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Shirzadi Z, Boyle R, Yau WYW, Coughlan G, Fu JF, Properzi MJ, Buckley RF, Yang HS, Scanlon CE, Hsieh S, Amariglio RE, Papp K, Rentz D, Price JC, Johnson KA, Sperling RA, Chhatwal JP, Schultz AP. Vascular contributions to cognitive decline: Beyond amyloid and tau in the Harvard aging brain study. J Cereb Blood Flow Metab 2024:271678X241237624. [PMID: 38452039 DOI: 10.1177/0271678x241237624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
In addition to amyloid and tau pathology, elevated systemic vascular risk, white matter injury, and reduced cerebral blood flow contribute to late-life cognitive decline. Given the strong collinearity among these parameters, we proposed a framework to extract the independent latent features underlying cognitive decline using the Harvard Aging Brain Study (N = 166 cognitively unimpaired older adults at baseline). We used the following measures from the baseline visit: cortical amyloid, inferior temporal cortex tau, relative cerebral blood flow, white matter hyperintensities, peak width of skeletonized mean diffusivity, and Framingham Heart Study cardiovascular disease risk. We used exploratory factor analysis to extract orthogonal factors from these variables and their interactions. These factors were used in a regression model to explain longitudinal Preclinical Alzheimer Cognitive Composite-5 (PACC) decline (follow-up = 8.5 ±2.7 years). We next examined whether gray matter volume atrophy acts as a mediator of factors and PACC decline. Latent factors of systemic vascular risk, white matter injury, and relative cerebral blood flow independently explain cognitive decline beyond amyloid and tau. Gray matter volume atrophy mediates these associations with the strongest effect on white matter injury. These results suggest that systemic vascular risk contributes to cognitive decline beyond current markers of cerebrovascular injury, amyloid, and tau.
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Affiliation(s)
- Zahra Shirzadi
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Rory Boyle
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Wai-Ying W Yau
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Gillian Coughlan
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Jessie Fanglu Fu
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Michael J Properzi
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Rachel F Buckley
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Hyun-Sik Yang
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Catherine E Scanlon
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Stephanie Hsieh
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Rebecca E Amariglio
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Kathryn Papp
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Dorene Rentz
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Julie C Price
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Keith A Johnson
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Reisa A Sperling
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Jasmeer P Chhatwal
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Aaron P Schultz
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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Papp KV, Jutten RJ, Soberanes D, Weizenbaum E, Hsieh S, Molinare C, Buckley R, Betensky RA, Marshall GA, Johnson KA, Rentz DM, Sperling R, Amariglio RE. Early Detection of Amyloid-Related Changes in Memory among Cognitively Unimpaired Older Adults with Daily Digital Testing. Ann Neurol 2024; 95:507-517. [PMID: 37991080 PMCID: PMC10922126 DOI: 10.1002/ana.26833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 09/28/2023] [Accepted: 10/23/2023] [Indexed: 11/23/2023]
Abstract
OBJECTIVE This study was undertaken to determine whether assessing learning over days reveals Alzheimer disease (AD) biomarker-related declines in memory consolidation that are otherwise undetectable with single time point assessments. METHODS Thirty-six (21.9%) cognitively unimpaired older adults (aged 60-91 years) were classified with elevated β-amyloid (Aβ+) and 128 (78%) were Aβ- using positron emission tomography with 11C Pittsburgh compound B. Participants completed the multiday Boston Remote Assessment for Neurocognitive Health (BRANCH) for 12 min/day on personal devices (ie, smartphones, laptops), which captures the trajectory of daily learning of the same content on 3 repeated tests (Digit Signs, Groceries-Prices, Face-Name). Learning is computed as a composite of accuracy across all 3 measures. Participants also completed standard in-clinic cognitive tests as part of the Preclinical Alzheimer's Cognitive Composite (PACC-5), with 123 participants undergoing PACC-5 follow-up after 1.07 (standard deviation = 0.25) years. RESULTS At the cross-section, there were no statistically significant differences in performance between Aβ+/- participants on any standard in-clinic cognitive tests (eg, PACC-5) or on day 1 of multiday BRANCH. Aβ+ participants exhibited diminished 7-day learning curves on multiday BRANCH after 4 days of testing relative to Aβ- participants (Cohen d = 0.49, 95% confidence interval = 0.10-0.87). Diminished learning curves were associated with greater annual PACC-5 decline (r = 0.54, p < 0.001). INTERPRETATION Very early Aβ-related memory declines can be revealed by assessing learning over days, suggesting that failures in memory consolidation predate other conventional amnestic deficits in AD. Repeated digital memory assessments, increasingly feasible and uniquely able to assess memory consolidation over short time periods, have the potential to be transformative for detecting the earliest cognitive changes in preclinical AD. ANN NEUROL 2024;95:507-517.
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Affiliation(s)
- Kathryn V. Papp
- Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts 02115
- Department of Neurology, Massachusetts General Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114
| | - Roos J. Jutten
- Department of Neurology, Massachusetts General Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114
| | - Daniel Soberanes
- Department of Neurology, Massachusetts General Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114
| | - Emma Weizenbaum
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02129
| | - Stephanie Hsieh
- Department of Neurology, Massachusetts General Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114
| | - Cassidy Molinare
- Department of Neurology, Massachusetts General Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114
| | - Rachel Buckley
- Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts 02115
- Department of Neurology, Massachusetts General Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114
| | - Rebecca A. Betensky
- Department of Biostatistics, New York University School of Global Public Health, New York, NY, 10003
| | - Gad A. Marshall
- Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts 02115
- Department of Neurology, Massachusetts General Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114
| | - Keith A Johnson
- Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts 02115
- Department of Neurology, Massachusetts General Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114
- Department of Radiology, Massachusetts General Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114
| | - Dorene M. Rentz
- Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts 02115
- Department of Neurology, Massachusetts General Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114
| | - Reisa Sperling
- Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts 02115
- Department of Neurology, Massachusetts General Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114
| | - Rebecca E. Amariglio
- Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts 02115
- Department of Neurology, Massachusetts General Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114
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Weizenbaum EL, Soberanes D, Hsieh S, Molinare CP, Buckley RF, Betensky RA, Properzi MJ, Marshall GA, Rentz DM, Johnson KA, Sperling RA, Amariglio RE, Papp KV. Capturing learning curves with the multiday Boston Remote Assessment of Neurocognitive Health (BRANCH): Feasibility, reliability, and validity. Neuropsychology 2024; 38:198-210. [PMID: 37971862 PMCID: PMC10841660 DOI: 10.1037/neu0000933] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023] Open
Abstract
OBJECTIVE Unsupervised remote digital cognitive assessment makes frequent testing feasible and allows for measurement of learning over repeated evaluations on participants' own devices. This provides the opportunity to derive individual multiday learning curve scores over short intervals. Here, we report feasibility, reliability, and validity, of a 7-day cognitive battery from the Boston Remote Assessment for Neurocognitive Health (Multiday BRANCH), an unsupervised web-based assessment. METHOD Multiday BRANCH was administered remotely to 181 cognitively unimpaired older adults using their own electronic devices. For 7 consecutive days, participants completed three tests with associative memory components (Face-Name, Groceries-Prices, Digit Signs), using the same stimuli, to capture multiday learning curves for each test. We assessed the feasibility of capturing learning curves across the 7 days. Additionally, we examined the reliability and associations of learning curves with demographics, and traditional cognitive and subjective report measures. RESULTS Multiday BRANCH was feasible with 96% of participants completing all study assessments; there were no differences dependent on type of device used (t = 0.71, p = .48) or time of day completed (t = -0.08, p = .94). Psychometric properties of the learning curves were sound including good test-retest reliability of individuals' curves (intraclass correlation = 0.94). Learning curves were positively correlated with in-person cognitive tests and subjective report of cognitive complaints. CONCLUSIONS Multiday BRANCH is a feasible, reliable, and valid cognitive measure that may be useful for identifying subtle changes in learning and memory processes in older adults. In the future, we will determine whether Multiday BRANCH is predictive of the presence of preclinical Alzheimer's disease. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Emma L Weizenbaum
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School
| | - Daniel Soberanes
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School
| | - Stephanie Hsieh
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School
| | - Cassidy P Molinare
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School
| | - Rachel F Buckley
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School
| | - Rebecca A Betensky
- Department of Biostatistics, School of Global Public Health, New York University
| | - Michael J Properzi
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School
| | - Gad A Marshall
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School
| | - Dorene M Rentz
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School
| | - Keith A Johnson
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School
| | - Reisa A Sperling
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School
| | - Rebecca E Amariglio
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School
| | - Kathryn V Papp
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School
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Jutten RJ, Amariglio RE, Maruff P, Properzi MJ, Rentz DM, Johnson KA, Sperling RA, Papp KV. Increased intraindividual variability in reaction time performance is associated with emerging cognitive decline in cognitively unimpaired adults. Neuropsychology 2024; 38:184-197. [PMID: 37971861 DOI: 10.1037/neu0000928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023] Open
Abstract
OBJECTIVE To investigate whether intraindividual variability (IIV) in reaction time (RT) over monthly administered cognitive tasks is increased in cognitively unimpaired older adults who are at risk for cognitive decline, and whether this is independent of mean RT performance. METHOD N = 109 cognitively unimpaired individuals (age 77.4 ± 5.0, 61.5% female, Mini-Mental State Examination 29.1 ± 1.3) from the Harvard Aging Brain Study completed the self-administered Computerized Cognitive Composite (C3) monthly at home for up to 1 year (12.7 ± 3.2 C3 assessments). Baseline C3 assessment coincided with routine in-clinic visits, including amyloid and tau positron emission tomography imaging and standardized cognitive testing, with cognitive testing repeated annually (1.6 ± 1.2 years follow-up). The C3 includes two simple RT tasks and two complex RT tasks. IIV estimates were derived by computing intraindividual standard deviations on residual RT scores after regressing out age and session order effects. Cross-sectional associations of IIV with cognition (global cognition, memory, executive functions [EF], processing speed) and amyloid and tau burden were examined using linear regression analyses correcting for demographics and mean RT. The association between IIV and cognitive decline was assessed using linear mixed models correcting for demographic factors, mean RT, and amyloid burden. RESULTS After adjusting for mean RT, increased IIV on complex RT tasks was independently associated with worse EF performance (β = -0.10, 95% CI [-.16, -0.03], p = .004), greater inferior-temporal tau deposition (β = 0.18, 95% CI [0.02, 0.34], p = .024), and faster cognitive decline in those with elevated amyloid (β = -0.62, 95% CI [-1.18, -0.06], p = .033). CONCLUSIONS Increased variability in monthly RT may reflect subtle EF deficits and provide unique information about short-term cognitive decline in preclinical Alzheimer's disease. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Roos J Jutten
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School
| | - Rebecca E Amariglio
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School
| | | | - Michael J Properzi
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School
| | - Dorene M Rentz
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School
| | - Keith A Johnson
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School
| | - Reisa A Sperling
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School
| | - Kathryn V Papp
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School
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Burling JE, Katz Z, Yuan Z, Munro C, Mimmack K, Ma G, Hanseeuw BJ, Papp KV, Amariglio RE, Vannini P, Rentz DM, Quiroz YT, Johnson KA, Sperling RA, Blacker D, Marshall GA, Yang HS, Gatchel JR. Study Partner Report of Apathy in Older Adults is Associated with AD Biomarkers: Findings from the Harvard Aging Brain Study. Am J Geriatr Psychiatry 2024:S1064-7481(24)00020-4. [PMID: 38443298 DOI: 10.1016/j.jagp.2024.01.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 01/13/2024] [Accepted: 01/15/2024] [Indexed: 03/07/2024]
Abstract
OBJECTIVES We examined relationships between apathy (self and study-partner-reported) and markers of Alzheimer's disease (AD) in older adults. DESIGN The study utilized a well-characterized sample of participants from the Harvard Aging Brain Study (HABS), a longitudinal cohort study. Participants were cognitively unimpaired without clinically significant neuropsychiatric symptoms at HABS baseline. The dependent variables, apathy evaluation scale-self (AES-S) and informant (AES-I), were administered cross-sectionally between years 6-9 and compared to the independent variables, amyloid and tau PET neuroimaging, from the same year. SETTING Community-dwelling participants assessed at research visits in an academic medical center. PARTICIPANTS Participants (n = 170) completed assessments within 1.5 years of their neuroimaging visit. At the time of apathy assessment, N = 156 were cognitively unimpaired and 14 had progressed to mild cognitive impairment (n = 8) or dementia (n = 6). MEASUREMENTS We utilized linear regression models to assess cross-sectional associations of AES-S and AES-I with AD PET imaging measures (beta-amyloid (Pittsburgh Compound B) and tau (Flortaucipir)), covarying for age, sex, education, and the time between PET scan-apathy assessment. RESULTS AES-I was significantly associated with beta-amyloid and temporal lobe tau, and the associations were retained after further adjusting for depressive symptoms. The associations between AES-S and AD biomarkers were not significant. In an exploratory subgroup analysis of cognitively unimpaired individuals with elevated Aβ, we observed an association between AES-I and inferior temporal tau. CONCLUSIONS Study-partner-reported, but not self-reported, apathy in older adults is associated with AD pathology, and we observed this relationship starting from the preclinical stage. Our findings highlight the importance of collateral information in capturing AD-related apathy.
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Affiliation(s)
- Jessa E Burling
- Department of Neurology (JEB, ZY, KM, KVP, REA, PV, DMR, YTQ, KAJ, RAS, GAM, H-SY), Massachusetts General Hospital, Boston, MA
| | - Zoe Katz
- Washington University School of Medicine in St. Louis (ZK), St. Louis, MO
| | - Ziwen Yuan
- Department of Neurology (JEB, ZY, KM, KVP, REA, PV, DMR, YTQ, KAJ, RAS, GAM, H-SY), Massachusetts General Hospital, Boston, MA
| | - Catherine Munro
- Department of Neurology (CM, KVP, REA, PV, DMR, KAJ, RAS, GAM, H-SY), Brigham and Women's Hospital, Boston, MA; Department of Psychiatry (CM, YTQ, DB, JRG), Massachusetts General Hospital, Boston, MA; Harvard Medical School (CM, GM, BJH, KVP, REA, PV, DMR, YTQ, KAJ, RAS, DB, GAM, H-SY, JRG), Boston, MA
| | - Kayden Mimmack
- Department of Neurology (JEB, ZY, KM, KVP, REA, PV, DMR, YTQ, KAJ, RAS, GAM, H-SY), Massachusetts General Hospital, Boston, MA
| | - Grace Ma
- Harvard Medical School (CM, GM, BJH, KVP, REA, PV, DMR, YTQ, KAJ, RAS, DB, GAM, H-SY, JRG), Boston, MA; Department of Psychiatry (GM), Brigham and Women's Hospital, Boston, MA
| | - Bernard J Hanseeuw
- Harvard Medical School (CM, GM, BJH, KVP, REA, PV, DMR, YTQ, KAJ, RAS, DB, GAM, H-SY, JRG), Boston, MA; Department of Radiology (BJH), Massachusetts General Research Institute, Boston, MA; Department of Neurology (BJH), Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Kathryn V Papp
- Department of Neurology (JEB, ZY, KM, KVP, REA, PV, DMR, YTQ, KAJ, RAS, GAM, H-SY), Massachusetts General Hospital, Boston, MA; Department of Neurology (CM, KVP, REA, PV, DMR, KAJ, RAS, GAM, H-SY), Brigham and Women's Hospital, Boston, MA; Harvard Medical School (CM, GM, BJH, KVP, REA, PV, DMR, YTQ, KAJ, RAS, DB, GAM, H-SY, JRG), Boston, MA
| | - Rebecca E Amariglio
- Department of Neurology (JEB, ZY, KM, KVP, REA, PV, DMR, YTQ, KAJ, RAS, GAM, H-SY), Massachusetts General Hospital, Boston, MA; Department of Neurology (CM, KVP, REA, PV, DMR, KAJ, RAS, GAM, H-SY), Brigham and Women's Hospital, Boston, MA; Harvard Medical School (CM, GM, BJH, KVP, REA, PV, DMR, YTQ, KAJ, RAS, DB, GAM, H-SY, JRG), Boston, MA
| | - Patrizia Vannini
- Department of Neurology (JEB, ZY, KM, KVP, REA, PV, DMR, YTQ, KAJ, RAS, GAM, H-SY), Massachusetts General Hospital, Boston, MA; Department of Neurology (CM, KVP, REA, PV, DMR, KAJ, RAS, GAM, H-SY), Brigham and Women's Hospital, Boston, MA; Harvard Medical School (CM, GM, BJH, KVP, REA, PV, DMR, YTQ, KAJ, RAS, DB, GAM, H-SY, JRG), Boston, MA
| | - Dorene M Rentz
- Department of Neurology (JEB, ZY, KM, KVP, REA, PV, DMR, YTQ, KAJ, RAS, GAM, H-SY), Massachusetts General Hospital, Boston, MA; Department of Neurology (CM, KVP, REA, PV, DMR, KAJ, RAS, GAM, H-SY), Brigham and Women's Hospital, Boston, MA; Harvard Medical School (CM, GM, BJH, KVP, REA, PV, DMR, YTQ, KAJ, RAS, DB, GAM, H-SY, JRG), Boston, MA
| | - Yakeel T Quiroz
- Department of Neurology (JEB, ZY, KM, KVP, REA, PV, DMR, YTQ, KAJ, RAS, GAM, H-SY), Massachusetts General Hospital, Boston, MA; Department of Psychiatry (CM, YTQ, DB, JRG), Massachusetts General Hospital, Boston, MA; Harvard Medical School (CM, GM, BJH, KVP, REA, PV, DMR, YTQ, KAJ, RAS, DB, GAM, H-SY, JRG), Boston, MA
| | - Keith A Johnson
- Department of Neurology (JEB, ZY, KM, KVP, REA, PV, DMR, YTQ, KAJ, RAS, GAM, H-SY), Massachusetts General Hospital, Boston, MA; Department of Neurology (CM, KVP, REA, PV, DMR, KAJ, RAS, GAM, H-SY), Brigham and Women's Hospital, Boston, MA; Harvard Medical School (CM, GM, BJH, KVP, REA, PV, DMR, YTQ, KAJ, RAS, DB, GAM, H-SY, JRG), Boston, MA; Department of Radiology (KAJ), Massachusetts General Hospital, Boston, MA
| | - Reisa A Sperling
- Department of Neurology (JEB, ZY, KM, KVP, REA, PV, DMR, YTQ, KAJ, RAS, GAM, H-SY), Massachusetts General Hospital, Boston, MA; Department of Neurology (CM, KVP, REA, PV, DMR, KAJ, RAS, GAM, H-SY), Brigham and Women's Hospital, Boston, MA; Harvard Medical School (CM, GM, BJH, KVP, REA, PV, DMR, YTQ, KAJ, RAS, DB, GAM, H-SY, JRG), Boston, MA
| | - Deborah Blacker
- Department of Psychiatry (CM, YTQ, DB, JRG), Massachusetts General Hospital, Boston, MA; Harvard Medical School (CM, GM, BJH, KVP, REA, PV, DMR, YTQ, KAJ, RAS, DB, GAM, H-SY, JRG), Boston, MA; Department of Epidemiology (DB), Harvard T. H. Chan School of Public Health, Boston, MA
| | - Gad A Marshall
- Department of Neurology (JEB, ZY, KM, KVP, REA, PV, DMR, YTQ, KAJ, RAS, GAM, H-SY), Massachusetts General Hospital, Boston, MA; Department of Neurology (CM, KVP, REA, PV, DMR, KAJ, RAS, GAM, H-SY), Brigham and Women's Hospital, Boston, MA; Harvard Medical School (CM, GM, BJH, KVP, REA, PV, DMR, YTQ, KAJ, RAS, DB, GAM, H-SY, JRG), Boston, MA
| | - Hyun-Sik Yang
- Department of Neurology (JEB, ZY, KM, KVP, REA, PV, DMR, YTQ, KAJ, RAS, GAM, H-SY), Massachusetts General Hospital, Boston, MA; Department of Neurology (CM, KVP, REA, PV, DMR, KAJ, RAS, GAM, H-SY), Brigham and Women's Hospital, Boston, MA; Harvard Medical School (CM, GM, BJH, KVP, REA, PV, DMR, YTQ, KAJ, RAS, DB, GAM, H-SY, JRG), Boston, MA
| | - Jennifer R Gatchel
- Department of Psychiatry (CM, YTQ, DB, JRG), Massachusetts General Hospital, Boston, MA; Harvard Medical School (CM, GM, BJH, KVP, REA, PV, DMR, YTQ, KAJ, RAS, DB, GAM, H-SY, JRG), Boston, MA; Department of Psychiatry (JRG), Massachusetts General Hospital, Boston MA; Department of Psychiatry (JRG), McLean Hospital, Belmont, MA; Department of Psychiatry (JRG), Baylor College of Medicine, Houston, TX; Michael E. DeBakey VA Medical Center (JRG), Houston, TX.
