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Published on: January 24, 2020
Biomarker-Informed Interpretation of Dyadic Cognitive Function Index Scores in Cognitively Unimpaired Older Adults
Ambre Mounié1,2, Kenichiro Sato1,3, Saki Nakashima1,3,4
1Dementia Inclusion and Therapeutics, The University of Tokyo Hospital, Tokyo, Japan.
Introduction:
Participant- and study partner-reported Cognitive Function Index scores may provide complementary information, but it remains unclear whether Alzheimer's disease biomarkers are associated with CFI scores across reporters, reporter-specific imbalance, or both.
Methods:
Using A4/LEARN screening data (screening sample, N = 1,686; primary dyadic analytic sample, N = 1,682; CDR global score = 0), we jointly modeled participant-reported (CFI-PT) and study partner-reported (CFI-SP) scores in long format to evaluate biomarker associations with CFI scores and biomarker × reporter interactions. As a secondary analysis, we compared tau PET with plasma p-tau217.
Results:
In an A4/LEARN-adapted regional extent model, reporter balance varied across amyloid regional extent categories, with the largest participant-leading contrast observed in the exploratory restricted early cortical subgroup. Tau PET was associated with higher CFI scores, but this association did not differ detectably between reporters. Plasma p-tau217 showed no clear CFI association or reporter-specific interaction in the A4-derived, amyloid-enriched subset.
Discussion:
Amyloid regional extent and tau PET were associated with different features of dyadic CFI data: reporter balance and CFI burden across reporters, respectively. Joint interpretation of CFI-PT and CFI-SP may support biomarker-informed interpretation of the instrument, although the cross-sectional findings require replication and longitudinal validation.
