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Clinical Manifestations.

Therese H Kim1, David L Sultzer2,3

  • 1UC Irvine Institute for Memory Impairments and Neurological Disorders (UCI MIND), Irvine, CA, USA.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
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Summary
This summary is machine-generated.

This study found that while age, sex, and cognitive scores predict cognitive decline in all individuals, amyloid levels influence which specific factors, like memory concerns or low energy, are most predictive. Understanding these differences is key for targeted interventions.

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Area of Science:

  • Neuroscience
  • Gerontology
  • Biomarkers

Background:

  • Cognitive decline is a growing concern in aging populations.
  • Brain amyloid accumulation is a hallmark of Alzheimer's disease.
  • Identifying predictors of cognitive decline is crucial for early intervention.

Purpose of the Study:

  • To examine associations between baseline risk factors and future cognitive decline.
  • To determine if predictors of cognitive impairment differ based on amyloid status.

Main Methods:

  • Analysis of 1133 participants from the A4 Study with 4.5-year follow-up data.
  • Logistic regression models assessed predictors including age, sex, education, APOE genotype, amyloid-β (Aβ) SUVR, PACC, GDS, and STAI scores.
  • Comparison of predictors for cognitive impairment (CDR>0) in Aβ-positive (Aβ+) and Aβ-negative (Aβ-) groups.

Main Results:

  • 282 Aβ+ and 51 Aβ- participants developed cognitive impairment.
  • Common predictors: older age, male sex, lower PACC scores.
  • Aβ SUVR strongly predicted impairment in Aβ+ individuals (OR=15.34); STAI scores were also significant (OR=1.07).
  • In Aβ- individuals, GDS scores predicted impairment (OR=1.27), with low energy being the most predictive symptom.
  • In Aβ+ individuals, memory concerns were the strongest predictor.

Conclusions:

  • Cognitive impairment predictors vary based on amyloid status.
  • Distinct mechanisms may underlie cognitive decline in Aβ+ versus Aβ- individuals.
  • Targeted interventions may require consideration of individual amyloid positivity.