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Dubbelman MA, Hall TC, Levesque IM, Mimmack KJ, Sikkes SAM, Fischer SH, Rentz DM, Sperling RA, Papp KV, Amariglio RE, Marshall GA. Using a digital tool to detect early changes in everyday functioning in older adults: A pilot study of the Assessment of Smartphone Everyday Tasks (ASSET). Alzheimers Dement (Amst) 2023; 15:e12506. [PMID: 38111596 PMCID: PMC10725838 DOI: 10.1002/dad2.12506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 10/27/2023] [Indexed: 12/20/2023]
Abstract
INTRODUCTION To investigate the utility of a new digital tool for measuring everyday functioning in preclinical Alzheimer's disease, we piloted the Assessment of Smartphone Everyday Tasks (ASSET) application. METHODS Forty-six participants (50.3 ± 27.1 years; 67% female; 20 young unimpaired, 17 old unimpaired, 9 mildly cognitively impaired) completed ASSET 7 times. ASSET comprises two main tasks, simulating a Patient Portal and a Calendar. We assessed ASSET's internal consistency, test-retest reliability, and user experience. RESULTS ASSET main tasks correlated with each other (r = 0.75, 95% confidence interval [CI] = [0.58, 0.86]). Performance on ASSET's Patient Portal related to cognition (r = 0.64, 95% CI = [0.42, 0.79]) and observer ratings of everyday functioning (r = 0.57, 95% CI = [0.24, 0.79]). Test-retest reliability was good (intraclass correlation coefficient = 0.87, 95% CI = [0.77, 0.93]). Most participants rated their experience with ASSET neutrally or positively. DISCUSSION ASSET is a promising smartphone-based digital assessment of everyday functioning. Future studies may investigate its utility for early diagnosis and evaluation of treatment of Alzheimer's disease.
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Affiliation(s)
- Mark A. Dubbelman
- Department of NeurologyMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
- Department of NeurologyCenter for Alzheimer Research and TreatmentBrigham and Women's HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Tia C. Hall
- Department of NeurologyCenter for Alzheimer Research and TreatmentBrigham and Women's HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Isabella M. Levesque
- Department of NeurologyCenter for Alzheimer Research and TreatmentBrigham and Women's HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Kayden J. Mimmack
- Department of NeurologyMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Sietske A. M. Sikkes
- Department of NeurologyAlzheimer Center AmsterdamVrije Universiteit AmsterdamAmsterdamThe Netherlands
- Faculty of Behavioral and Movement SciencesClinical Developmental Psychology and Clinical NeuropsychologyVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | | | - Dorene M. Rentz
- Department of NeurologyMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
- Department of NeurologyCenter for Alzheimer Research and TreatmentBrigham and Women's HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Reisa A. Sperling
- Department of NeurologyMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
- Department of NeurologyCenter for Alzheimer Research and TreatmentBrigham and Women's HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Kathryn V. Papp
- Department of NeurologyMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
- Department of NeurologyCenter for Alzheimer Research and TreatmentBrigham and Women's HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Rebecca E. Amariglio
- Department of NeurologyMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
- Department of NeurologyCenter for Alzheimer Research and TreatmentBrigham and Women's HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Gad A. Marshall
- Department of NeurologyMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
- Department of NeurologyCenter for Alzheimer Research and TreatmentBrigham and Women's HospitalHarvard Medical SchoolBostonMassachusettsUSA
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7
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Robinson T, Klinger H, Buckley R, Deters KD, Quiroz YT, Rentz D, Rabin JS, Sperling RA, Amariglio RE. Subjective cognitive decline across ethnoracial groups in the A4 study. Alzheimers Dement 2023; 19:4084-4093. [PMID: 37218387 PMCID: PMC10524317 DOI: 10.1002/alz.13138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 03/29/2023] [Accepted: 04/24/2023] [Indexed: 05/24/2023]
Abstract
INTRODUCTION The associations between subjective cognitive decline (SCD), cognition, and amyloid were explored across diverse participants in the A4 study. METHODS Five thousand one hundred and fifty-one non-Hispanic White, 262 non-Hispanic Black, 179 Hispanic-White, and 225 Asian participants completed the Preclinical Alzheimer Cognitive Composite (PACC), self- and study partner-reported Cognitive Function Index (CFI). A subsample underwent amyloid positron emission tomography (18 F-florbetapir) (N = 4384). We examined self-reported CFI, PACC, amyloid, and study partner-reported CFI by ethnoracial group. RESULTS The associations between PACC-CFI and amyloid-CFI were moderated by race. The relationships were weaker or non-significant in non-Hispanic Black and Hispanic White groups. Depression and anxiety scores were stronger predictors of CFI in these groups. Despite group differences in the types of study partners, self- and study partner-CFI were congruent across groups. DISCUSSION SCD may not uniformly relate to cognition or AD biomarkers in different ethnoracial groups. Nonetheless, self- and study partner-SCD were congruent despite differences in study partner type. Highlights Association between SCD and objective cognition was moderated by ethnoracial group. Association between SCD and amyloid was moderated by ethnoracial group. Depression and anxiety were stronger predictors of SCD in Black and Hispanic groups. Study-partner and self-reported SCD are congruent across groups. Study-partner report was consistent despite difference in study partner types.
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Affiliation(s)
- Talia Robinson
- Department of Neurology, Brigham and Women’s Hospital and Harvard Medical School, Boston MA, 02115, USA
| | - Hannah Klinger
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, USA
| | - Rachel Buckley
- Department of Neurology, Brigham and Women’s Hospital and Harvard Medical School, Boston MA, 02115, USA
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, USA
- Melbourne School of Psychological Science and Florey Institute, University of Melbourne, Victoria, 3052, Australia
| | - Kacie D. Deters
- Department of Integrative Biology and Physiology, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Yakeel T. Quiroz
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, USA
| | - Dorene Rentz
- Department of Neurology, Brigham and Women’s Hospital and Harvard Medical School, Boston MA, 02115, USA
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, USA
- Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women’s Hospital, Boston, Massachusetts, 02115, USA
| | - Jennifer S. Rabin
- Harquail Centre for Neuromodulation, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario, Canada, M4N 3M5
- Rehabilitation Sciences Institute, University of Toronto, Canada, M5G 1V7
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Reisa A. Sperling
- Department of Neurology, Brigham and Women’s Hospital and Harvard Medical School, Boston MA, 02115, USA
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, USA
- Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women’s Hospital, Boston, Massachusetts, 02115, USA
| | - Rebecca E. Amariglio
- Department of Neurology, Brigham and Women’s Hospital and Harvard Medical School, Boston MA, 02115, USA
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, USA
- Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women’s Hospital, Boston, Massachusetts, 02115, USA
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8
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Dubbelman MA, Mimmack KJ, Sprague EH, Amariglio RE, Vannini P, Marshall GA. Regional cerebral tau predicts decline in everyday functioning across the Alzheimer's disease spectrum. Alzheimers Res Ther 2023; 15:120. [PMID: 37408004 PMCID: PMC10320884 DOI: 10.1186/s13195-023-01267-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 06/29/2023] [Indexed: 07/07/2023]
Abstract
BACKGROUND Emerging difficulty performing cognitively complex everyday tasks, or 'instrumental activities of daily living' (IADL) may be an early clinical sign of Alzheimer's disease (AD). We aimed to investigate how changes over time in everyday functioning relate to cerebral tau burden across the AD clinical spectrum. METHODS We included 581 participants (73.9 ± 7.6 years old; 52% female) from the Alzheimer's Disease Neuroimaging Initiative who underwent tau positron emission tomography (PET) and completed at least two assessments of the Functional Activities Questionnaire (FAQ). Participants were classified as cognitively normal (n = 334) or symptomatic (n = 247). We analyzed the association between longitudinal FAQ scores and baseline tau in six temporal, parietal, and frontal brain regions in mixed-effects models. Models were run in the entire sample, as well as stratified by diagnostic group (cognitively normal or symptomatic). We additionally investigated tau-PET adjusted for, as well as interacting with, amyloid-β. RESULTS Greater tau burden in several frontal, temporal, and parietal regions was associated with steeper decline over time in everyday functioning. These findings remained when adjusting for baseline global cortical amyloid-β; amyloid-β itself was only associated with change over time in FAQ scores when tau was not included in the model. When stratifying by diagnostic group, most associations between tau and everyday functioning, adjusted for amyloid-β, were present only in the symptomatic group. CONCLUSIONS The rate of change in everyday functioning is related to baseline tau burden in various brain regions, more strongly so than global cortical amyloid-β, specifically in cognitively symptomatic individuals. Longitudinal studies in incident dementia populations are needed to better understand functional changes in response to AD pathology across the disease.
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Affiliation(s)
- Mark A Dubbelman
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
- Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, 60 Fenwood Road, Boston, MA, 02115, USA.
| | - Kayden J Mimmack
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Emily H Sprague
- Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, 60 Fenwood Road, Boston, MA, 02115, USA
| | - Rebecca E Amariglio
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, 60 Fenwood Road, Boston, MA, 02115, USA
| | - Patrizia Vannini
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, 60 Fenwood Road, Boston, MA, 02115, USA
| | - Gad A Marshall
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, 60 Fenwood Road, Boston, MA, 02115, USA
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9
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Hampton OL, Mukherjee S, Properzi MJ, Schultz AP, Crane PK, Gibbons LE, Hohman TJ, Maruff P, Lim YY, Amariglio RE, Papp KV, Johnson KA, Rentz DM, Sperling RA, Buckley RF. Harmonizing the preclinical Alzheimer cognitive composite for multicohort studies. Neuropsychology 2023; 37:436-449. [PMID: 35862098 PMCID: PMC9859944 DOI: 10.1037/neu0000833] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVES Studies are increasingly examining research questions across multiple cohorts using data from the preclinical Alzheimer cognitive composite (PACC). Our objective was to use modern psychometric approaches to develop a harmonized PACC. METHOD We used longitudinal data from the Alzheimer's Disease Neuroimaging Initiative (ADNI), Harvard Aging Brain Study (HABS), and Australian Imaging, Biomarker and Lifestyle Study of Ageing (AIBL) cohorts (n = 2,712). We further demonstrated our method with the Anti-Amyloid Treatment of Asymptomatic Alzheimer's Disease (A4) Study prerandomized data (n = 4,492). For the harmonization method, we used confirmatory factor analysis (CFA) on the final visit of the longitudinal cohorts to determine parameters to generate latent PACC (lPACC) scores. Overlapping tests across studies were set as "anchors" that tied cohorts together, while parameters from unique tests were freely estimated. We performed validation analyses to assess the performance of lPACC versus the common standardized PACC (zPACC). RESULTS Baseline (BL) scores for the zPACC were centered on zero, by definition. The harmonized lPACC did not define a common mean of zero and demonstrated differences in baseline ability levels across the cohorts. Baseline lPACC slightly outperformed zPACC in the prediction of progression to dementia. Longitudinal change in the lPACC was more constrained and less variable relative to the zPACC. In combined-cohort analyses, longitudinal lPACC slightly outperformed longitudinal zPACC in its association with baseline β-amyloid status. CONCLUSIONS This study proposes procedures for harmonizing the PACC that make fewer strong assumptions than the zPACC, facilitating robust multicohort analyses. This implementation of item response theory lends itself to adapting across future cohorts with similar composites. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Olivia L. Hampton
- Department of Neurology, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, United States
| | - Shubhabrata Mukherjee
- Department of Medicine, Division of General Internal Medicine, University of Washington
| | - Michael J. Properzi
- Department of Neurology, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, United States
| | - Aaron P. Schultz
- Department of Neurology, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, United States
| | - Paul K. Crane
- Department of Medicine, Division of General Internal Medicine, University of Washington
| | - Laura E. Gibbons
- Department of Medicine, Division of General Internal Medicine, University of Washington
| | - Timothy J. Hohman
- Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee, United States
| | - Paul Maruff
- Cogstate Ltd., Melbourne, Victoria, Australia
| | - Yen Ying Lim
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia
| | - Rebecca E. Amariglio
- Department of Neurology, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, United States
- Department of Neurology, Brigham and Women’s Hospital, Center for Alzheimer Research and Treatment, Boston, Massachusetts, United States
| | - Kathryn V. Papp
- Department of Neurology, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, United States
- Department of Neurology, Brigham and Women’s Hospital, Center for Alzheimer Research and Treatment, Boston, Massachusetts, United States
| | - Keith A. Johnson
- Department of Neurology, Brigham and Women’s Hospital, Center for Alzheimer Research and Treatment, Boston, Massachusetts, United States
- Department of Radiology, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, United States
| | - Dorene M. Rentz
- Department of Neurology, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, United States
- Department of Neurology, Brigham and Women’s Hospital, Center for Alzheimer Research and Treatment, Boston, Massachusetts, United States
| | - Reisa A. Sperling
- Department of Neurology, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, United States
- Department of Neurology, Brigham and Women’s Hospital, Center for Alzheimer Research and Treatment, Boston, Massachusetts, United States
| | - Rachel F. Buckley
- Department of Neurology, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, United States
- Department of Neurology, Brigham and Women’s Hospital, Center for Alzheimer Research and Treatment, Boston, Massachusetts, United States
- Melbourne School of Psychological Science, University of Melbourne
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10
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Rabin LA, Sikkes SA, Tommet D, Jones RN, Crane PK, Elbulok-Charcape MM, Dubbelman MA, Koscik R, Amariglio RE, Buckley RF, Boada M, Chételat G, Dubois B, Ellis KA, Gifford KA, Jefferson AL, Jessen F, Johnson S, Katz MJ, Lipton RB, Luck T, Margioti E, Maruff P, Molinuevo JL, Perrotin A, Petersen RC, Rami L, Reisberg B, Rentz DM, Riedel-Heller SG, Risacher SL, Rodriguez-Gomez O, Sachdev PS, Saykin AJ, Scarmeas N, Smart C, Snitz BE, Sperling RA, Taler V, van der Flier WM, van Harten AC, Wagner M, Wolfsgruber S. Linking self-perceived cognitive functioning questionnaires using item response theory: The subjective cognitive decline initiative. Neuropsychology 2023; 37:463-499. [PMID: 37276136 PMCID: PMC10564559 DOI: 10.1037/neu0000888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023] Open
Abstract
OBJECTIVE Self-perceived cognitive functioning, considered highly relevant in the context of aging and dementia, is assessed in numerous ways-hindering the comparison of findings across studies and settings. Therefore, the present study aimed to link item-level self-report questionnaire data from international aging studies. METHOD We harmonized secondary data from 24 studies and 40 different questionnaires with item response theory (IRT) techniques using a graded response model with a Bayesian estimator. We compared item information curves to identify items with high measurement precision at different levels of the self-perceived cognitive functioning latent trait. Data from 53,030 neuropsychologically intact older adults were included, from 13 English language and 11 non-English (or mixed) language studies. RESULTS We successfully linked all questionnaires and demonstrated that a single-factor structure was reasonable for the latent trait. Items that made the greatest contribution to measurement precision (i.e., "top items") assessed general and specific memory problems and aspects of executive functioning, attention, language, calculation, and visuospatial skills. These top items originated from distinct questionnaires and varied in format, range, time frames, response options, and whether they captured ability and/or change. CONCLUSIONS This was the first study to calibrate self-perceived cognitive functioning data of geographically diverse older adults. The resulting item scores are on the same metric, facilitating joint or pooled analyses across international studies. Results may lead to the development of new self-perceived cognitive functioning questionnaires guided by psychometric properties, content, and other important features of items in our item bank. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Laura A. Rabin
- Department of Psychology, Brooklyn College, Brooklyn, NY, USA and The Graduate Center of CUNY, NY, NY, USA
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Sietske A.M. Sikkes
- Epidemiology and Data Science, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands
| | - Douglas Tommet
- Department of Psychiatry and Human Behavior and Neurology, Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Richard N. Jones
- Department of Psychiatry and Human Behavior and Neurology, Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Paul K. Crane
- Division of General Internal Medicine, University of Washington, Seattle, WA, USA
| | | | - Mark A. Dubbelman
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands
| | - Rebecca Koscik
- Wisconsin Alzheimer's Institute University of Wisconsin School of Medicine and Public Health Madison WI, USA
- Department of Medicine, University of Wisconsin School of Medicine and Public Health Madison WI, USA
| | - Rebecca E. Amariglio
- Department of Neurology, Brigham and Women’s Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Rachel F. Buckley
- Department of Neurology, Brigham and Women’s Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry and Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Mercè Boada
