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Published on: March 21, 2017
Plasma Aβ42:Aβ40 ratio as a biomarker for cognitive impairment in haemodialysis patients: a multicentre study
Xujiao Chen1, Mengjing Wang1,2, Jianying Niu3
1Division of Nephrology, Huashan Hospital, Fudan University, Shanghai, China.
Background:
Mild cognitive impairment (MCI) and dementia are more prevalent in patients undergoing haemodialysis (HD). Although the cerebrospinal fluid amyloid beta (Aβ) and tau (τ) have proven to be valid biomarkers for the diagnosis of Alzheimer's disease (AD) in the general population, the roles of plasma Aβ and τ for the diagnosis of cognitive impairment in HD patients remain unknown.
Methods:
We conducted a cross-sectional study including patients receiving HD in three hospitals in Shanghai. All patients completed the Montreal Cognitive Assessment-Basic (MoCA-B). To validate the effectiveness of the MoCA-B score for screening MCI, a subset group underwent neuropsychological batteries. Serum proteomes were compared in HD patients with normal cognitive function and dementia. Plasma Aβ42, Aβ40 and total τ were measured using a single molecule array.
Results:
A total of 311 HD patients were enrolled (mean age 63 years, 55% male). The best cut-off score of MoCA-B for differentiating MCI and normal cognition was 24, with an area under the curve of 0.94. Serum proteomics revealed that neurodegenerative pathways related to AD were enriched in HD patients with dementia. The plasma Aβ42:Aβ40 ratio was significantly reduced in patients with MCI and dementia and was independently associated with cognitive function after adjusting for age, sex and education levels.
Conclusions:
We validated the MoCA-B as an optimal cognitive function screening instrument for MCI in HD patients. The plasma Aβ42:Aβ40 ratio was a potential biomarker in distinguishing normal cognition, MCI and dementia in HD populations.
Insights
This study shows the Montreal Cognitive Assessment-Basic (MoCA-B) effectively screens for mild cognitive impairment (MCI) in hemodialysis (HD) patients. The plasma amyloid beta 42:40 ratio is a promising biomarker for cognitive decline in HD populations.
Area of Science:
- Nephrology and Neurology
- Biomarker Discovery
- Cognitive Impairment Research
Background:
- Mild cognitive impairment (MCI) and dementia are common in hemodialysis (HD) patients.
- Cerebrospinal fluid biomarkers for Alzheimer's disease (AD) are established, but plasma biomarkers for cognitive impairment in HD patients are not well understood.
Purpose of the Study:
- To evaluate the Montreal Cognitive Assessment-Basic (MoCA-B) for screening MCI in HD patients.
- To investigate the role of plasma amyloid beta (Aβ) and tau (τ) as biomarkers for cognitive impairment in HD patients.
Main Methods:
- A cross-sectional study of 311 hemodialysis patients in Shanghai.
- Cognitive function assessed using MoCA-B, with a subset undergoing neuropsychological testing.
- Plasma Aβ42, Aβ40, and total tau measured; serum proteomes compared between cognitive groups.
Main Results:
- MoCA-B demonstrated high accuracy (AUC 0.94) for differentiating MCI from normal cognition with a cut-off score of 24.
- Serum proteomics indicated enriched neurodegenerative pathways in HD patients with dementia.
- The plasma Aβ42:Aβ40 ratio was significantly lower in patients with MCI and dementia and independently associated with cognitive function.
Conclusions:
- MoCA-B is validated as an effective screening tool for MCI in the HD population.
- The plasma Aβ42:Aβ40 ratio shows potential as a biomarker for distinguishing cognitive states (normal, MCI, dementia) in HD patients.
