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Amyloid-Beta Pathology and Cognitive Performance in Centenarians.

Susan K Rohde1,2,3,4, Maruelle C Luimes1,2,3,5, Linda M C Lorenz1,2,5

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Amyloid-beta (Aβ) pathology in centenarians is linked to cognitive decline, not a benign aging effect. High Aβ loads correlate with poorer cognitive performance, challenging previous assumptions.

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Area of Science:

  • Neuropathology
  • Neuroscience
  • Aging Research

Background:

  • Older individuals without dementia often exhibit amyloid-beta (Aβ) Thal phases similar to Alzheimer's disease (AD) patients.
  • This observation suggested Aβ pathology might be a benign consequence of aging.

Purpose of the Study:

  • To investigate the association between Aβ pathology and cognitive performance in centenarians.
  • To determine if Aβ accumulation in extreme longevity is linked to cognitive status.

Main Methods:

  • Longitudinal cohort study using cross-sectional data from the Dutch 100-plus Study.
  • Assessed Aβ pathology via Thal phase and quantitative loads in centenarian brains (n=95) and compared with AD patients.
  • Correlated neuropathological findings with antemortem cognitive test performance.

Main Results:

  • Centenarians with high Aβ loads showed significantly lower cognitive performance than those with no or low Aβ.
  • Increased Aβ loads in neocortical and hippocampal regions were associated with impaired executive functioning.
  • Five resilient centenarians with high Aβ loads maintained cognitive function, exhibiting less tau pathology.

Conclusions:

  • Aβ pathology is not benign in aging and contributes to cognitive impairment even in centenarians.
  • The interaction between Aβ and tau pathology in the oldest individuals supports the amyloid cascade hypothesis.
  • These findings highlight the detrimental impact of Aβ accumulation on cognition across the lifespan.