- Alzheimer Research Center and Memory Clinic of Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain
| | - Gaël Chételat
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", NeuroPresage Team, Cyceron, 14000 Caen, France
| | - Bruno Dubois
- Université Pierre et Marie Curie-Paris 6, AP-HP, Hôpital de la Salpêtrière, Paris, France
- Centre des Maladies Cognitives et Comportementales, Institut du Cerveau et de la Moelle épinière (ICM), UMRS975, Paris, France
| | - Kathryn A. Ellis
- Department of Psychiatry and Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Katherine A. Gifford
- Vanderbilt Memory & Alzheimer’s Center, Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Angela L. Jefferson
- Vanderbilt Memory & Alzheimer’s Center, Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Frank Jessen
- Department of Psychiatry and Psychotherapy, Medical Faculty, University of Cologne, Cologne, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Sterling Johnson
- Geriatric Research Education and Clinical Center William S. Middleton Memorial Veterans Hospital Madison WI, USA
- University of Wisconsin School of Medicine and Public Health, Madison WI, USA
| | - Mindy J. Katz
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Richard B. Lipton
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
- Department of Psychiatry and Behavioral Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Tobias Luck
- Faculty of Applied Social Sciences, University of Applied Sciences Erfurt, Erfurt, Germany
| | - Eleni Margioti
- Laboratory of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Aviv Clinics, Jumeirah Lake Towers, Dubai, United Arab Emirates
| | | | - Jose Luis Molinuevo
- Alzheimer’s Disease and Other Cognitive Disorders Unit, IDIBAPS, Hospital Clinic, Barcelona, Spain
| | - Audrey Perrotin
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", NeuroPresage Team, Cyceron, 14000 Caen, France
| | - Ronald C. Petersen
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Lorena Rami
- Alzheimer’s Disease and Other Cognitive Disorders Unit, IDIBAPS, Hospital Clinic, Barcelona, Spain
| | - Barry Reisberg
- Department of Psychiatry, New York University Langone Medical Center, New York, NY, USA
- Silberstein Aging and Dementia Research Center, New York University School of Medicine, New York, NY, USA
| | - Dorene M. Rentz
- Department of Neurology, Brigham and Women’s Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Steffi G. Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
| | - Shannon L. Risacher
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA
- Indiana Alzheimer’s Disease Research Center, Indiana University School of Medicine, Indianapolis, IN
| | - Octavio Rodriguez-Gomez
- Alzheimer Research Center and Memory Clinic of Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain
| | - Perminder S. Sachdev
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Andrew J. Saykin
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA
- Indiana Alzheimer’s Disease Research Center, Indiana University School of Medicine, Indianapolis, IN
| | - Nikolaos Scarmeas
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Greece
- Department of Neurology, Columbia University, New York, USA
| | - Colette Smart
- Department of Psychology, University of Victoria, Victoria, BC, Canada
- Centre on Aging, University of Victoria, Victoria, BC, Canada
| | - Beth E. Snitz
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Reisa A. Sperling
- Department of Neurology, Brigham and Women’s Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Vanessa Taler
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
- Bruyère Research Institute, Ottawa, ON, Canada
| | - Wiesje M. van der Flier
- Epidemiology and Data Science, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
| | - Argonde C. van Harten
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
| | - Michael Wagner
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University of Bonn, Bonn, Germany
| | - Steffen Wolfsgruber
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Department of Psychiatry and Psychotherapy University of Bonn, Bonn, Germany
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11
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Gonzalez C, Mimmack KJ, Amariglio RE, Becker JA, Chhatwal JP, Fitzpatrick CD, Gatchel JR, Johnson KA, Katz ZS, Kuppe MK, Locascio JJ, Udeogu OJ, Papp KV, Premnath P, Properzi MJ, Rentz DM, Schultz AP, Sperling RA, Vannini P, Wang S, Marshall GA. Associations of the Harvard Automated Phone Task and Alzheimer's Disease Pathology in Cognitively Normal Older Adults: Preliminary Findings. J Alzheimers Dis 2023; 94:217-226. [PMID: 37212093 PMCID: PMC10330453 DOI: 10.3233/jad-220885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
BACKGROUND Detecting clinically meaningful changes in instrumental activities of daily living (IADL) at the earliest stages of Alzheimer's disease (AD) is critical. OBJECTIVE The objective of this exploratory study was to examine the cross-sectional relationship between a performance-based IADL test, the Harvard Automated Phone Task (APT), and cerebral tau and amyloid burden in cognitively normal (CN) older adults. METHODS Seventy-seven CN participants underwent flortaucipir tau and Pittsburgh Compound B amyloid PET. IADL were assessed using the three Harvard APT tasks: prescription refill (APT-Script), health insurance company call (APT-PCP), and bank transaction (APT-Bank). Linear regression models were used to determine associations between each APT task and entorhinal cortex, inferior temporal, or precuneus tau with or without an interaction with amyloid. RESULTS Significant associations were found between APT-Bank task rate and interaction between amyloid and entorhinal cortex tau, and APT-PCP task and interactions between amyloid and inferior temporal and precuneus tau. No significant associations were found between the APT tasks and tau or amyloid alone. CONCLUSION Our preliminary findings suggest an association between a simulated real-life IADL test and interactions of amyloid and several regions of early tau accumulation in CN older adults. However, some analyses were underpowered due to the small number of participants with elevated amyloid, and findings should be interpreted with caution. Future studies will further explore these associations cross-sectionally and longitudinally in order to determine whether the Harvard APT can serve as a reliable IADL outcome measure for preclinical AD prevention trials and ultimately in the clinic setting.
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Affiliation(s)
- Christopher Gonzalez
- Department of Psychology, Illinois Institute of Technology,
Chicago, IL 60616, USA
| | - Kayden J. Mimmack
- Department of Neurology, Massachusetts General Hospital,
Harvard Medical School, Boston, MA 02114, USA
| | - Rebecca E. Amariglio
- Department of Neurology, Massachusetts General Hospital,
Harvard Medical School, Boston, MA 02114, USA
- Center for Alzheimer Research and Treatment, Brigham and
Women’s Hospital, Harvard Medical School, Boston, MA, 02115, USA
- Department of Neurology, Brigham and Women’s
Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - J. Alex Becker
- Department of Radiology, Massachusetts General Hospital,
Harvard Medical School, Boston, MA 02114, USA
| | - Jasmeer P. Chhatwal
- Department of Neurology, Massachusetts General Hospital,
Harvard Medical School, Boston, MA 02114, USA
- Center for Alzheimer Research and Treatment, Brigham and
Women’s Hospital, Harvard Medical School, Boston, MA, 02115, USA
- Department of Neurology, Brigham and Women’s
Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Colleen D. Fitzpatrick
- Department of Neurology, Massachusetts General Hospital,
Harvard Medical School, Boston, MA 02114, USA
| | - Jennifer R. Gatchel
- Department of Psychiatry, Massachusetts General Hospital,
Harvard Medical School, Boston, MA 02114, USA
- Division of Geriatric Psychiatry, McLean Hospital, Harvard
Medical School, Belmont, MA 02478, USA
| | - Keith A. Johnson
- Department of Neurology, Massachusetts General Hospital,
Harvard Medical School, Boston, MA 02114, USA
- Department of Radiology, Massachusetts General Hospital,
Harvard Medical School, Boston, MA 02114, USA
- Center for Alzheimer Research and Treatment, Brigham and
Women’s Hospital, Harvard Medical School, Boston, MA, 02115, USA
- Department of Neurology, Brigham and Women’s
Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Zoe S. Katz
- Department of Neurology, Massachusetts General Hospital,
Harvard Medical School, Boston, MA 02114, USA
| | - Madeline K. Kuppe
- Cognitive Neuroimaging Laboratory, Graduate Program for
Neuroscience, Boston University, Boston, MA 02215, USA
| | - Joseph J. Locascio
- Department of Neurology, Massachusetts General Hospital,
Harvard Medical School, Boston, MA 02114, USA
| | - Onyinye J. Udeogu
- Department of Neurology, Massachusetts General Hospital,
Harvard Medical School, Boston, MA 02114, USA
| | - Kathryn V. Papp
- Department of Neurology, Massachusetts General Hospital,
Harvard Medical School, Boston, MA 02114, USA
- Center for Alzheimer Research and Treatment, Brigham and
Women’s Hospital, Harvard Medical School, Boston, MA, 02115, USA
- Department of Neurology, Brigham and Women’s
Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Pranitha Premnath
- Department of Psychology, The Graduate Center, City
University of New York, New York, NY 10016, USA
| | - Michael J. Properzi
- Department of Neurology, Massachusetts General Hospital,
Harvard Medical School, Boston, MA 02114, USA
| | - Dorene M. Rentz
- Department of Neurology, Massachusetts General Hospital,
Harvard Medical School, Boston, MA 02114, USA
- Center for Alzheimer Research and Treatment, Brigham and
Women’s Hospital, Harvard Medical School, Boston, MA, 02115, USA
- Department of Neurology, Brigham and Women’s
Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Aaron P. Schultz
- Department of Neurology, Massachusetts General Hospital,
Harvard Medical School, Boston, MA 02114, USA
| | - Reisa A. Sperling
- Department of Neurology, Massachusetts General Hospital,
Harvard Medical School, Boston, MA 02114, USA
- Center for Alzheimer Research and Treatment, Brigham and
Women’s Hospital, Harvard Medical School, Boston, MA, 02115, USA
- Department of Neurology, Brigham and Women’s
Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Patrizia Vannini
- Department of Neurology, Massachusetts General Hospital,
Harvard Medical School, Boston, MA 02114, USA
- Center for Alzheimer Research and Treatment, Brigham and
Women’s Hospital, Harvard Medical School, Boston, MA, 02115, USA
- Department of Neurology, Brigham and Women’s
Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Sharon Wang
- Department of Neurology, Massachusetts General Hospital,
Harvard Medical School, Boston, MA 02114, USA
| | - Gad A. Marshall
- Department of Neurology, Massachusetts General Hospital,
Harvard Medical School, Boston, MA 02114, USA
- Center for Alzheimer Research and Treatment, Brigham and
Women’s Hospital, Harvard Medical School, Boston, MA, 02115, USA
- Department of Neurology, Brigham and Women’s
Hospital, Harvard Medical School, Boston, MA, 02115, USA
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12
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Jutten RJ, Rentz DM, Amariglio RE, Properzi MJ, Maruff P, Johnson KA, Sperling RA, Papp KV. Fluctuations in reaction time performance as a marker of incipient amyloid‐related cognitive decline in clinically unimpaired older adults. Alzheimers Dement 2022. [DOI: 10.1002/alz.066578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Roos J. Jutten
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
| | - Dorene M. Rentz
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
- Brigham and Women’s Hospital, Harvard Medical School Boston MA USA
| | - Rebecca E. Amariglio
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
- Brigham and Women’s Hospital, Harvard Medical School Boston MA USA
| | | | - Paul Maruff
- Cogstate Ltd. Melbourne VIC Australia
- The Florey Institute of Neuroscience and Mental Health Melbourne VIC Australia
| | - Keith A. Johnson
- Massachusetts General Hospital, Brigham and Women’s Hospital,Harvard Medical School Boston MA USA
| | - Reisa A. Sperling
- Brigham and Women’s Hospital, Harvard Medical School Boston MA USA
- Massachusetts General Hospital, Brigham and Women’s Hospital,Harvard Medical School Boston MA USA
| | - Kathryn V. Papp
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
- Brigham and Women’s Hospital, Harvard Medical School Boston MA USA
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13
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Munro CE, Buckley RF, Vannini P, Hanseeuw B, Quiroz YT, Farrell ME, Rentz DM, Blacker D, Sperling RA, Johnson KA, Amariglio RE, Marshall GA, Gatchel JR. A longitudinal analysis of depressive symptoms in relation to repeated measurements of regional tau. Alzheimers Dement 2022. [DOI: 10.1002/alz.067697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
| | - Rachel F. Buckley
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
| | - Patrizia Vannini
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
| | - Bernard Hanseeuw
- Saint Luc University Hospital, Université Catholique de Louvain Brussels Belgium
- Harvard Medical School Boston MA USA
- Institute of Neuroscience, Université Catholique de Louvain Brussels Belgium
| | - Yakeel T. Quiroz
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia Medellin Colombia
| | - Michelle E. Farrell
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
- Athinoula A. Martinos Center for Biomedical Imaging Charlestown MA USA
| | - Dorene M. Rentz
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
- Brigham and Women’s Hospital, Harvard Medical School Boston MA USA
| | - Deborah Blacker
- Massachusetts General Hospital Boston MA USA
- Harvard University Boston MA USA
- Department of Epidemiology, Harvard T. H. Chan School of Public Health Boston MA USA
| | - Reisa A. Sperling
- Brigham and Women’s Hospital, Harvard Medical School Boston MA USA
- Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women’s Hospital Boston MA USA
- Massachusetts General Hospital and the Athinoula A Martinos Center for Biomedical Imaging Boston MA USA
| | - Keith A. Johnson
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
- Gordon Center for Medical Imaging, Massachusetts General Hospital, Harvard Medical School Boston MA USA
| | - Rebecca E. Amariglio
- Brigham and Women’s Hospital Boston MA USA
- Harvard Medical School Boston MA USA
- Massachusetts General Hospital Boston MA USA
| | - Gad A Marshall
- Massachusetts General Hospital Boston MA USA
- Center for Alzheimer’s Research and Treatment, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School Boston MA USA
| | - Jennifer R Gatchel
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
- McLean Hospital Belmont MA USA
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14
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Robinson TL, Klinger H, Buckley RF, Deters KD, Quiroz YT, Rentz DM, Sperling RA, Amariglio RE. Evaluation of ethnoracial differences in self‐ and study partner‐reported subjective cognitive decline in the A4 Study screen data. Alzheimers Dement 2022. [DOI: 10.1002/alz.066113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Talia L Robinson
- Harvard Partners Consortium / Harvard Medical School Boston MA USA
| | - Hannah Klinger
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
| | - Rachel F. Buckley
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
| | | | - Yakeel T. Quiroz
- Harvard Medical School, Massachusetts General Hospital Boston MA USA
| | - Dorene M. Rentz
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
| | - Reisa A. Sperling
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
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15
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Katz ZS, Mimmack KJ, Marshall GA, Blacker D, Amariglio RE, Munro CE, Rentz DM, Johnson KA, Sperling RA, Yang H, Gatchel JR. Association of Apathy with Amyloid‐β and Tau in Cognitively Unimpaired Older Adults: Findings from the Harvard Aging Brain Study. Alzheimers Dement 2022. [DOI: 10.1002/alz.067122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Zoe S Katz
- Massachusetts General Hospital Boston MA USA
- Brigham and Women’s Hospital Boston MA USA
| | - Kayden J. Mimmack
- Massachusetts General Hospital Boston MA USA
- Athinoula A. Martinos Center for Biomedical Imaging Charlestown MA USA
| | - Gad A Marshall
- Athinoula A. Martinos Center for Biomedical Imaging Charlestown MA USA
- Center for Alzheimer’s Research and Treatment, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School Boston MA USA
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
- Brigham and Women’s Hospital, Harvard Medical School Boston MA USA
| | - Deborah Blacker
- Massachusetts General Hospital Boston MA USA
- Department of Epidemiology, Harvard T. H. Chan School of Public Health Boston MA USA
| | - Rebecca E. Amariglio
- Athinoula A. Martinos Center for Biomedical Imaging Charlestown MA USA
- Center for Alzheimer’s Research and Treatment, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School Boston MA USA
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
- Brigham and Women’s Hospital, Harvard Medical School Boston MA USA
| | - Catherine E Munro
- Massachusetts General Hospital Boston MA USA
- Brigham and Women’s Hospital Boston MA USA
| | - Dorene M. Rentz
- Center for Alzheimer’s Research and Treatment, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School Boston MA USA
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
- Brigham and Women’s Hospital, Harvard Medical School Boston MA USA
| | - Keith A. Johnson
- Athinoula A. Martinos Center for Biomedical Imaging Charlestown MA USA
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
- Center for Alzheimer’s Research and Treatment, Brigham and Women’s Hospital/Harvard Medical School Boston MA USA
- Gordon Center for Medical Imaging, Massachusetts General Hospital, Harvard Medical School Boston MA USA
| | - Reisa A. Sperling
- Athinoula A. Martinos Center for Biomedical Imaging Charlestown MA USA
- Center for Alzheimer’s Research and Treatment, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School Boston MA USA
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
- Brigham and Women’s Hospital, Harvard Medical School Boston MA USA
| | - Hyun‐Sik Yang
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
- Brigham and Women’s Hospital, Harvard Medical School Boston MA USA
| | - Jennifer R Gatchel
- Athinoula A. Martinos Center for Biomedical Imaging Charlestown MA USA
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
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16
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Dubbelman MA, Hall TC, Levesque IM, Mimmack KJ, Sikkes SA, Fischer SH, Tatar D, Rentz DM, Sperling RA, Papp KV, Amariglio RE, Marshall GA. Assessing everyday functioning using a novel smartphone app in cognitively normal adults: A pilot study of the Assessment of Smartphone Everyday Tasks (ASSET). Alzheimers Dement 2022. [DOI: 10.1002/alz.063844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Mark A. Dubbelman
- Center for Alzheimer’s Research and Treatment, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School Boston MA USA
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Tia C. Hall
- Center for Alzheimer’s Research and Treatment, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School Boston MA USA
| | - Isabella M. Levesque
- Center for Alzheimer’s Research and Treatment, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School Boston MA USA
| | | | - Sietske A.M. Sikkes
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
