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Association Between Elevated Brain Amyloid and Subsequent Cognitive Decline Among Cognitively Normal Persons.
Michael C Donohue1, Reisa A Sperling2, Ronald Petersen3
1Alzheimer's Therapeutic Research Institute, Department of Neurology, University of Southern California, San Diego.
JAMA
|June 14, 2017
Summary
Elevated brain amyloid in cognitively normal individuals is linked to increased risk of Alzheimer's-related cognitive decline. Further research is needed to confirm clinical significance and long-term effects.
Area of Science:
- Neuroscience
- Gerontology
- Biomarkers
Background:
- Elevated brain amyloid levels in cognitively normal individuals may indicate a heightened risk for future Alzheimer's disease-related cognitive decline.
- Understanding this association is crucial for early detection and intervention strategies.
Purpose of the Study:
- To quantify the risk of cognitive decline in cognitively normal individuals with elevated brain amyloid.
- To characterize the relationship between brain amyloid levels and cognitive trajectories.
Main Methods:
- Longitudinal data from 445 cognitively normal participants in the Alzheimer's Disease Neuroimaging Initiative (ADNI) were analyzed.
- Participants were classified based on baseline brain amyloid levels (normal vs. elevated) using PET imaging or CSF assays.
- Cognitive function was assessed using the Preclinical Alzheimer Cognitive Composite (PACC), MMSE, CDR-Sum of Boxes, and Logical Memory Delayed Recall over a median follow-up of 3.1 years.
Main Results:
- Individuals with elevated baseline brain amyloid showed significantly worse cognitive performance at 4 years compared to those with normal amyloid.
- This included declines in PACC, MMSE, and CDR-Sum of Boxes scores.
- No statistically significant difference was observed in Logical Memory Delayed Recall scores at 4 years.
Conclusions:
- Elevated brain amyloid in cognitively normal individuals is associated with an increased likelihood of cognitive decline.
- The clinical significance and long-term implications of these findings require further investigation.
- Longer follow-up studies are necessary to fully assess the impact of amyloid on cognitive trajectories.
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