germany.
- Institute for Cognitive Neurology and Dementia Research, Otto-von-Guericke University, Magdeburg, Germany.
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6
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Pozzi FE, Remoli G, Tremolizzo L, Appollonio I, Ferrarese C, Cuffaro L. Brain Health and Cognition in Older Adults: Roadmap and Milestones towards the Implementation of Preventive Strategies. Brain Sci 2024; 14:55. [PMID: 38248270 PMCID: PMC10813413 DOI: 10.3390/brainsci14010055] [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: 11/28/2023] [Revised: 01/02/2024] [Accepted: 01/04/2024] [Indexed: 01/23/2024] Open
Abstract
In this narrative review, we delve into the evolving concept of brain health, as recognized by the WHO, focusing on its intersection with cognitive decline. We emphasize the imperative need for preventive strategies, particularly in older adults. We describe the target population that might benefit the most from risk-based approaches-namely, people with subjective cognitive decline. Additionally, we consider universal prevention in cognitively unimpaired middle-aged and older adults. Delving into multidomain personalized preventive strategies, we report on empirical evidence surrounding modifiable risk factors and interventions crucial in mitigating cognitive decline. Next, we highlight the emergence of brain health services (BHS). We explain their proposed role in risk assessment, risk communication, and tailored interventions to reduce the risk of dementia. Commenting on ongoing BHS pilot experiences, we present the inception and framework of our own BHS in Monza, Italy, outlining its operational structure and care pathways. We emphasize the need for global collaboration and intensified research efforts to address the intricate determinants of brain health and their potential impact on healthcare systems worldwide.
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Affiliation(s)
- Federico Emanuele Pozzi
- School of Medicine and Surgery, University of Milano-Bicocca, 20100 Milan, Italy; (G.R.); (L.T.); (I.A.); (C.F.); (L.C.)
- Neurology Department & Brain Health Service, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy
- Milan Center for Neuroscience (Neuro-MI), University of Milano-Bicocca, 20126 Milan, Italy
| | - Giulia Remoli
- School of Medicine and Surgery, University of Milano-Bicocca, 20100 Milan, Italy; (G.R.); (L.T.); (I.A.); (C.F.); (L.C.)
- Neurology Department & Brain Health Service, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy
| | - Lucio Tremolizzo
- School of Medicine and Surgery, University of Milano-Bicocca, 20100 Milan, Italy; (G.R.); (L.T.); (I.A.); (C.F.); (L.C.)
- Neurology Department & Brain Health Service, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy
- Milan Center for Neuroscience (Neuro-MI), University of Milano-Bicocca, 20126 Milan, Italy
| | - Ildebrando Appollonio
- School of Medicine and Surgery, University of Milano-Bicocca, 20100 Milan, Italy; (G.R.); (L.T.); (I.A.); (C.F.); (L.C.)
- Neurology Department & Brain Health Service, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy
- Milan Center for Neuroscience (Neuro-MI), University of Milano-Bicocca, 20126 Milan, Italy
| | - Carlo Ferrarese
- School of Medicine and Surgery, University of Milano-Bicocca, 20100 Milan, Italy; (G.R.); (L.T.); (I.A.); (C.F.); (L.C.)
- Neurology Department & Brain Health Service, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy
- Milan Center for Neuroscience (Neuro-MI), University of Milano-Bicocca, 20126 Milan, Italy
| | - Luca Cuffaro
- School of Medicine and Surgery, University of Milano-Bicocca, 20100 Milan, Italy; (G.R.); (L.T.); (I.A.); (C.F.); (L.C.)