- Faculty of Behavioural and Movement Sciences, Clinical Developmental Psychology & Clinical Neuropsychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands Amsterdam Netherlands
| | | | | | - Dorene M. Rentz
- Center for Alzheimer’s Research and Treatment, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School Boston MA USA
| | - Reisa A. Sperling
- Center for Alzheimer’s Research and Treatment, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School Boston MA USA
- Massachusetts General Hospital, Brigham and Women’s Hospital,Harvard Medical School Boston MA USA
| | - Kathryn V. Papp
- Center for Alzheimer’s Research and Treatment, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School Boston MA USA
| | - Rebecca E. Amariglio
- Center for Alzheimer’s Research and Treatment, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School Boston MA USA
| | - Gad A Marshall
- Center for Alzheimer’s Research and Treatment, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School Boston MA USA
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17
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Munro CE, Buckley RF, Vannini P, Hanseeuw B, Quiroz YT, Farrell ME, Rentz DM, Blacker D, Sperling RA, Johnson KA, Amariglio RE, Marshall GA, Gatchel JR. A longitudinal analysis of depressive symptoms in relation to repeated measurements of regional tau. Alzheimers Dement 2022. [DOI: 10.1002/alz.068136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
| | - Rachel F. Buckley
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
| | - Patrizia Vannini
- Brigham and Women's Hospital Boston MA USA
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
- Harvard Medical School Boston MA USA
| | - Bernard Hanseeuw
- Harvard Medical School Boston MA USA
- Massachusetts General Hospital Boston MA USA
- Institute of Neuroscience, Université Catholique de Louvain Brussels Belgium
| | - Yakeel T. Quiroz
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia Medellin Colombia
| | - Michelle E. Farrell
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
- Athinoula A. Martinos Center for Biomedical Imaging Charlestown MA USA
| | - Dorene M. Rentz
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School Boston MA USA
- Brigham and Women's Hospital, Harvard Medical School Boston MA USA
| | - Deborah Blacker
- Massachusetts General Hospital Boston MA USA
- Harvard University Boston MA USA
- Department of Epidemiology, Harvard T. H. Chan School of Public Health Boston MA USA
| | - Reisa A. Sperling
- Brigham and Women's Hospital Boston MA USA
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
- Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women’s Hospital Boston MA USA
| | - Keith A. Johnson
- Center for Alzheimer’s Research and Treatment, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School Boston MA USA
- Department of Radiology, Division of Molecular Imaging and Nuclear Medicine, Massachusetts General Hospital Boston MA USA
| | - Rebecca E. Amariglio
- Brigham and Women's Hospital Boston MA USA
- Harvard Medical School Boston MA USA
- Massachusetts General Hospital Boston MA USA
| | - Gad A Marshall
- Brigham and Women's Hospital Boston MA USA
- Massachusetts General Hospital Boston MA USA
- Center for Alzheimer’s Research and Treatment, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School Boston MA USA
| | - Jennifer R Gatchel
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
- McLean Hospital Belmont MA USA
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18
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Dubbelman MA, Sanchez JS, Schultz AP, Rentz DM, Amariglio RE, Sikkes SA, Sperling RA, Johnson KA, Marshall GA. The relationship between everyday functioning and cerebral tau burden in cognitively normal older adults. Alzheimers Dement 2022. [DOI: 10.1002/alz.062840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Mark A. Dubbelman
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Justin S Sanchez
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
| | - Aaron P. Schultz
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
| | - Dorene M. Rentz
- Center for Alzheimer’s Research and Treatment, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School Boston MA USA
| | - Rebecca E. Amariglio
- Center for Alzheimer’s Research and Treatment, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School Boston MA USA
| | - Sietske A.M. Sikkes
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
- Faculty of Behavioural and Movement Sciences, Clinical Developmental Psychology & Clinical Neuropsychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands, Amsterdam, Netherlands
| | - Reisa A. Sperling
- Center for Alzheimer’s Research and Treatment, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School Boston MA USA
- Massachusetts General Hospital, Brigham and Women’s Hospital, Harvard Medical School Boston MA USA
| | - Keith A. Johnson
- Massachusetts General Hospital, Brigham and Women’s Hospital, Harvard Medical School Boston MA USA
| | - Gad A Marshall
- Center for Alzheimer’s Research and Treatment, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School Boston MA USA
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19
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Boyle RT, Coughlan GT, Properzi MJ, Archdeacon C, Chou HL, Klinger H, Jacobs HI, Papp KV, Amariglio RE, Farrell ME, Donohue MC, Hohman TJ, Mormino EC, Hanseeuw BJ, Chhatwal JP, Rentz DM, Price JC, Johnson KA, Schultz AP, Sperling RA, Buckley RF. Defining the ATN framework using longitudinal biomarker trajectories reveals an emerging amyloid accumulation group. Alzheimers Dement 2022. [DOI: 10.1002/alz.068001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Rory Thomas Boyle
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
| | | | | | - Claire Archdeacon
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
| | | | - Hannah Klinger
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
| | - Heidi I.L. Jacobs
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
| | - Kathryn V. Papp
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
| | | | | | - Michael C. Donohue
- Alzheimer's Therapeutic Research Institute, Keck School of Medicine, University of Southern California San Diego CA USA
| | - Timothy J. Hohman
- Vanderbilt Memory & Alzheimer’s Center, Vanderbilt University Medical Center Nashville TN USA
| | | | | | | | - Dorene M. Rentz
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
| | - Julie C Price
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
| | - Keith A. Johnson
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
| | - Aaron P. Schultz
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
| | - Reisa A. Sperling
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
| | - Rachel F. Buckley
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
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20
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Papp KV, Amariglio RE. Boston Remote Assessment for Neurocognitive Health in preclinical AD. Alzheimers Dement 2022. [DOI: 10.1002/alz.059636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Kathryn V. Papp
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
- Center for Alzheimer Research and Treatment, Brigham and Womens Hospital, Harvard Medical School Boston MA USA
- Brigham and Women’s Hospital, Harvard Medical School Boston MA USA
| | - Rebecca E. Amariglio
- Massachusetts General Hospital Boston MA USA
- Harvard Medical School Boston MA USA
- Center for Alzheimer’s Research and Treatment, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School Boston MA USA
- Brigham and Women’s Hospital Boston MA USA
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21
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Weizenbaum EL, Soberanes D, Hsieh S, Schneider OR, Buckley RF, Properzi MJ, Rentz DM, Johnson KA, Sperling RA, Papp KV, Amariglio RE. Using a digital assessment of multi‐day learning curves to detect preclinical AD. Alzheimers Dement 2022. [DOI: 10.1002/alz.062194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Emma L Weizenbaum
- Harvard Medical School Boston MA USA
- Mass General Brigham Boston MA USA
| | | | - Stephanie Hsieh
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
| | | | - Rachel F. Buckley
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
| | | | - Dorene M. Rentz
- Brigham and Women’s Hospital, Harvard Medical School Boston MA USA
| | - Keith A. Johnson
- Massachusetts General Hospital, Brigham and Women’s Hospital,Harvard Medical School Boston MA USA
| | - Reisa A. Sperling
- Massachusetts General Hospital, Brigham and Women’s Hospital,Harvard Medical School Boston MA USA
| | - Kathryn V. Papp
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
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22
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Jutten RJ, Rentz DM, Fu JF, Mayblyum DV, Amariglio RE, Buckley RF, Properzi MJ, Maruff P, Stark CE, Yassa MA, Johnson KA, Sperling RA, Papp KV. Monthly At-Home Computerized Cognitive Testing to Detect Diminished Practice Effects in Preclinical Alzheimer's Disease. Front Aging Neurosci 2022; 13:800126. [PMID: 35095476 PMCID: PMC8792465 DOI: 10.3389/fnagi.2021.800126] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 12/14/2021] [Indexed: 01/12/2023] Open
Abstract
Introduction: We investigated whether monthly assessments of a computerized cognitive composite (C3) could aid in the detection of differences in practice effects (PE) in clinically unimpaired (CU) older adults, and whether diminished PE were associated with Alzheimer's disease (AD) biomarkers and annual cognitive decline. Materials and Methods: N = 114 CU participants (age 77.6 ± 5.0, 61% female, MMSE 29 ± 1.2) from the Harvard Aging Brain Study completed the self-administered C3 monthly, at-home, on an iPad for one year. At baseline, participants underwent in-clinic Preclinical Alzheimer's Cognitive Composite-5 (PACC5) testing, and a subsample (n = 72, age = 77.8 ± 4.9, 59% female, MMSE 29 ± 1.3) had 1-year follow-up in-clinic PACC5 testing available. Participants had undergone PIB-PET imaging (0.99 ± 1.6 years before at-home baseline) and Flortaucipir PET imaging (n = 105, 0.62 ± 1.1 years before at-home baseline). Linear mixed models were used to investigate change over months on the C3 adjusting for age, sex, and years of education, and to extract individual covariate-adjusted slopes over the first 3 months. We investigated the association of 3-month C3 slopes with global amyloid burden and tau deposition in eight predefined regions of interest, and conducted Receiver Operating Characteristic analyses to examine how accurately 3-month C3 slopes could identify individuals that showed >0.10 SD annual decline on the PACC-5. Results: Overall, individuals improved on all C3 measures over 12 months (β = 0.23, 95% CI [0.21-0.25], p < 0.001), but improvement over the first 3 months was greatest (β = 0.68, 95% CI [0.59-0.77], p < 0.001), suggesting stronger PE over initial repeated exposures. However, lower PE over 3 months were associated with more global amyloid burden (r = -0.20, 95% CI [-0.38 - -0.01], p = 0.049) and tau deposition in the entorhinal cortex (r = -0.38, 95% CI [-0.54 - -0.19], p < 0.001) and inferior-temporal lobe (r = -0.23, 95% CI [-0.41 - -0.02], p = 0.03). 3-month C3 slopes exhibited good discriminative ability to identify PACC-5 decliners (AUC 0.91, 95% CI [0.84-0.98]), which was better than baseline C3 (p < 0.001) and baseline PACC-5 scores (p = 0.02). Conclusion: While PE are commonly observed among CU adults, diminished PE over monthly cognitive testing are associated with greater AD biomarker burden and cognitive decline. Our findings imply that unsupervised computerized testing using monthly retest paradigms can provide rapid detection of diminished PE indicative of future cognitive decline in preclinical AD.
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Affiliation(s)
- Roos J. Jutten
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Dorene M. Rentz
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
- Department of Neurology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - Jessie F. Fu
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Danielle V. Mayblyum
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Rebecca E. Amariglio
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
- Department of Neurology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - Rachel F. Buckley
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Michael J. Properzi
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Paul Maruff
- CogState Ltd., Melbourne, VIC, Australia
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Craig E. Stark
- Department of Neurobiology and Behavior, Center for the Neurobiology of Learning and Memory, University of California, Irvine, Irvine, CA, United States
| | - Michael A. Yassa
- Department of Neurobiology and Behavior, Center for the Neurobiology of Learning and Memory, University of California, Irvine, Irvine, CA, United States
| | - Keith A. Johnson
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Reisa A. Sperling
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
- Department of Neurology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - Kathryn V. Papp
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
- Department of Neurology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
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23
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Dubbelman MA, Sanchez J, Schultz AP, Rentz DM, Amariglio RE, Sikkes SAM, Sperling RA, Johnson KA, Marshall GA. Everyday Functioning and Entorhinal and Inferior Temporal Tau Burden in Cognitively Normal Older Adults. J Prev Alzheimers Dis 2022; 9:801-808. [PMID: 36281685 DOI: 10.14283/jpad.2022.58] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
BACKGROUND Performance of cognitively complex "instrumental activities of daily living" (IADL) has previously been related to amyloid deposition in preclinical Alzheimer's disease. OBJECTIVES We aimed to investigate the relationship between IADL performance and cerebral tau accumulation in cognitively normal older adults. DESIGN Cross-sectional. SETTING Data was collected in the Anti-Amyloid Treatment in Asymptomatic Alzheimer's (A4) and Longitudinal Evaluation of Amyloid Risk and Neurodegeneration (LEARN) studies. PARTICIPANTS Participants (n = 447, age 71.9±4.9 years, 57.5% female) who underwent tau positron emission tomography were selected from the A4 and LEARN studies. MEASUREMENTS IADL performance was measured using the self- and study partner-reported versions of the Alzheimer's Disease Cooperative Study Activities of Daily Living - Prevention Instrument (ADCS ADL-PI). We also investigated discordance between participants and their study partners. Cross-sectional associations between entorhinal and inferior temporal tau (independent variables) and ADCS ADL-PI total scores, item-level scores and discordance (dependent variables) were investigated in linear and logistic regressions. Analyses were adjusted for age, sex and education and a tau by amyloid interaction was also included. RESULTS Participants and their study partners reported high levels of IADL performance. Entorhinal and inferior temporal tau were related to study partner but not to self-reported total ADCS ADL-PI scores. The association was not retained after adjustment for global cerebral amyloid burden. At the item level, greater entorhinal tau was associated with study partner-reported difficulties remembering important dates (odds ratio (OR) = 1.24, 95% confidence interval (95%CI) = [1.06, 1.45], p = 0.008) and difficulties remembering the details of TV programs and movies (OR = 1.32, 95%CI = [1.08, 1.61], p = 0.007). Greater inferior temporal tau was associated with self-reported difficulties managing to find personal belongings (OR = 1.23, 95%CI = [1.04, 1.46], p = 0.018) and study partner-reported difficulties remembering the details of TV programs and movies (OR = 1.39, 95%CI = [1.11, 1.75], p = 0.005). Discordance between participant and study partner-report was more likely with greater entorhinal (OR = 1.18, 95%CI = [1.05, 1.33], p = 0.005) and inferior temporal tau burden (OR = 1.29, 95%CI = [1.10, 1.51], p = 0.002). DISCUSSION We found a cross-sectional relationship between study partner-reported everyday functioning and tau in cognitively normal older adults. Participants were more likely to self-report difficulties differently from their study partners when tau burden was higher. This may hint at an altered early-disease awareness of functional changes and underscores the importance of self-report of IADL functioning in addition to collateral report by a study partner.
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Affiliation(s)
- M A Dubbelman
- Gad A. Marshall, MD, Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, 60 Fenwood Road, 9016P, Boston, MA 02115, P: 617-732-8085, F: 617-264-6831, E:
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Reynolds GO, Manning L, Kirn D, Klein H, Hampton O, Burke O, Buckley R, Rentz D, Sperling R, Marshall GA, Amariglio RE. Subjective Cognitive Decline in a Registry Sample: Relation to Psychiatric History, Loneliness, and Personality. J Prev Alzheimers Dis 2022; 9:435-440. [PMID: 35841244 PMCID: PMC8940594 DOI: 10.14283/jpad.2022.31] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 06/09/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND With the increasing focus on prevention of Alzheimer's disease, there is need for characterization of preclinical populations. Local participant registries offer an opportunity to facilitate research engagement via remote data collection, inform recruitment, and characterize preclinical samples, including individuals with subjective cognitive decline. OBJECTIVES We sought to characterize subjective cognitive decline in a registry sample, as related to psychiatric history and related variables, including personality and loneliness, quality of life, and factors related to dementia risk (e.g., family history of dementia). DESIGN, SETTING, PARTICIPANTS Participants were 366 individuals (mean age=67.2 (range 50-88), 65% female, 94% white, 97% non-Hispanic or Latino, 82% with at least a bachelor's degree) with no reported history of mild cognitive impairment or dementia. All participants had expressed interest in research, primarily via community outreach events and prior research involvement. Data was collected via electronic surveys, distributed using REDCap. Electronic questionnaires included questions on demographic variables, subjective cognitive decline, quality of life, loneliness, and personality. RESULTS There was a high prevalence of risk factors for dementia in the registry sample (68% with family history of dementia, 31% with subjective cognitive decline). Subjective cognitive decline was more common in women and associated with history of depression, but not with family history of dementia. Subjective cognitive decline was also associated with lower conscientiousness and lower emotional stability, as well as higher loneliness and lower quality of life. Among participants who endorsed a psychiatric history, most reported onset more than 10 years prior, rather than within the last 10 years. CONCLUSIONS Subjective cognitive decline in a registry sample may be more strongly associated with longstanding psychiatric and personality variables, rather than family history of dementia, adding to the literature on characterization of subjective cognitive decline across different settings. These findings highlight the acceptability of remote data collection and the potential of registries to inform recruitment by characterizing registrants, which may help to stratify dementia risk and match participants to eligible trials.
