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Clinical Manifestations.

Audrey A Keleman1,2,3, Alyssa Weakley4, Rebecca M Bollinger1

  • 1Washington University in St. Louis School of Medicine, St. Louis, MO, USA.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 26, 2025
PubMed
Summary
This summary is machine-generated.

Cognitive function and Alzheimer's disease (AD) biomarkers significantly predict daily living activities in cognitively normal older adults. Early detection of these predictors can aid in developing interventions for preclinical AD.

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Area of Science:

  • Neuroscience
  • Gerontology
  • Biomarkers

Background:

  • Cognitive decline and Alzheimer's disease (AD) pathology impact daily functioning.
  • Understanding predictors of instrumental activities of daily living (IADL) is crucial for early detection and intervention in preclinical AD.

Purpose of the Study:

  • To investigate the relationship between cognition, AD biomarkers, and IADL performance in cognitively normal (CN) older adults.
  • To identify key predictors of IADL performance for developing targeted screening tools and interventions.

Main Methods:

  • 173 CN older adults completed home-based IADL tasks (shopping, checkbook balancing, medication management).
  • Amyloid and tau positron emission tomography (PET) were used to assess AD pathology.
  • Logistic regression models analyzed cognitive and biomarker predictors of IADL performance, controlling for demographics.

Main Results:

  • Global cognition and Attention & Processing domains were strong predictors of IADL performance.
  • Higher amyloid burden was associated with worse IADL performance; tauopathy showed a trend.
  • Cognition and amyloid burden had additive effects on predicting IADL performance.

Conclusions:

  • Cognitive function and AD pathology significantly and complementarily influence IADL performance in CN older adults.
  • Findings can inform the development of sensitive functional assessments for preclinical AD.
  • Interventions targeting identified deficits may improve IADL performance and compensatory strategies.