- Neurology Department & Brain Health Service, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy
- Milan Center for Neuroscience (Neuro-MI), University of Milano-Bicocca, 20126 Milan, Italy
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7
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Sannemann L, Bartels C, Brosseron F, Buerger K, Fliessbach K, Freiesleben SD, Frommann I, Glanz W, Heneka MT, Janowitz D, Kilimann I, Kleineidam L, Lammerding D, Laske C, Munk MHJ, Perneczky R, Peters O, Priller J, Rauchmann BS, Rostamzadeh A, Roy-Kluth N, Schild AK, Schneider A, Schneider LS, Spottke A, Spruth EJ, Teipel S, Wagner M, Wiltfang J, Wolfsgruber S, Duezel E, Jessen F. Symptomatic Clusters Related to Amyloid Positivity in Cognitively Unimpaired Individuals. J Alzheimers Dis 2024; 100:193-205. [PMID: 38848176 DOI: 10.3233/jad-231335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2024]
Abstract
Background The NIA-AA Research Framework on Alzheimer's disease (AD) proposes a transitional stage (stage 2) characterized by subtle cognitive decline, subjective cognitive decline (SCD) and mild neurobehavioral symptoms (NPS). Objective To identify participant clusters based on stage 2 features and assess their association with amyloid positivity in cognitively unimpaired individuals. Methods We included baseline data of N = 338 cognitively unimpaired participants from the DELCODE cohort with data on cerebrospinal fluid biomarkers for AD. Classification into the AD continuum (i.e., amyloid positivity, A+) was based on Aβ42/40 status. Neuropsychological test data were used to assess subtle objective cognitive dysfunction (OBJ), the subjective cognitive decline interview (SCD-I) was used to detect SCD, and the Neuropsychiatric Inventory Questionnaire (NPI-Q) was used to assess NPS. A two-step cluster analysis was carried out and differences in AD biomarkers between clusters were analyzed. Results We identified three distinct participant clusters based on presented symptoms. The highest rate of A+ participants (47.6%) was found in a cluster characterized by both OBJ and SCD. A cluster of participants that presented with SCD and NPS (A+:26.6%) and a cluster of participants with overall few symptoms (A+:19.7%) showed amyloid positivity in a range that was not higher than the expected A+ rate for the age group. Across the full sample, participants with a combination of SCD and OBJ in the memory domain showed a lower Aβ42/ptau181 ratio compared to those with neither SCD nor OBJ. Conclusions The cluster characterized by participants with OBJ and concomitant SCD was enriched for amyloid pathology.
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Affiliation(s)
- Lena Sannemann
- Department of Psychiatry, University of Cologne, Medical Faculty, Cologne, Germany
| | - Claudia Bartels
- Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, University of Goettingen, Göttingen, Germany
| | | | - Katharina Buerger
- German Center for Neurodegenerative Diseases - DZNE, Munich, Germany
- Institute for Stroke and Dementia Research - ISD, University Hospital, LMU Munich, Munich, Germany
| | - Klaus Fliessbach
- German Center for Neurodegenerative Diseases - DZNE, Bonn, Germany
- Department of Neurodegenerative Disease and Geriatric Psychiatry/Psychiatry, University of Bonn Medical Center, Bonn, Germany
| | - Silka Dawn Freiesleben
- German Center for Neurodegenerative Diseases - DZNE, Berlin, Germany
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin-Department of Psychiatry and Neurosciences, Berlin, Germany
| | - Ingo Frommann
- German Center for Neurodegenerative Diseases - DZNE, Bonn, Germany
- Department of Neurodegenerative Disease and Geriatric Psychiatry/Psychiatry, University of Bonn Medical Center, Bonn, Germany
| | - Wenzel Glanz
- German Center for Neurodegenerative Diseases - DZNE, Magdeburg, Germany
| | - Michael T Heneka
- Luxembourg Centre for Systems Biomedicine - LCSB, University of Luxembourg, Belvaux, Luxembourg
| | - Daniel Janowitz
- Institute for Stroke and Dementia Research - ISD, University Hospital, LMU Munich, Munich, Germany
| | - Ingo Kilimann
- German Center for Neurodegenerative Diseases - DZNE, Rostock, Germany
- Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