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Affiliation(s)
- G O Reynolds
- Gretchen Reynolds PhD, 60 Fenwood Road, Boston MA 02115, USA,
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25
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Grober E, Papp KV, Rentz DM, Sperling RA, Johnson KA, Amariglio RE, Schultz A, Lipton RB, Ezzati A. Neuroimaging correlates of Stages of Objective Memory Impairment (SOMI) system. Alzheimers Dement (Amst) 2021; 13:e12224. [PMID: 35005192 PMCID: PMC8719429 DOI: 10.1002/dad2.12224] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 06/11/2021] [Accepted: 06/11/2021] [Indexed: 06/14/2023]
Abstract
INTRODUCTION To assess the relationship between memory performance defined by the Stages of Objective Memory Impairment (SOMI) system and the Alzheimer's disease (AD) ATN (amyloid beta [A], pathologic tau [T], and neurodegeneration [N]) biomarker system. METHODS We used data from the Harvard Aging Brain Study cohort to estimate the level of ATN biomarkers: amyloid beta (C-Pittsburgh compound B-positron emission tomography [PET]), tau (F-18-flortaucipir [FTP] PET), and neurodegeneration (magnetic resonance imaging volumetrics). We assessed the cross-sectional relationship of SOMI classification with global amyloid levels, entorhinal and inferior temporal tau deposition, and hippocampal atrophy. RESULTS Participants with both memory storage and retrieval deficits (SOMI-3, -4) had smaller hippocampal volumes and higher entorhinal and inferior temporal tau burden than participants with no memory impairment (SOMI-0) or mild retrieval difficulty (SOMI-1). Amyloid burden did not differ among SOMI stages. DISCUSSION This pilot supports the close relationship between tau pathology and memory impairment across the AD continuum. SOMI may be useful to determine eligibility for randomized controlled trials prior to the assessment of biomarker status.
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Affiliation(s)
- Ellen Grober
- Department of NeurologyAlbert Einstein College of Medicine and Montefiore Medical CenterBronxNew YorkUSA
| | - Kathryn V. Papp
- Harvard Aging Brain StudyDepartment of NeurologyMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
- Center for Alzheimer Research and TreatmentDepartment of NeurologyBrigham and Women's HospitalBostonMassachusettsUSA
| | - Dorene M. Rentz
- Harvard Aging Brain StudyDepartment of NeurologyMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
- Center for Alzheimer Research and TreatmentDepartment of NeurologyBrigham and Women's HospitalBostonMassachusettsUSA
| | - Reisa A. Sperling
- Harvard Aging Brain StudyDepartment of NeurologyMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
- Center for Alzheimer Research and TreatmentDepartment of NeurologyBrigham and Women's HospitalBostonMassachusettsUSA
| | - Keith A. Johnson
- Harvard Aging Brain StudyDepartment of NeurologyMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
- Center for Alzheimer Research and TreatmentDepartment of NeurologyBrigham and Women's HospitalBostonMassachusettsUSA
| | - Rebecca E. Amariglio
- Harvard Aging Brain StudyDepartment of NeurologyMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
- Center for Alzheimer Research and TreatmentDepartment of NeurologyBrigham and Women's HospitalBostonMassachusettsUSA
| | - Aaron Schultz
- Harvard Aging Brain StudyDepartment of NeurologyMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Richard B. Lipton
- Department of NeurologyAlbert Einstein College of Medicine and Montefiore Medical CenterBronxNew YorkUSA
| | - Ali Ezzati
- Department of NeurologyAlbert Einstein College of Medicine and Montefiore Medical CenterBronxNew YorkUSA
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Babulal GM, Torres VL, Acosta DM, Aguero C, Aguilar‐Navarro SG, Amariglio RE, Ussui JA, Baena AY, Bocanegra Y, Brucki SMD, Bustin J, Cabrera D, Custodio N, Diaz MM, Duque L, Franco I, Gatchel JR, Garza‐Naveda AP, Gonzalez‐Lara M, Gutiérrez LA, Guzman‐Velez E, Hanseeuw BJ, Jiménez‐Velazquez IZ, Leon T, Llibre‐Guerra JJ, Marquine MJ, Martinez JE, Medina LD, Miranda‐Castillo C, Morlett A, Munera D, Nuñez‐Herrera A, de Oliveira MO, Cancel SP, Pardilla‐Delgado E, Perales J, Pluim CF, Ramirez‐Gomez LA, Rentz D, Rivera‐Fernandez C, Rosselli M, Serrano C, Suing MJ, Slachevsky A, Soto M, Sperling RA, Torrente F, Thumala D, Vannini P, Vila‐Castelar C, Escalante TMY, Quiroz YT. The impact of COVID‐19 on the well‐being and cognition of older adults living in the United States and Latin America. Alzheimers Dement 2021. [PMCID: PMC9011705 DOI: 10.1002/alz.055601] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Valeria L Torres
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
| | - Daisy M Acosta
- Universidad Nacional Pedro Henriquez Ureña Santo Domingo Dominican Republic
| | - Cinthya Aguero
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
| | | | | | - Juliana Aya Ussui
- Massachusetts General Hospital, Harvard Medical School Charlestown MA USA
| | - Ana Y Baena
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia Medellin Colombia
| | - Yamile Bocanegra
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia Medellin Colombia
| | - Sonia MD Brucki
- Cognitive and Behavioural Neurology Unit ‐ University of São Paulo São Paulo Brazil
| | | | - Diego Cabrera
- Universidad Peruana Cayetano Heredia San Martín de Porres Peru
| | | | | | | | | | | | | | - Mariana Gonzalez‐Lara
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán Distrito Federal DF Mexico
| | | | | | | | | | - Tomas Leon
- Memory and Neuropsychiatry Disorders Clinic (CMYN) Santiago Chile
| | | | | | - Jairo E Martinez
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
| | | | | | | | - Diana Munera
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
| | | | | | | | | | - Jaime Perales
- University of Kansas Alzheimer's Disease Center Fairway KS USA
| | - Celina F Pluim
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
| | | | | | | | | | | | - María Jose Suing
- Instituo Nacional de Ciencias Médicas y Nutrición Salvador Zubirán México DF Mexico
| | - Andrea Slachevsky
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Physiopathology Department ‐ ICBM, Neuroscience and East Neuroscience Departments, Faculty of Medicine, Universidad de Chile Santiago Chile
| | - Marcio Soto
- Universidad Nacional de San Agustin de Arequipa Arequipa Peru
| | - Reisa A Sperling
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
| | - Fernando Torrente
- Institute of Cognitive and Translational Neurosciences (CONICET ‐ Favaloro University ‐ INECO Foundation) Buenos Aires Argentina
| | | | - Patrizia Vannini
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
| | | | | | - Yakeel T Quiroz
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
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Papp KV, Rentz DM, Winskill C, Betensky RA, Amariglio RE, Schultz AP, Johnson KA, Sperling RA. Associations between biomarker status (amyloid, tau) and risk for progression to MCI/Dementia in the Harvard Aging Brain Study. Alzheimers Dement 2021. [DOI: 10.1002/alz.056231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Kate V. Papp
- Brigham and Women's Hospital Harvard Medical School Boston MA USA
| | - Dorene M. Rentz
- Center for Alzheimer’s Research and Treatment Department of Neurology Brigham and Women’s Hospital Harvard Medical School Boston MA USA
| | | | | | | | - Aaron P. Schultz
- Massachusetts General Hospital Harvard Medical School Department of Neurology Massachusetts General Hospital Harvard Medical School Boston MA USA
| | - Keith A. Johnson
- Center for Alzheimer’s Research and Treatment Department of Neurology Brigham and Women’s Hospital Harvard Medical School Boston MA USA
| | - Reisa A. Sperling
- Center for Alzheimer’s Research and Treatment Department of Neurology Brigham and Women’s Hospital Harvard Medical School Boston MA USA
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28
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Papp KV, Rentz DM, Buckley RF, Schneider OR, Hsieh S, Soberanes D, Properzi MJ, Schultz AP, Johnson KA, Sperling RA, Amariglio RE. Associations between remote cognitive testing on an individual’s own digital device and amyloid burden on neuroimaging in clinically normal older adults: Results from Boston Remote Assessment for Neurocognitive Health (BRANCH). Alzheimers Dement 2021. [DOI: 10.1002/alz.056209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Kate V. Papp
- Brigham and Women's Hospital, Harvard Medical School Boston MA USA
| | - Dorene M. Rentz
- Center for Alzheimer’s Research and Treatment, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School Boston MA USA
| | | | | | | | | | | | | | - Keith A. Johnson
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
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29
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Mayblyum DV, Premnath PY, Rubinstein ZB, Sanchez JS, Thibault EG, Farrell ME, Quiroz YT, Amariglio RE, Vannini P, Rentz DM, Sperling RA, Johnson KA, Blacker D, Marshall GA, Gatchel JR. Multimodal neuroimaging biomarkers of Alzheimer’s disease in older adults with depression: Preliminary findings from a pilot cohort. Alzheimers Dement 2021. [DOI: 10.1002/alz.057824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | | | | | | | | | | | | | - Rebecca E. Amariglio
- Massachusetts General Hospital Boston MA USA
- Brigham and Women's Hospital Boston MA USA
| | - Patrizia Vannini
- Massachusetts General Hospital Boston MA USA
- Brigham and Women's Hospital Boston MA USA
| | - Dorene M Rentz
- Massachusetts General Hospital Boston MA USA
- Brigham and Women's Hospital Boston MA USA
| | - Reisa A. Sperling
- Massachusetts General Hospital Boston MA USA
- Brigham and Women's Hospital Boston MA USA
| | - Keith A. Johnson
- Massachusetts General Hospital Boston MA USA
- Brigham and Women's Hospital Boston MA USA
| | | | - Gad A Marshall
- Massachusetts General Hospital Boston MA USA
- Brigham and Women's Hospital Boston MA USA
| | - Jennifer R Gatchel
- Massachusetts General Hospital Boston MA USA
- McLean Hospital Belmont MA USA
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30
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Kuppe MK, Gagliardi G, Gatchel JR, Munro CE, Marshall GA, Sperling RA, Amariglio RE, Vannini P. Resilience and perceived stress in cognitively normal older adults during the COVID‐19 pandemic. Alzheimers Dement 2021. [PMCID: PMC9011550 DOI: 10.1002/alz.056361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
| | - Geoffroy Gagliardi
- Massachusetts General Hospital Boston MA USA
- Brigham and Women's Hospital Boston MA USA
| | - Jennifer R Gatchel
- Massachusetts General Hospital Boston MA USA
- McLean Hospital Belmont MA USA
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
- Harvard Medical School Boston MA USA
- Athinoula A. Martinos Center for Biomedical Imaging Charlestown MA USA
| | - Catherine E Munro
- Massachusetts General Hospital Boston MA USA
- Brigham and Women's Hospital Boston MA USA
| | - Gad A Marshall
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
- Harvard Medical School Boston MA USA
- Center for Alzheimer Research and Treatment Boston MA USA
- Brigham and Women's Hospital, Harvard Medical School Boston MA USA
| | - Reisa A. Sperling
- Brigham and Women's Hospital Boston MA USA
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
- Athinoula A. Martinos Center for Biomedical Imaging Charlestown MA USA
- Center for Alzheimer Research and Treatment Boston MA USA
| | - Rebecca E. Amariglio
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
- Harvard Medical School Boston MA USA
- Brigham and Women's Hospital, Harvard Medical School Boston MA USA
- Center for Alzheimer Research and Treatment, Brigham and Women's Hospital Boston MA USA
| | - Patrizia Vannini
- Massachusetts General Hospital Boston MA USA
- Brigham and Women's Hospital Boston MA USA
- Harvard Medical School Boston MA USA
- Athinoula A. Martinos Center for Biomedical Imaging Charlestown MA USA
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31
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Gagliardi GP, Diez IP, Bueichekú E, Farrell ME, Kuppe MK, Marshall GA, Amariglio RE, Sepulcre J, Sperling RA, Vannini P. Trajectories of self‐rated concerns in individuals developing cognitive decline. Alzheimers Dement 2021. [DOI: 10.1002/alz.053152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Geoffroy Pierre Gagliardi
- Brigham and Women's Hospital Boston MA USA
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
| | - Ibai Palacio Diez
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
| | - Elisenda Bueichekú
- Massachusetts General Hospital, Athinoula A. Martinos Center for Biomedical Imaging, Harvard Medical School Boston MA USA
| | - Michelle E. Farrell
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School Charlestown MA USA
| | | | - Gad A Marshall
- Brigham and Women's Hospital Boston MA USA
- Massachusetts General Hospital Boston MA USA
- Harvard Medical School Boston MA USA
- Center for Alzheimer Research and Treatment, Brigham and Women's Hospital Boston MA USA
| | - Rebecca E. Amariglio
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
- Center for Alzheimer Research and Treatment, Brigham and Women's Hospital Boston MA USA
- Brigham and Women's Hospital, Harvard Medical School Boston MA USA
| | - Jorge Sepulcre
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
| | - Reisa A. Sperling
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School Charlestown MA USA
- Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Harvard Medical School Boston MA USA
| | - Patrizia Vannini
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
- Harvard Medical School Boston MA USA
- Brigham and Women's Hospital, Harvard Medical School Boston MA USA
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Vannini P, Gagliardi G, Kuppe MK, Dossett M, Donovan N, Gatchel JR, Quiroz YT, Premnath PY, Amariglio RE, Sperling RA, Marshall GA. Greater psychological resilience during the COVID‐19 pandemic is associated with lower tau burden in cognitively unimpaired individuals. Alzheimers Dement 2021. [PMCID: PMC9011472 DOI: 10.1002/alz.053952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Background The outbreak of the 2019 novel coronavirus SARS‐CoV‐2, causing the COVID‐19 pandemic, along with the global measures used to control the spread of the disease, have been particularly stressful for older individuals. Robust evidence suggests that stress‐related physiological processes may play a significant role in the onset of age‐related cognitive decline and dementia, such as Alzheimer’s disease (AD). For example, previous animal and human research have shown that stress exacerbates tau pathology and subsequent cognitive impairment. One important factor determining a person’s level of stress is psychological resilience, which refers to a person’s ability to return to equilibrium when difficulties occur. As such, resilience may buffer and protect individuals against the deleterious effects of stress. The objectives of this study were to examine the relationship between psychological resilience and tau burden in cognitively unimpaired individuals, and to evaluate whether amyloid (Aß) pathology modifies this relationship. Method A total of 114 older adults (mean age=74.5;66 females (57.9%)) enrolled in the Harvard Aging Brain Study or the Instrumental Activities of Daily Living study completed an electronic survey online including measures of psychological resilience (Connor‐Davidson Resilience Scale‐10, where a higher score indicates greater resilience) during the COVID‐19 pandemic period (May 2020). We used previously collected (mean time from survey=1.75 year) PET imaging data to assess Aß and tau burden. Results Overall, participants demonstrated high levels of resilience (mean=29.5,range=9‐40). Multiple regression analyses (correcting for age, gender and time difference between survey and PET) demonstrated an interaction between resilience and amyloid on tau pathology (ß=‐0.01,p=0.015, Figure1). Specifically, in Aß+ individuals (SUVR>1.324), those with higher psychological resilience also had lower tau pathology. No relationship was seen in Aß‐ individuals. Conclusion Our findings suggest that greater resilience during the pandemic is associated with lower tau burden in individuals at higher risk of cognitive decline (i.e. preclinical AD). Future studies are needed to determine the impact of stress and psychological resilience on prospective pathological brain changes and subsequent cognitive decline. Furthermore, resilience may be an important target for interventions to support older adults navigating stressful situations and to lessen the influence of stressors on AD pathological processes.
