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Amyloid-PET imaging predicts functional decline in clinically normal individuals.

Lisa Quenon1,2, Lyduine E Collij3,4,5, David Vállez Garcia3,4

  • 1Institute of Neuroscience, UCLouvain, Brussels, Belgium. lisa.quenon@uclouvain.be.

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Summary

Elevated amyloid-beta (Aβ) PET scans predict functional decline in clinically normal individuals. Specific Centiloid (CL) thresholds, 41 for CDR-SOB and 28 for A-IADL-Q, identify those at risk.

Keywords:
Amyloid-PETCentiloidFunctional declineInstrumental activities of daily livingPreclinical Alzheimer

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Area of Science:

  • Neuroimaging and Biomarkers
  • Alzheimer's Disease Research
  • Clinical Neuropsychology

Background:

  • Elevated amyloid-beta (Aβ) positron emission tomography (PET) signal is linked to cognitive decline in clinically normal (CN) individuals.
  • The association between Aβ burden and decline in daily living activities in CN individuals requires further investigation.
  • Optimal Aβ-PET Centiloid (CL) thresholds for predicting functional decline are not yet established.

Purpose of the Study:

  • To investigate the association between Aβ burden, measured by Aβ-PET Centiloids (CL), and functional decline in daily living activities among clinically normal (CN) individuals.
  • To establish optimal Aβ-PET CL thresholds for predicting functional decline in CN individuals.

Main Methods:

  • Analysis of the European amyloid-PET imaging AMYPAD-PNHS dataset, including 1032 CN individuals and 228 with questionable functional impairment.
  • Amyloid-PET was assessed using Centiloid (CL) scale and categorized into Aβ-, Aβ-intermediate/Aβ±, and Aβ+ groups.
  • Functional abilities were assessed using the Clinical Dementia Rating (Global-CDR, CDR-SOB) and Amsterdam Instrumental Activities of Daily Living Questionnaire (A-IADL-Q).

Main Results:

  • Cross-sectional analysis showed CL values associated with Clinical Dementia Rating (CDR) outcomes.
  • Longitudinal analysis revealed that baseline CL values predicted prospective changes in CDR-SOB and A-IADL-Q scores in CN participants.
  • Optimal thresholds for predicting decline were identified at 41 CL for CDR-SOB and 28 CL for A-IADL-Q.

Conclusions:

  • Amyloid-PET quantification effectively identifies clinically normal individuals at risk of functional decline.
  • Established Aβ-PET CL thresholds can aid in predicting the trajectory of functional impairment.