| | - Luca Kleineidam
- German Center for Neurodegenerative Diseases - DZNE, Bonn, Germany
- Department of Neurodegenerative Disease and Geriatric Psychiatry/Psychiatry, University of Bonn Medical Center, Bonn, Germany
| | - Dominik Lammerding
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin-Department of Psychiatry and Neurosciences, Berlin, Germany
| | - Christoph Laske
- German Center for Neurodegenerative Diseases - DZNE, Tübingen, Germany
- Department of Psychiatry and Psychotherapy, Section for Dementia Research, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Matthias H J Munk
- German Center for Neurodegenerative Diseases - DZNE, Tübingen, Germany
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Robert Perneczky
- German Center for Neurodegenerative Diseases - DZNE, Munich, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
- Munich Cluster for Systems Neurology - SyNergy, Munich, Munich, Germany
- Ageing Epidemiology Research Unit - AGE, School of Public Health, Imperial College London, London, UK
| | - Oliver Peters
- German Center for Neurodegenerative Diseases - DZNE, Berlin, Germany
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin-Department of Psychiatry and Neurosciences, Berlin, Germany
| | - Josef Priller
- German Center for Neurodegenerative Diseases - DZNE, Berlin, Germany
- Department of Psychiatry and Psychotherapy, Charité, Charitéplatz 1, Berlin, Germany
- Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich, Germany
- University of Edinburgh and UK DRI, Edinburgh, UK
| | - Boris-Stephan Rauchmann
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
- Sheffield Institute for Translational Neuroscience - SITraN, University of Sheffield, Sheffield, UK
- Department of Neuroradiology, University Hospital LMU, Munich, Germany
| | - Ayda Rostamzadeh
- Department of Psychiatry, University of Cologne, Medical Faculty, Cologne, Germany
| | - Nina Roy-Kluth
- German Center for Neurodegenerative Diseases - DZNE, Bonn, Germany
| | - Ann-Katrin Schild
- Department of Psychiatry, University of Cologne, Medical Faculty, Cologne, Germany
| | - Anja Schneider
- German Center for Neurodegenerative Diseases - DZNE, Bonn, Germany
- Department of Neurodegenerative Disease and Geriatric Psychiatry/Psychiatry, University of Bonn Medical Center, Bonn, Germany
| | - Luisa-Sophie Schneider
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin-Department of Psychiatry and Neurosciences, Berlin, Germany
| | - Annika Spottke
- German Center for Neurodegenerative Diseases - DZNE, Bonn, Germany
- Department of Neurology, University of Bonn, Bonn, Germany
| | - Eike Jakob Spruth
- German Center for Neurodegenerative Diseases - DZNE, Berlin, Germany
- Department of Psychiatry and Psychotherapy, Charité, Charitéplatz 1, Berlin, Germany
| | - Stefan Teipel
- German Center for Neurodegenerative Diseases - DZNE, Rostock, Germany
- Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
| | - Michael Wagner
- German Center for Neurodegenerative Diseases - DZNE, Bonn, Germany
- Department of Neurodegenerative Disease and Geriatric Psychiatry/Psychiatry, University of Bonn Medical Center, Bonn, Germany
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, University of Goettingen, Göttingen, Germany
- German Center for Neurodegenerative Diseases - DZNE, Göttingen, Germany
- Department of Medical Sciences, Neurosciences and Signaling Group, Institute of Biomedicine - iBiMED, University of Aveiro, Aveiro, Portugal
| | - Steffen Wolfsgruber
- German Center for Neurodegenerative Diseases - DZNE, Bonn, Germany
- Department of Neurodegenerative Disease and Geriatric Psychiatry/Psychiatry, University of Bonn Medical Center, Bonn, Germany
| | - Emrah Duezel
- German Center for Neurodegenerative Diseases - DZNE, Magdeburg, Germany
- Institute of Cognitive Neurology and Dementia Research - IKND, Otto-von-Guericke University, Magdeburg, Germany
| | - Frank Jessen
- Department of Psychiatry, University of Cologne, Medical Faculty, Cologne, Germany
- German Center for Neurodegenerative Diseases - DZNE, Bonn, Germany
- Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases - CECAD, University of Cologne, Cologne, Germany
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