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Affiliation(s)
- Patrizia Vannini
- Brigham and Women's Hospital, Harvard Medical School Boston MA USA
- Harvard Medical School Boston MA USA
- Athinoula A. Martinos Center for Biomedical Imaging Charlestown MA USA
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
| | - Geoffroy Gagliardi
- Massachusetts General Hospital Boston MA USA
- Brigham and Women's Hospital Boston MA USA
| | | | | | | | - Jennifer R Gatchel
- Harvard Medical School Boston MA USA
- Athinoula A. Martinos Center for Biomedical Imaging Charlestown MA USA
- Massachusetts General Hospital Boston MA USA
- McLean Hospital Belmont MA USA
| | - Yakeel T. Quiroz
- Harvard Medical School Boston MA USA
- Massachusetts General Hospital Boston MA USA
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia Medellin Colombia
| | | | - Rebecca E. Amariglio
- Brigham and Women's Hospital, Harvard Medical School Boston MA USA
- Harvard Medical School Boston MA USA
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
| | - Reisa A. Sperling
- Harvard Medical School Boston MA USA
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
- Brigham and Women's Hospital Boston MA USA
| | - Gad A Marshall
- Harvard Medical School Boston MA USA
- Massachusetts General Hospital Boston MA USA
- Brigham and Women's Hospital Boston MA USA
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Jutten RJ, Amariglio RE, Properzi MJ, Buckley RF, Maruff PT, Stark CE, Yassa MA, Johnson KA, Sperling RA, Rentz DM, Papp KV. Monthly computerized at‐home assessments to detect cognitive change in preclinical Alzheimer’s disease. Alzheimers Dement 2021. [DOI: 10.1002/alz.056055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Roos J. Jutten
- Massachusetts General Hospital Boston MA USA
- Harvard Medical School Boston MA USA
| | - Rebecca E. Amariglio
- Harvard Medical School Boston MA USA
- Brigham and Women's Hospital, Harvard Medical School Boston MA USA
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
| | - Michael J Properzi
- Harvard Medical School Boston MA USA
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
| | - Rachel F. Buckley
- Harvard Medical School Boston MA USA
- Massachusetts General Hospital/Harvard Medical School Boston MA USA
- Melbourne School of Psychological Sciences, University of Melbourne Melbourne VIC Australia
| | - Paul T Maruff
- Cogstate Ltd. Melbourne VIC Australia
- The Florey Institute of Neuroscience and Mental Health Melbourne VIC Australia
| | | | | | - Keith A. Johnson
- Harvard Medical School Boston MA USA
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
| | - Reisa A. Sperling
- Harvard Medical School Boston MA USA
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
- Brigham and Women's Hospital Boston MA USA
| | - Dorene M. Rentz
- Harvard Medical School Boston MA USA
- Brigham and Women's Hospital, Harvard Medical School Boston MA USA
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
| | - Kate V. Papp
- Massachusetts General Hospital Boston MA USA
- Harvard Medical School Boston MA USA
- Brigham and Women's Hospital Boston MA USA
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Rodriguez‐Vieitez E, Montal V, Sepulcre J, Lois C, Hanseeuw B, Vilaplana E, Schultz AP, Properzi MJ, Scott MR, Amariglio RE, Papp KV, Marshall GA, Fortea J, Johnson KA, Sperling RA, Vannini P. Cortical microstructure is associated with tau burden and predicts cognitive decline and clinical progression in healthy older adults. Alzheimers Dement 2021. [DOI: 10.1002/alz.053011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Elena Rodriguez‐Vieitez
- Athinoula A. Martinos Center for Biomedical Imaging Charlestown MA USA
- Massachusetts General Hospital Harvard Medical School Boston MA USA
- Karolinska Institutet Stockholm Sweden
| | - Victor Montal
- CIBERNED Network Center for Biomedical Research in Neurodegenerative Diseases National Institute of Health Carlos III Madrid Spain
- Sant Pau Memory Unit Hospital de la Santa Creu i Sant Pau‐Biomedical Research Institute Sant Pau‐Universitat Autònoma de Barcelona Barcelona Spain
| | - Jorge Sepulcre
- Massachusetts General Hospital Harvard Medical School Boston MA USA
- Gordon Center for Medical Imaging Boston MA USA
| | - Cristina Lois
- Massachusetts General Hospital Harvard Medical School Boston MA USA
- Gordon Center for Medical Imaging Boston MA USA
| | - Bernard Hanseeuw
- Massachusetts General Hospital Harvard Medical School Boston MA USA
- Gordon Center for Medical Imaging Boston MA USA
- Saint Luc University Hospital Université Catholique de Louvain Brussels Belgium
| | - Eduard Vilaplana
- CIBERNED Network Center for Biomedical Research in Neurodegenerative Diseases National Institute of Health Carlos III Madrid Spain
- Sant Pau Memory Unit Hospital de la Santa Creu i Sant Pau‐Biomedical Research Institute Sant Pau‐Universitat Autònoma de Barcelona Barcelona Spain
| | - Aaron P. Schultz
- Athinoula A. Martinos Center for Biomedical Imaging Charlestown MA USA
- Massachusetts General Hospital Harvard Medical School Boston MA USA
| | - Michael J Properzi
- Athinoula A. Martinos Center for Biomedical Imaging Charlestown MA USA
- Massachusetts General Hospital Harvard Medical School Boston MA USA
| | - Matthew R. Scott
- Athinoula A. Martinos Center for Biomedical Imaging Charlestown MA USA
- Massachusetts General Hospital Harvard Medical School Boston MA USA
| | - Rebecca E. Amariglio
- Athinoula A. Martinos Center for Biomedical Imaging Charlestown MA USA
- Massachusetts General Hospital Harvard Medical School Boston MA USA
- Brigham and Women's Hospital Harvard Medical School Boston MA USA
| | - Kate V. Papp
- Athinoula A. Martinos Center for Biomedical Imaging Charlestown MA USA
- Massachusetts General Hospital Harvard Medical School Boston MA USA
- Brigham and Women's Hospital Harvard Medical School Boston MA USA
| | - Gad A Marshall
- Athinoula A. Martinos Center for Biomedical Imaging Charlestown MA USA
- Massachusetts General Hospital Harvard Medical School Boston MA USA
- Brigham and Women's Hospital Harvard Medical School Boston MA USA
| | - Juan Fortea
- CIBERNED Network Center for Biomedical Research in Neurodegenerative Diseases National Institute of Health Carlos III Madrid Spain
- Sant Pau Memory Unit Hospital de la Santa Creu i Sant Pau‐Biomedical Research Institute Sant Pau‐Universitat Autònoma de Barcelona Barcelona Spain
| | - Keith A. Johnson
- Massachusetts General Hospital Harvard Medical School Boston MA USA
- Gordon Center for Medical Imaging Boston MA USA
| | - Reisa A. Sperling
- Athinoula A. Martinos Center for Biomedical Imaging Charlestown MA USA
- Massachusetts General Hospital Harvard Medical School Boston MA USA
- Brigham and Women's Hospital Harvard Medical School Boston MA USA
| | - Patrizia Vannini
- Athinoula A. Martinos Center for Biomedical Imaging Charlestown MA USA
- Massachusetts General Hospital Harvard Medical School Boston MA USA
- Brigham and Women's Hospital Harvard Medical School Boston MA USA
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Gonzalez C, Premnath PY, Kuppe MK, Fitzpatrick CD, Properzi MJ, Becker A, Johnson KA, Rentz DM, Gatchel JR, Vannini P, Amariglio RE, Marshall GA. Association between the Harvard automated phone task and Alzheimer’s disease pathology in clinically normal older adults. Alzheimers Dement 2021. [DOI: 10.1002/alz.052879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Christopher Gonzalez
- Massachusetts General Hospital Boston MA USA
- Brigham and Women's Hospital Boston MA USA
| | | | | | | | | | - Alex Becker
- Massachusetts General Hospital Boston MA USA
| | - Keith A. Johnson
- Brigham and Women's Hospital Boston MA USA
- Center for Alzheimer’s Research and Treatment Department of Neurology Brigham and Women’s Hospital Harvard Medical School Boston MA USA
- Department of Neurology Massachusetts General Hospital Boston MA USA
| | - Dorene M. Rentz
- Massachusetts General Hospital Harvard Medical School Boston MA USA
- Center for Alzheimer’s Research and Treatment Department of Neurology Brigham and Women’s Hospital Harvard Medical School Boston MA USA
- Brigham and Women's Hospital Harvard Medical School Boston MA USA
| | | | - Patrizia Vannini
- Massachusetts General Hospital Harvard Medical School Boston MA USA
- Brigham and Women's Hospital Harvard Medical School Boston MA USA
- Center for Alzheimer Research and Treatment Brigham and Women's Hospital Boston MA USA
| | - Rebecca E. Amariglio
- Massachusetts General Hospital Harvard Medical School Boston MA USA
- Brigham and Women's Hospital Harvard Medical School Boston MA USA
- Center for Alzheimer Research and Treatment Brigham and Women's Hospital Boston MA USA
| | - Gad A. Marshall
- Massachusetts General Hospital Boston MA USA
- Brigham and Women's Hospital Boston MA USA
- Center for Alzheimer Research and Treatment Brigham and Women's Hospital Boston MA USA
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Munro CE, Buckley RF, Vannini P, Sperling RA, Rentz DM, Johnson KA, Gatchel JR, Amariglio RE. Longitudinal trajectories of remote assessment of self‐ and study partner‐rated cognitive concerns, mood and Alzheimer’s disease biomarkers. Alzheimers Dement 2021. [DOI: 10.1002/alz.052336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Catherine E Munro
- Brigham and Women’s Hospital/Massachusetts General Hospital Boston MA USA
| | - Rachel F. Buckley
- Harvard Medical School Boston MA USA
- Massachusetts General Hospital Boston MA USA
- Massachusetts General Hospital/Harvard Medical School Boston MA USA
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School Boston MA USA
| | - Patrizia Vannini
- Harvard Medical School Boston MA USA
- Brigham and Women's Hospital, Harvard Medical School Boston MA USA
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
| | - Reisa A. Sperling
- Harvard Medical School Boston MA USA
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School Boston MA USA
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
- Brigham and Women's Hospital Boston MA USA
- Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Harvard Medical School Boston MA USA
| | - Dorene M. Rentz
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School Boston MA USA
- Brigham and Women's Hospital, Harvard Medical School Boston MA USA
- Center for Alzheimer’s Research and Treatment, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School Boston MA USA
| | - Keith A. Johnson
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
- Brigham and Women's Hospital Boston MA USA
- Department of Neurology, Massachusetts General Hospital Boston MA USA
| | - Jennifer R Gatchel
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
- McLean Hospital Belmont MA USA
| | - Rebecca E. Amariglio
- Brigham and Women's Hospital, Harvard Medical School Boston MA USA
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
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Wang L, Laurentiev J, Yang J, Lo YC, Amariglio RE, Blacker D, Sperling RA, Marshall GA, Zhou L. Development and Validation of a Deep Learning Model for Earlier Detection of Cognitive Decline From Clinical Notes in Electronic Health Records. JAMA Netw Open 2021; 4:e2135174. [PMID: 34792589 PMCID: PMC8603078 DOI: 10.1001/jamanetworkopen.2021.35174] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
IMPORTANCE Detecting cognitive decline earlier among older adults can facilitate enrollment in clinical trials and early interventions. Clinical notes in longitudinal electronic health records (EHRs) provide opportunities to detect cognitive decline earlier than it is noted in structured EHR fields as formal diagnoses. OBJECTIVE To develop and validate a deep learning model to detect evidence of cognitive decline from clinical notes in the EHR. DESIGN, SETTING, AND PARTICIPANTS Notes documented 4 years preceding the initial mild cognitive impairment (MCI) diagnosis were extracted from Mass General Brigham's Enterprise Data Warehouse for patients aged 50 years or older and with initial MCI diagnosis during 2019. The study was conducted from March 1, 2020, to June 30, 2021. Sections of notes for cognitive decline were labeled manually and 2 reference data sets were created. Data set I contained a random sample of 4950 note sections filtered by a list of keywords related to cognitive functions and was used for model training and testing. Data set II contained 2000 randomly selected sections without keyword filtering for assessing whether the model performance was dependent on specific keywords. MAIN OUTCOMES AND MEASURES A deep learning model and 4 baseline models were developed and their performance was compared using the area under the receiver operating characteristic curve (AUROC) and area under the precision recall curve (AUPRC). RESULTS Data set I represented 1969 patients (1046 [53.1%] women; mean [SD] age, 76.0 [13.3] years). Data set II comprised 1161 patients (619 [53.3%] women; mean [SD] age, 76.5 [10.2] years). With some overlap of patients deleted, the unique population was 2166. Cognitive decline was noted in 1453 sections (29.4%) in data set I and 69 sections (3.45%) in data set II. Compared with the 4 baseline models, the deep learning model achieved the best performance in both data sets, with AUROC of 0.971 (95% CI, 0.967-0.976) and AUPRC of 0.933 (95% CI, 0.921-0.944) for data set I and AUROC of 0.997 (95% CI, 0.994-0.999) and AUPRC of 0.929 (95% CI, 0.870-0.969) for data set II. CONCLUSIONS AND RELEVANCE In this diagnostic study, a deep learning model accurately detected cognitive decline from clinical notes preceding MCI diagnosis and had better performance than keyword-based search and other machine learning models. These results suggest that a deep learning model could be used for earlier detection of cognitive decline in the EHRs.
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Affiliation(s)
- Liqin Wang
- Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - John Laurentiev
- Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Jie Yang
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Ying-Chih Lo
- Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Rebecca E. Amariglio
- Department of Neurology, Brigham and Women’s Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Deborah Blacker
- Department of Epidemiology, Harvard T. H. Chan School of Public Health and Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Reisa A. Sperling
- Department of Neurology, Brigham and Women’s Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Gad A. Marshall
- Department of Neurology, Brigham and Women’s Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Li Zhou
- Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
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Amariglio RE, Sikkes SAM, Marshall GA, Buckley RF, Gatchel JR, Johnson KA, Rentz DM, Donohue MC, Raman R, Sun CK, Yaari R, Holdridge KC, Sims JR, Grill JD, Aisen PS, Sperling RA. Item-Level Investigation of Participant and Study Partner Report on the Cognitive Function Index from the A4 Study Screening Data. J Prev Alzheimers Dis 2021; 8:257-262. [PMID: 34101781 PMCID: PMC8240963 DOI: 10.14283/jpad.2021.8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Greater subjective cognitive changes on the Cognitive Function Index (CFI) was previously found to be associated with elevated amyloid (Aß) status in participants screening for the A4 Study, reported by study partners and the participants themselves. While the total score on the CFI related to amyloid for both sources respectively, potential differences in the specific types of cognitive changes reported by either participants or their study partners was not investigated. OBJECTIVES To determine the specific types of subjective cognitive changes endorsed by participants and their study partners that are associated with amyloid status in individuals screening for an AD prevention trial. DESIGN, SETTING, PARTICIPANTS Four thousand four hundred and eighty-six cognitively unimpaired (CDR=0; MMSE 25-30) participants (ages 65-85) screening for the A4 Study completed florbetapir (Aß) Positron Emission Tomography (PET) imaging. Participants were classified as elevated amyloid (Aß+; n=1323) or non-elevated amyloid (Aß-; n=3163). MEASUREMENTS Prior to amyloid PET imaging, subjective report of changes in cognitive functioning were measured using the CFI (15 item questionnaire; Yes/Maybe/No response options) and administered separately to both participants and their study partners (i.e., a family member or friend in regular contact with the participant). The impact of demographic factors on CFI report was investigated. For each item of the CFI, the relationship between Aß and CFI response was investigated using an ordinal mixed effects model for participant and study partner report. RESULTS Independent of Aß status, participants were more likely to report 'Yes' or 'Maybe' compared to the study partners for nearly all CFI items. Older age (r= 0.06, p<0.001) and lower education (r=-0.08, p<0.001) of the participant were associated with higher CFI. Highest coincident odds ratios related to Aß+ for both respondents included items assessing whether 'a substantial decline in memory' had occurred in the last year (ORsp= 1.35 [95% CI 1.11, 1.63]; ORp= 1.55 [95% CI 1.34, 1.79]) and whether the participant had 'seen a doctor about memory' (ORsp= 1.56 [95% CI 1.25, 1.95]; ORp =1.71 [95% CI 1.37, 2.12]). For two items, associations were significant for only study partner report; whether the participant 'Repeats questions' (ORsp = 1.30 [95% CI 1.07, 1.57]) and has 'trouble following the news' (ORsp= 1.46[95% CI 1.12, 1.91]). One question was significant only for participant report; 'trouble driving' (ORp= 1.25 [95% CI 1.04, 1.49]). CONCLUSIONS Elevated Aβ is associated with greater reporting of subjective cognitive changes as measured by the CFI in this cognitively unimpaired population. While participants were more likely than study partners to endorse change on most CFI items, unique CFI items were associated with elevated Aß for participants and their study partners, supporting the value of both sources of information in clinical trials.
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Affiliation(s)
- R E Amariglio
- R.E. Amariglio, Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, 02115, USA,
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Papp KV, Samaroo A, Chou HC, Buckley R, Schneider OR, Hsieh S, Soberanes D, Quiroz Y, Properzi M, Schultz A, García-Magariño I, Marshall GA, Burke JG, Kumar R, Snyder N, Johnson K, Rentz DM, Sperling RA, Amariglio RE. Unsupervised mobile cognitive testing for use in preclinical Alzheimer's disease. Alzheimers Dement (Amst) 2021; 13:e12243. [PMID: 34621977 PMCID: PMC8481881 DOI: 10.1002/dad2.12243] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 07/08/2021] [Accepted: 08/03/2021] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Unsupervised digital cognitive testing is an appealing means to capture subtle cognitive decline in preclinical Alzheimer's disease (AD). Here, we describe development, feasibility, and validity of the Boston Remote Assessment for Neurocognitive Health (BRANCH) against in-person cognitive testing and amyloid/tau burden. METHODS BRANCH is web-based, self-guided, and assesses memory processes vulnerable in AD. Clinically normal participants (n = 234; aged 50-89) completed BRANCH; a subset underwent in-person cognitive testing and positron emission tomography imaging. Mean accuracy across BRANCH tests (Categories, Face-Name-Occupation, Groceries, Signs) was calculated. RESULTS BRANCH was feasible to complete on participants' own devices (primarily smartphones). Technical difficulties and invalid/unusable data were infrequent. BRANCH psychometric properties were sound, including good retest reliability. BRANCH was correlated with in-person cognitive testing (r = 0.617, P < .001). Lower BRANCH score was associated with greater amyloid (r = -0.205, P = .007) and entorhinal tau (r = -0.178, P = .026). DISCUSSION BRANCH reliably captures meaningful cognitive information remotely, suggesting promise as a digital cognitive marker sensitive early in the AD trajectory.
