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Biomarkers for predicting cognitive decline in those with normal cognition
Kyle Steenland1, Liping Zhao2, Felicia Goldstein3
1Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA Emory Alzheimer's Disease Research Center, Emory University, Atlanta, GA, USA.
Journal of Alzheimer'S Disease : JAD
|February 6, 2014
Summary
Cerebrospinal fluid biomarkers, not cognitive tests, effectively predict cognitive decline in individuals with normal cognition. These Alzheimer's disease biomarkers can help identify those at risk for future decline.
Area of Science:
- Neuroscience
- Biomarker Research
- Alzheimer's Disease Pathogenesis
Background:
- Longitudinal studies on Alzheimer's disease (AD) biomarkers primarily focus on mild cognitive impairment (MCI) progression to AD.
- Data on biomarker predictability in cognitively normal individuals is limited.
- Understanding early predictors in normal cognition is crucial for timely intervention.
Purpose of the Study:
- To identify which biomarkers best predict cognitive decline in individuals with normal cognition at baseline.
- To establish optimal cut-point values for these biomarkers to predict decline.
- To assess the predictive accuracy of these biomarkers for cognitive decline and transition to MCI/AD.
Main Methods:
- Analysis of 191 cognitively normal subjects from the Alzheimer's Disease Neuroimaging Initiative (ADNI) with longitudinal data.
- Utilized repeated measures linear regression with neuropsychological tests, cerebrospinal fluid (CSF) biomarkers, and structural MRI data.
- Assessed the predictive power of biomarkers on cognitive decline measured by the Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog).
Main Results:
- Cerebrospinal fluid (CSF) biomarkers and MRI variables significantly predicted ADAS-Cog decline, with CSF markers showing the strongest predictive power.
- Neuropsychological tests did not significantly predict cognitive decline.
- Established optimal cut points for CSF biomarkers (Aβ42, t-tau, p-tau, t-tau/Aβ42, p-tau/Aβ42) to predict decline and progression to MCI/AD with 65% accuracy.
Conclusions:
- CSF biomarkers are potent predictors of cognitive decline in individuals with normal cognition.
- The findings support current Alzheimer's disease progression models.
- Biomarker criteria can potentially predict cognitive decline and transition to MCI in at-risk individuals.
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