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Item-Level Investigation of Participant and Study Partner Report on the Cognitive Function Index from the A4 Study
R E Amariglio1, S A M Sikkes, G A Marshall
1R.E. Amariglio, Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, 02115, USA, ramariglio@partners.org.
The Journal of Prevention of Alzheimer'S Disease
|June 8, 2021
Summary
Elevated amyloid (Aß) is linked to subjective cognitive changes in cognitively normal individuals. Both participant and study partner reports on the Cognitive Function Index (CFI) reveal specific changes associated with Aß status.
Area of Science:
- Neuroscience
- Alzheimer's Disease Research
- Cognitive Aging
Background:
- Subjective cognitive decline is a potential early indicator of Alzheimer's disease (AD).
- Previous studies linked overall cognitive changes to amyloid (Aß) levels.
- Specific cognitive changes reported by participants versus their study partners and their association with Aß were not well understood.
Purpose of the Study:
- To identify specific subjective cognitive changes associated with amyloid status in individuals undergoing screening for an AD prevention trial.
- To compare cognitive changes reported by participants and their study partners in relation to amyloid positivity.
Main Methods:
- Utilized data from 4,486 cognitively unimpaired participants (ages 65-85) in the A4 Study.
- Assessed amyloid status using florbetapir Positron Emission Tomography (PET) imaging, classifying participants as amyloid-positive (Aß+) or amyloid-negative (Aß-).
- Measured subjective cognitive changes using the 15-item Cognitive Function Index (CFI), administered to both participants and their study partners before PET imaging.
Main Results:
- Participants reported more cognitive changes than study partners across most CFI items.
- Elevated amyloid (Aß+) was associated with reports of substantial memory decline and seeking medical advice for memory issues by both participants and partners.
- Specific items, such as repeating questions and trouble following news, were uniquely associated with Aß+ for study partners, while trouble driving was uniquely associated for participants.
Conclusions:
- Elevated amyloid is associated with increased subjective cognitive changes in cognitively unimpaired individuals.
- Both participant and study partner reports on the CFI provide valuable, complementary information regarding cognitive changes linked to amyloid status.
- Findings support the use of both participant and study partner perspectives in clinical trials for AD prevention.