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Affiliation(s)
- Kathryn V Papp
- Center for Alzheimer Research and Treatment Department of Neurology Brigham and Women's Hospital Harvard Medical School Boston Massachusetts USA
- Department of Neurology Massachusetts General Hospital Massachusetts General Hospital Harvard Medical School Boston Massachusetts USA
| | - Aubryn Samaroo
- Department of Neurology Massachusetts General Hospital Massachusetts General Hospital Harvard Medical School Boston Massachusetts USA
| | - Hsiang-Chin Chou
- Department of Neurology Massachusetts General Hospital Massachusetts General Hospital Harvard Medical School Boston Massachusetts USA
| | - Rachel Buckley
- Center for Alzheimer Research and Treatment Department of Neurology Brigham and Women's Hospital Harvard Medical School Boston Massachusetts USA
- Department of Neurology Massachusetts General Hospital Massachusetts General Hospital Harvard Medical School Boston Massachusetts USA
- Melbourne School of Psychological Science University of Melbourne Melbourne Victoria Australia
| | - Olivia R Schneider
- Department of Neurology Massachusetts General Hospital Massachusetts General Hospital Harvard Medical School Boston Massachusetts USA
| | - Stephanie Hsieh
- Department of Neurology Massachusetts General Hospital Massachusetts General Hospital Harvard Medical School Boston Massachusetts USA
| | - Daniel Soberanes
- Center for Alzheimer Research and Treatment Department of Neurology Brigham and Women's Hospital Harvard Medical School Boston Massachusetts USA
| | - Yakeel Quiroz
- Department of Neurology Massachusetts General Hospital Massachusetts General Hospital Harvard Medical School Boston Massachusetts USA
| | - Michael Properzi
- Department of Neurology Massachusetts General Hospital Massachusetts General Hospital Harvard Medical School Boston Massachusetts USA
| | - Aaron Schultz
- Department of Neurology Massachusetts General Hospital Massachusetts General Hospital Harvard Medical School Boston Massachusetts USA
| | - Iván García-Magariño
- Department of Software Engineering and Artificial Intelligence Complutense University of Madrid Madrid Spain
- Instituto de Tecnología del Conocimiento UCM Madrid Spain
| | - Gad A Marshall
- Center for Alzheimer Research and Treatment Department of Neurology Brigham and Women's Hospital Harvard Medical School Boston Massachusetts USA
- Department of Neurology Massachusetts General Hospital Massachusetts General Hospital Harvard Medical School Boston Massachusetts USA
| | - Jane G Burke
- Department of Neurology Massachusetts General Hospital Massachusetts General Hospital Harvard Medical School Boston Massachusetts USA
| | - Raya Kumar
- Department of Neurology Massachusetts General Hospital Massachusetts General Hospital Harvard Medical School Boston Massachusetts USA
| | - Noah Snyder
- Department of Neurology Massachusetts General Hospital Massachusetts General Hospital Harvard Medical School Boston Massachusetts USA
| | - Keith Johnson
- Department of Neurology Massachusetts General Hospital Massachusetts General Hospital Harvard Medical School Boston Massachusetts USA
- Department of Radiology Massachusetts General Hospital Harvard Medical School Boston Massachusetts USA
| | - Dorene M Rentz
- Center for Alzheimer Research and Treatment Department of Neurology Brigham and Women's Hospital Harvard Medical School Boston Massachusetts USA
- Department of Neurology Massachusetts General Hospital Massachusetts General Hospital Harvard Medical School Boston Massachusetts USA
| | - Reisa A Sperling
- Center for Alzheimer Research and Treatment Department of Neurology Brigham and Women's Hospital Harvard Medical School Boston Massachusetts USA
- Department of Neurology Massachusetts General Hospital Massachusetts General Hospital Harvard Medical School Boston Massachusetts USA
| | - Rebecca E Amariglio
- Center for Alzheimer Research and Treatment Department of Neurology Brigham and Women's Hospital Harvard Medical School Boston Massachusetts USA
- Department of Neurology Massachusetts General Hospital Massachusetts General Hospital Harvard Medical School Boston Massachusetts USA
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Samaroo A, Amariglio RE, Burnham S, Sparks P, Properzi M, Schultz AP, Buckley R, Johnson KA, Sperling RA, Rentz DM, Papp KV. Diminished Learning Over Repeated Exposures (LORE) in preclinical Alzheimer's disease. Alzheimers Dement (Amst) 2021; 12:e12132. [PMID: 33426266 PMCID: PMC7784542 DOI: 10.1002/dad2.12132] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 09/24/2020] [Accepted: 10/13/2020] [Indexed: 12/13/2022]
Abstract
INTRODUCTION We determine whether diminished Learning Over Repeated Exposures (LORE) identifies subtle memory decrements in cognitively unimpaired (CU) older adults with Alzheimer's disease (AD) biomarker burden. METHODS Ninety-four CU participants (mean age = 77.6 ± 5.02) completed a challenging associative memory test, at home, monthly, for up to 1 year (mean = 9.97 months) on a study-issued iPad. Learning curves for face-name memory were computed for two versions completed monthly: same face-name pairs (A-A-A) and alternate face-name pairs (B-C-D). Positron emission tomography (PET) imaging characterized global amyloid (Pittsburgh Compound-B (PiB); amyloid beta (Aβ)+/-) and regional tau burden (flortaucipir). RESULTS Diminished LORE for same (but not alternate) face-name pairs was associated with greater amyloid and tau burden. Aβ+/- group differences for same face-name pairs emerged by the fourth exposure and was of medium-to-large magnitude (Cohen's d = 0.66; 95% confidence interval [CI] = 0.25-1.08). DISCUSSION Subtle decrements in learning related to AD pathological burden in CU are detectable over short time-intervals (ie, months). Implications for prevention trial design are discussed.
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Affiliation(s)
- Aubryn Samaroo
- Department of NeurologyMassachusetts General HospitalBostonMassachusettsUSA
| | - Rebecca E. Amariglio
- Department of NeurologyMassachusetts General HospitalBostonMassachusettsUSA
- Department of NeurologyBrigham and Women's HospitalBostonMassachusettsUSA
- Harvard Medical SchoolBostonMassachusettsUSA
| | - Samantha Burnham
- Health Commonwealth Scientific and Industrial Research Organization (CSIRO) Health and BiosecurityParkvilleVictoriaAustralia
| | - Paige Sparks
- Department of NeurologyBrigham and Women's HospitalBostonMassachusettsUSA
| | - Michael Properzi
- Department of NeurologyMassachusetts General HospitalBostonMassachusettsUSA
| | - Aaron P. Schultz
- Department of NeurologyMassachusetts General HospitalBostonMassachusettsUSA
- Harvard Medical SchoolBostonMassachusettsUSA
| | - Rachel Buckley
- Department of NeurologyMassachusetts General HospitalBostonMassachusettsUSA
- Harvard Medical SchoolBostonMassachusettsUSA
- Melbourne School of Psychological SciencesUniversity of MelbourneVictoriaAustralia
| | - Keith A. Johnson
- Department of NeurologyBrigham and Women's HospitalBostonMassachusettsUSA
- Harvard Medical SchoolBostonMassachusettsUSA
- Department of RadiologyMassachusetts General HospitalBostonMassachusettsUSA
| | - Reisa A. Sperling
- Department of NeurologyMassachusetts General HospitalBostonMassachusettsUSA
- Department of NeurologyBrigham and Women's HospitalBostonMassachusettsUSA
- Harvard Medical SchoolBostonMassachusettsUSA
| | - Dorene M. Rentz
- Department of NeurologyMassachusetts General HospitalBostonMassachusettsUSA
- Department of NeurologyBrigham and Women's HospitalBostonMassachusettsUSA
- Harvard Medical SchoolBostonMassachusettsUSA
| | - Kathryn V. Papp
- Department of NeurologyMassachusetts General HospitalBostonMassachusettsUSA
- Department of NeurologyBrigham and Women's HospitalBostonMassachusettsUSA
- Harvard Medical SchoolBostonMassachusettsUSA
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Gonzalez C, Tommasi NS, Briggs D, Properzi MJ, Amariglio RE, Marshall GA. Financial Capacity and Regional Cerebral Tau in Cognitively Normal Older Adults, Mild Cognitive Impairment, and Alzheimer's Disease Dementia. J Alzheimers Dis 2021; 79:1133-1142. [PMID: 33386806 DOI: 10.3233/jad-201122] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Financial capacity is often one of the first instrumental activities of daily living to be affected in cognitively normal (CN) older adults who later progress to amnestic mild cognitive impairment (MCI) and Alzheimer's disease (AD) dementia. OBJECTIVE The objective of this study was to investigate the association between financial capacity and regional cerebral tau. METHODS Cross-sectional financial capacity was assessed using the Financial Capacity Instrument -Short Form (FCI-SF) in 410 CN, 199 MCI, and 61 AD dementia participants who underwent flortaucipir tau positron emission tomography from the Alzheimer's Disease Neuroimaging Initiative (ADNI). Linear regression models with backward elimination were used with FCI-SF total score as the dependent variable and regional tau and tau-amyloid interaction as predictors of interest in separate analyses. Education, age, sex, Rey Auditory Verbal Learning Test Total Learning, and Trail Making Test B were used as covariates. RESULTS Significant associations were found between FCI-SF and tau regions (entorhinal: p < 0.001; inferior temporal: p < 0.001; dorsolateral prefrontal: p = 0.01; posterior cingulate: p = 0.03; precuneus: p < 0.001; and supramarginal gyrus: p = 0.005) across all participants. For the tau-amyloid interaction, significant associations were found in four regions (amyloid and dorsolateral prefrontal tau interaction: p = 0.005; amyloid and posterior cingulate tau interaction: p = 0.005; amyloid and precuneus tau interaction: p < 0.001; and amyloid and supramarginal tau interaction: p = 0.002). CONCLUSION Greater regional tau burden was modestly associated with financial capacity impairment in early-stage AD. Extending this work with longitudinal analyses will further illustrate the utility of such assessments in detecting clinically meaningful decline, which may aid clinical trials of early-stage AD.
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Affiliation(s)
- Christopher Gonzalez
- Center for Alzheimer Research and Treatment, Boston, MA, USA.,Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Nicole S Tommasi
- Center for Alzheimer Research and Treatment, Boston, MA, USA.,Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Danielle Briggs
- Center for Alzheimer Research and Treatment, Boston, MA, USA.,Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Michael J Properzi
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Rebecca E Amariglio
- Center for Alzheimer Research and Treatment, Boston, MA, USA.,Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Gad A Marshall
- Center for Alzheimer Research and Treatment, Boston, MA, USA.,Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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Marshall GA, Sikkes SAM, Amariglio RE, Gatchel JR, Rentz DM, Johnson KA, Langford O, Sun C, Donohue MC, Raman R, Aisen PS, Sperling RA, Galasko DR. Instrumental activities of daily living, amyloid, and cognition in cognitively normal older adults screening for the A4 Study. Alzheimers Dement (Amst) 2020; 12:e12118. [PMID: 33163609 PMCID: PMC7596668 DOI: 10.1002/dad2.12118] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 09/16/2020] [Indexed: 11/17/2022]
Abstract
INTRODUCTION We examined the associations among instrumental activities of daily living (IADL), cortical amyloid, and cognition in cognitively normal (CN) older adults. METHODS CN participants screening for the A4 Study (n = 4486) underwent florbetapir (amyloid) positron emission tomography. IADL were assessed using the Alzheimer's Disease Cooperative Study Activities of Daily Living Prevention Instrument. Separate logistic regression models were run with cortical amyloid or cognition as independent variable and IADL as dependent variable, adjusting for age and sex. RESULTS IADL difficulties were endorsed infrequently (≤16%). Overall IADL and four select IADL item difficulties ("remembering appointments," "finding belongings," "following TV programs," and "remembering current events") reported by both participant and study partner were significantly associated with greater amyloid burden and worse cognition. DISCUSSION Although IADL deficits were infrequent in this CN cohort, greater participant and study partner report of overall IADL deficits and subtle difficulties in specific IADL items were associated with mildly higher amyloid burden and worse cognition.
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Affiliation(s)
- Gad A. Marshall
- Center for Alzheimer Research and TreatmentDepartment of NeurologyBrigham and Women's HospitalHarvard Medical SchoolBostonMassachusettsUSA
- Department of NeurologyMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Sietske A. M. Sikkes
- Department of NeurologyMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
- VUmc Alzheimer CenterVU University Medical CenterAmsterdamthe Netherlands
| | - Rebecca E. Amariglio
- Center for Alzheimer Research and TreatmentDepartment of NeurologyBrigham and Women's HospitalHarvard Medical SchoolBostonMassachusettsUSA
- Department of NeurologyMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Jennifer R. Gatchel
- Department of PsychiatryMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
- Division of Geriatric PsychiatryMcLean HospitalHarvard Medical SchoolBelmontMassachusettsUSA
| | - Dorene M. Rentz
- Center for Alzheimer Research and TreatmentDepartment of NeurologyBrigham and Women's HospitalHarvard Medical SchoolBostonMassachusettsUSA
- Department of NeurologyMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Keith A. Johnson
- Center for Alzheimer Research and TreatmentDepartment of NeurologyBrigham and Women's HospitalHarvard Medical SchoolBostonMassachusettsUSA
- Department of RadiologyMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Oliver Langford
- Alzheimer's Therapeutic Research InstituteUniversity of Southern CaliforniaSan DiegoCaliforniaUSA
| | - Chung‐Kai Sun
- Alzheimer's Therapeutic Research InstituteUniversity of Southern CaliforniaSan DiegoCaliforniaUSA
| | - Michael C. Donohue
- Alzheimer's Therapeutic Research InstituteUniversity of Southern CaliforniaSan DiegoCaliforniaUSA
| | - Rema Raman
- Alzheimer's Therapeutic Research InstituteUniversity of Southern CaliforniaSan DiegoCaliforniaUSA
| | - Paul S. Aisen
- Alzheimer's Therapeutic Research InstituteUniversity of Southern CaliforniaSan DiegoCaliforniaUSA
| | - Reisa A. Sperling
- Center for Alzheimer Research and TreatmentDepartment of NeurologyBrigham and Women's HospitalHarvard Medical SchoolBostonMassachusettsUSA
- Department of NeurologyMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Douglas R. Galasko
- Shiley‐Marcos Alzheimer's Disease Research CenterUniversity of CaliforniaSan Diego Health—La JollaSan DiegoCaliforniaUSA
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Dubbelman MA, Jutten RJ, Tomaszewski Farias SE, Amariglio RE, Buckley RF, Visser PJ, Rentz DM, Johnson KA, Properzi MJ, Schultz A, Donovan N, Gatchell JR, Teunissen CE, Van Berckel BNM, Van der Flier WM, Sperling RA, Papp KV, Scheltens P, Marshall GA, Sikkes SAM. Decline in cognitively complex everyday activities accelerates along the Alzheimer's disease continuum. Alzheimers Res Ther 2020; 12:138. [PMID: 33121534 PMCID: PMC7597034 DOI: 10.1186/s13195-020-00706-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 10/12/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Impairment in daily functioning is a clinical hallmark of dementia. Difficulties with "instrumental activities of daily living" (IADL) seem to increase gradually over the course of Alzheimer's disease (AD), before dementia onset. However, it is currently not well established how difficulties develop along the preclinical and prodromal stages of AD. We aimed to investigate the trajectories of decline in IADL performance, as reported by a study partner, along the early stages of AD. METHODS In a longitudinal multicenter study, combining data from community-based and memory clinic cohorts, we included 1555 individuals (mean age 72.5 ± 7.8 years; 50% female) based on availability of amyloid biomarkers, longitudinal IADL data, and clinical information at baseline. Median follow-up duration was 2.1 years. All amyloid-positive participants (n = 982) were classified into the National Institute on Aging-Alzheimer's Association (NIA-AA) clinical stages ranging from preclinical AD (1) to overt dementia (4+). Cognitively normal amyloid-negative individuals (n = 573) served as a comparison group. The total scores of three study-partner reported IADL questionnaires were standardized. RESULTS The rate of decline in cognitively normal (stage 1) individuals with and without abnormal amyloid did not differ (p = .453). However, from stage 2 onwards, decline was significantly faster in individuals on the AD continuum (B [95%CI] = - 0.32 [- 0.55, - 0.09], p = .007). The rate of decline increased with each successive stage: one standard deviation (SD) unit per year in stage 3 (- 1.06 [- 1.27, - 0.85], p < .001) and nearly two SD units per year in stage 4+ (1.93 [- 2.19, - 1.67], p < .001). Overall, results were similar between community-based and memory clinic study cohorts. CONCLUSIONS Our results suggest that the rate of functional decline accelerates along the AD continuum, as shown by steeper rates of decline in each successive NIA-AA clinical stage. These results imply that incremental changes in function are a meaningful measure for early disease monitoring. Combined with the low-cost assessment, this advocates the use of these functional questionnaires for capturing the effects of early AD-related cognitive decline on daily life.
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Affiliation(s)
- Mark A Dubbelman
- Department of Neurology, Amsterdam Neuroscience, Alzheimer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam UMC, location VUmc, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands.
| | - Roos J Jutten
- Department of Neurology, Amsterdam Neuroscience, Alzheimer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam UMC, location VUmc, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands
| | | | - Rebecca E Amariglio
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Rachel F Buckley
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Pieter Jelle Visser
- Department of Neurology, Amsterdam Neuroscience, Alzheimer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam UMC, location VUmc, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Dorene M Rentz
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Keith A Johnson
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Michael J Properzi
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Aaron Schultz
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Nancy Donovan
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Jennifer R Gatchell
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Charlotte E Teunissen
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Bart N M Van Berckel
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Wiesje M Van der Flier
- Department of Neurology, Amsterdam Neuroscience, Alzheimer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam UMC, location VUmc, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - Reisa A Sperling
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Kathryn V Papp
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Philip Scheltens
- Department of Neurology, Amsterdam Neuroscience, Alzheimer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam UMC, location VUmc, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - Gad A Marshall
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Sietske A M Sikkes
- Department of Neurology, Amsterdam Neuroscience, Alzheimer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam UMC, location VUmc, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands
- Department of Clinical, Neuro- & Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Vila-Castelar C, Muñoz N, Papp KV, Amariglio RE, Baena A, Guzmán-Vélez E, Bocanegra Y, Sanchez JS, Reiman EM, Johnson KA, Sperling RA, Lopera F, Rentz DM, Quiroz YT. The Latin American Spanish version of the Face-Name Associative Memory Exam is sensitive to cognitive and pathological changes in preclinical autosomal dominant Alzheimer's disease. Alzheimers Res Ther 2020; 12:104. [PMID: 32912283 PMCID: PMC7488408 DOI: 10.1186/s13195-020-00671-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 08/25/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND To determine whether performance on the Latin American Spanish version of the Face-Name Associative Memory Exam (LAS-FNAME) can differentiate between cognitively intact carriers of an autosomal dominant Alzheimer's disease mutation (E280A) in Presenilin-1, who are genetically determined to develop early-onset dementia, from matched non-carriers. We also sought to examine whether LAS-FNAME performance is associated with amyloid-β and regional tau burden in mutation carriers. METHODS A total of 35 cognitively intact mutation carriers (age range 26-41), 19 symptomatic carriers, and 48 matched non-carriers (age range 27-44) completed a neuropsychological assessment including the LAS-FNAME. A subset of participants (31 carriers [12 symptomatic] and 35 non-carriers) traveled from Colombia to Boston to undergo positron emission tomography (PET) using Pittsburgh compound B to measure mean cortical amyloid-β and flortaucipir for regional tau. ANOVA analyses and Spearman correlations were used to examine group differences and relationships among LAS-FNAME performance and amyloid-β and tau accumulation. RESULTS Compared to non-carriers, cognitively intact mutation carriers had lower scores on the LAS-FNAME Total Scores (p = .040). Across all carriers (including symptomatic carriers), higher levels of amyloid-β (r = - .436, p = .018) and regional tau in the entorhinal (r = - .394, p = .031) and inferior temporal cortex (r = - .563, p = .001) were associated with lower LAS-FNAME Total Scores. CONCLUSIONS Performance on the LAS-FNAME differentiated between cognitively intact mutation carriers from non-carriers and was associated with greater amyloid and tau burden when examining all carriers. Findings suggest that the LAS-FNAME is sensitive to early clinical and pathological changes and can potentially help track disease progression in Spanish-speaking individuals.
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Affiliation(s)
- Clara Vila-Castelar
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Nathalia Muñoz
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Kathryn V Papp
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Rebecca E Amariglio
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Ana Baena
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellín, Colombia
| | - Edmarie Guzmán-Vélez
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Yamile Bocanegra
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellín, Colombia
| | - Justin S Sanchez
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Keith A Johnson
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Reisa A Sperling
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Francisco Lopera
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellín, Colombia
| | - Dorene M Rentz
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Yakeel T Quiroz
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellín, Colombia.
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Buckley RF, Scott MR, Jacobs HIL, Schultz AP, Properzi MJ, Amariglio RE, Hohman TJ, Mayblyum DV, Rubinstein ZB, Manning L, Hanseeuw BJ, Mormino EC, Rentz DM, Johnson KA, Sperling RA. Sex Mediates Relationships Between Regional Tau Pathology and Cognitive Decline. Ann Neurol 2020; 88:921-932. [PMID: 32799367 DOI: 10.1002/ana.25878] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 08/13/2020] [Accepted: 08/13/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVE The goal of this study was to examine sex differences in tau distribution across the brain of older adults, using positron emission tomography (PET), and investigate how these differences might associate with cognitive trajectories. METHODS Participants were 343 clinically normal individuals (women, 58%; 73.8 [8.5] years) and 55 individuals with mild cognitive impairment (MCI; women, 38%; 76.9 [7.3] years) from the Harvard Aging Brain Study and the Alzheimer's Disease Neuroimaging Initiative. We examined 18 F-Flortaucipir (FTP)-positron emission tomography (PET) signal across 41 cortical and subcortical regions of interest (ROIs). Linear regression models estimated the effect of sex on FTP-signal for each ROI after adjusting for age and cohort. We also examined interactions between sex*Aβ-PET positive / negative (+ / -) and sex*apolipoprotein ε4 (APOEε4) status. Linear mixed models estimated the moderating effect of sex on the relationship between a composite of sex-differentiated tau ROIs and cognitive decline. RESULTS Women showed significantly higher FTP-signals than men across multiple regions of the cortical mantle (p < 0.007). β-amyloid (Aβ)-moderated sex differences in tau signal were localized to medial and inferio-lateral temporal regions (p < 0.007); Aβ + women exhibited greater FTP-signal than other groups. APOEε4-moderated sex differences in FTP-signal were only found in the lateral occipital lobe. Women with higher FTP-signals in composite ROI exhibited faster cognitive decline than men (p = 0.04). INTERPRETATION Tau vulnerability in women is not just limited to the medial temporal lobe and significantly contributed to greater risk of faster cognitive decline. Interactive effects of sex and Aβ were predominantly localized in the temporal lobe, however, sex differences in extra-temporal tau highlights the possibility of accelerated tau proliferation in women with the onset of clinical symptomatology. ANN NEUROL 2020;88:921-932.
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Affiliation(s)
- Rachel F Buckley
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.,Brigham and Women's Hospital, Department of Neurology, Center for Alzheimer Research and Treatment, Boston, MA, USA.,Melbourne School of Psychological Science, University of Melbourne, Melbourne, VIC, Australia
| | - Matthew R Scott
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Heidi I L Jacobs
- Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, Maastricht, The Netherlands.,Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | - Aaron P Schultz
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Michael J Properzi
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Rebecca E Amariglio
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.,Brigham and Women's Hospital, Department of Neurology, Center for Alzheimer Research and Treatment, Boston, MA, USA
| | - Timothy J Hohman
- Department of Neurology, Vanderbilt Memory and Alzheimer's Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Danielle V Mayblyum
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | - Zoe B Rubinstein
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | - Lyssa Manning
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Bernard J Hanseeuw
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.,Department of Neurology, Cliniques Universitaires Saint-Luc, Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium
| | | | - Dorene M Rentz
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.,Brigham and Women's Hospital, Department of Neurology, Center for Alzheimer Research and Treatment, Boston, MA, USA
| | - Keith A Johnson
- Brigham and Women's Hospital, Department of Neurology, Center for Alzheimer Research and Treatment, Boston, MA, USA.,Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | - Reisa A Sperling
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.,Brigham and Women's Hospital, Department of Neurology, Center for Alzheimer Research and Treatment, Boston, MA, USA
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Rabin JS, Neal TE, Nierle HE, Sikkes SAM, Buckley RF, Amariglio RE, Papp KV, Rentz DM, Schultz AP, Johnson KA, Sperling RA, Hedden T. Multiple markers contribute to risk of progression from normal to mild cognitive impairment. Neuroimage Clin 2020; 28:102400. [PMID: 32919366 PMCID: PMC7491146 DOI: 10.1016/j.nicl.2020.102400] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 08/17/2020] [Accepted: 08/25/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To identify a parsimonious set of markers that optimally predicts subsequent clinical progression from normal to mild cognitive impairment (MCI). METHODS 250 clinically normal adults (mean age = 73.6 years, SD = 6.0) from the Harvard Aging Brain Study were assessed at baseline on a wide set of markers, including magnetic resonance imaging markers of gray matter thickness and volume, white matter lesions, fractional anisotropy, resting state functional connectivity, positron emission tomography markers of glucose metabolism and β-amyloid (Aβ) burden, and a measure of vascular risk. Participants were also tested annually on a battery of clinical and cognitive tests (median follow-up = 5.0 years, SD = 1.66). We applied least absolute shrinkage and selection operator (LASSO) Cox models to determine the minimum set of non-redundant markers that predicts subsequent clinical progression from normal to MCI, adjusting for age, sex, and education. RESULTS 23 participants (9.2%) progressed to MCI over the study period (mean years of follow-up to diagnosis = 3.96, SD = 1.89). Progression was predicted by several brain markers, including reduced entorhinal thickness (hazard ratio, HR = 1.73), greater Aβ burden (HR = 1.58), lower default network connectivity (HR = 1.42), and smaller hippocampal volume (HR = 1.30). When cognitive test scores were added to the model, the aforementioned neuroimaging markers remained significant and lower striatum volume as well as lower scores on baseline memory and processing speed tests additionally contributed to progression. CONCLUSION Among a large set of brain, vascular and cognitive markers, a subset of markers independently predicted progression from normal to MCI. These markers may enhance risk stratification by identifying clinically normal individuals who are most likely to develop clinical symptoms and would likely benefit most from therapeutic intervention.
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Affiliation(s)
- Jennifer S Rabin
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02144, USA; Harquail Centre for Neuromodulation and Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, ON M4N 3M5, Canada; Department of Medicine (Neurology), University of Toronto, Toronto, ON M5S 3H2, Canada
| | - Taylor E Neal
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02144, USA; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Hannah E Nierle
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02144, USA; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Sietske A M Sikkes
- Alzheimer Center and Department of Neurology, Amsterdam Neuroscience, Amsterdam University Medical Center, Vrije Universiteit, The Netherlands; Department of Epidemiology and Biostatistics, Amsterdam University Medical Center, Vrije Universiteit, Amsterdam, The Netherlands; Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02144, USA
| | - Rachel F Buckley
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02144, USA; Florey Institutes of Neuroscience and Mental Health, Melbourne and Melbourne School of Psychological Science, University of Melbourne, Melbourne, Australia; Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Rebecca E Amariglio
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02144, USA; Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Kathryn V Papp
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02144, USA; Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Dorene M Rentz
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02144, USA; Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Aaron P Schultz
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02144, USA; Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02129, USA
| | - Keith A Johnson
- Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Boston, MA 02115, USA; Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02129, USA; Division of Nuclear Medicine and Molecular Imaging, Massachusetts General Hospital, Boston, MA 02144, USA
| | - Reisa A Sperling
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02144, USA; Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Boston, MA 02115, USA; Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02129, USA
| | - Trey Hedden
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02129, USA.
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Yang HS, Chhatwal JP, Xu J, White CC, Hanseeuw B, Rabin JS, Papp KV, Buckley RF, Schultz AP, Properzi MJ, Gatchel JR, Amariglio RE, Donovan NJ, Mormino EC, Hedden T, Marshall GA, Rentz DM, Johnson KA, De Jager PL, Sperling RA. An UNC5C Allele Predicts Cognitive Decline and Hippocampal Atrophy in Clinically Normal Older Adults. J Alzheimers Dis 2020; 68:1161-1170. [PMID: 30883345 DOI: 10.3233/jad-180788] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND The UNC5C rs3846455G allele has been linked to poor cognitive resilience against age-related neuropathologies, but this association remains to be replicated, and the allele's effect on hippocampal neurodegeneration needs to be examined. OBJECTIVE To further validate the association between rs3846455G and faster cognitive decline, especially among cognitively normal older adults, and to assess whether rs3846455G predicts accelerated hippocampal volume loss in older adults. METHODS We assessed participants in the Harvard Aging Brain Study (HABS), a longitudinal cohort study of older adults who were clinically normal at baseline. To avoid bias from population admixture, analyses were limited to participants of European descent with longitudinal neuroimaging data (n = 174). Linear mixed effect models were used to examine the effect of rs3846455G on longitudinal change of the Preclinical Alzheimer Cognitive Composite (PACC) and MRI-measured bilateral hippocampal volume, adjusting for baseline amyloid-β (Aβ) measured by the cortical Pittsburgh Compound B PET distributed volume ratio. We also tested whether hippocampal atrophy mediates the association between rs3846455G and greater PACC decline through a mediation analysis. RESULTS rs3846455G was associated with greater PACC decline (β= -0.087/year, 95% CI -0.169 to -0.005, p = 0.039) after controlling for baseline Aβ. Further, rs3846455G predicted accelerated hippocampal atrophy after controlling for baseline Aβ (β= -57.3 mm3/year, 95% CI -102.8 to -11.9, p = 0.014). The association between rs3846455G and greater PACC decline was partially mediated by accelerated hippocampal atrophy (mediated effect (relative scale) = -0.014, 95% CI -0.032 to -6.0×10-4, p = 0.039). CONCLUSION UNC5C rs3846455G predicts greater cognitive decline and accelerated hippocampal atrophy in clinically normal older adults.
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Affiliation(s)
- Hyun-Sik Yang
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.,Department of Neurology, Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA.,Cell Circuits Program, Broad Institute of MIT and Harvard, Cambridge, MAs, USA
| | - Jasmeer P Chhatwal
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Jishu Xu
- Cell Circuits Program, Broad Institute of MIT and Harvard, Cambridge, MAs, USA
| | - Charles C White
- Cell Circuits Program, Broad Institute of MIT and Harvard, Cambridge, MAs, USA
| | - Bernard Hanseeuw
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA.,Department of Neurology, Cliniques Universitaires Saint-Luc, Institute of Neurosciences, Université Catholique de Louvain, Brussels, Belgium
| | - Jennifer S Rabin
- Harvard Medical School, Boston, MA, USA.,Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Kathryn V Papp
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.,Department of Neurology, Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Rachel F Buckley
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.,Department of Neurology, Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA.,Florey Institutes of Neuroscience and Mental Health, Melbourne, VIC, Australia.,Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Aaron P Schultz
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA.,Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Michael J Properzi
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Jennifer R Gatchel
- Harvard Medical School, Boston, MA, USA.,Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.,Division of Geriatric Psychiatry, McLean Hospital, Belmont, MA, USA.,Gerontology Research Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Rebecca E Amariglio
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.,Department of Neurology, Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Nancy J Donovan
- Department of Neurology, Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA.,Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.,Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA
| | - Elizabeth C Mormino
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA.,Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA, USA
| | - Trey Hedden
- Harvard Medical School, Boston, MA, USA.,Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Gad A Marshall
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.,Department of Neurology, Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Dorene M Rentz
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.,Department of Neurology, Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Keith A Johnson
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.,Department of Neurology, Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA.,Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Philip L De Jager
- Cell Circuits Program, Broad Institute of MIT and Harvard, Cambridge, MAs, USA.,Department of Neurology, Center for Translational & Computational Neuroimmunology, Columbia University Medical Center, New York, NY, USA
| | - Reisa A Sperling
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.,Department of Neurology, Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
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Jacobs HIL, Augustinack JC, Schultz AP, Hanseeuw BJ, Locascio J, Amariglio RE, Papp KV, Rentz DM, Sperling RA, Johnson KA. The presubiculum links incipient amyloid and tau pathology to memory function in older persons. Neurology 2020; 94:e1916-e1928. [PMID: 32273431 PMCID: PMC7274925 DOI: 10.1212/wnl.0000000000009362] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Accepted: 11/14/2019] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To identify the hippocampal subregions linking initial amyloid and tau pathology to memory performance in clinically normal older individuals, reflecting preclinical Alzheimer disease (AD). METHODS A total of 127 individuals from the Harvard Aging Brain Study (mean age 76.22 ± 6.42 years, 68 women [53.5%]) with a Clinical Dementia Rating score of 0, a flortaucipir tau-PET scan, a Pittsburgh compound B amyloid-PET scan, a structural MRI scan, and cognitive testing were included. From these images, we calculated neocortical, hippocampal, and entorhinal amyloid pathology; entorhinal and hippocampal tau pathology; and the volumes of 6 hippocampal subregions and total hippocampal volume. Memory was assessed with the selective reminding test. Mediation and moderation analyses modeled associations between regional markers and memory. Analyses included covariates for age, sex, and education. RESULTS Neocortical amyloid, entorhinal tau, and presubiculum volume univariately associated with memory performance. The relationship between neocortical amyloid and memory was mediated by entorhinal tau and presubiculum volume, which was modified by hippocampal amyloid burden. With other biomarkers held constant, presubiculum volume was the only marker predicting memory performance in the total sample and in individuals with elevated hippocampal amyloid burden. CONCLUSIONS The presubiculum captures unique AD-related biological variation that is not reflected in total hippocampal volume. Presubiculum volume may be a promising marker of imminent memory problems and can contribute to understanding the interaction between incipient AD-related pathologies and memory performance. The modulation by hippocampal amyloid suggests that amyloid is a necessary, but not sufficient, process to drive neurodegeneration in memory-related regions.
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Affiliation(s)
- Heidi I L Jacobs
- From the Department of Radiology (H.I.L.J., A.P.S., K.A.J.), Division of Nuclear Medicine and Molecular Imaging, Department of Radiology (H.I.L.J., J.C.A., A.P.S., B.J.H., R.A.S.), The Athinoula A. Martinos Center for Biomedical Imaging, and Department of Neurology/Biostatistics (J.L., R.A.S., K.A.J.), Massachusetts General Hospital/Harvard Medical School, Boston; Faculty of Health, Medicine and Life Sciences (H.I.L.J.), School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, the Netherlands; Department of Neurology (B.J.H., R.A.E., K.V.P., D.M.R., R.A.S., K.A.J.), Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; and Department of Neurology (B.J.H.), Cliniques Universitaires Saint-Luc, Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium.
| | - Jean C Augustinack
- From the Department of Radiology (H.I.L.J., A.P.S., K.A.J.), Division of Nuclear Medicine and Molecular Imaging, Department of Radiology (H.I.L.J., J.C.A., A.P.S., B.J.H., R.A.S.), The Athinoula A. Martinos Center for Biomedical Imaging, and Department of Neurology/Biostatistics (J.L., R.A.S., K.A.J.), Massachusetts General Hospital/Harvard Medical School, Boston; Faculty of Health, Medicine and Life Sciences (H.I.L.J.), School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, the Netherlands; Department of Neurology (B.J.H., R.A.E., K.V.P., D.M.R., R.A.S., K.A.J.), Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; and Department of Neurology (B.J.H.), Cliniques Universitaires Saint-Luc, Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium
| | - Aaron P Schultz
- From the Department of Radiology (H.I.L.J., A.P.S., K.A.J.), Division of Nuclear Medicine and Molecular Imaging, Department of Radiology (H.I.L.J., J.C.A., A.P.S., B.J.H., R.A.S.), The Athinoula A. Martinos Center for Biomedical Imaging, and Department of Neurology/Biostatistics (J.L., R.A.S., K.A.J.), Massachusetts General Hospital/Harvard Medical School, Boston; Faculty of Health, Medicine and Life Sciences (H.I.L.J.), School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, the Netherlands; Department of Neurology (B.J.H., R.A.E., K.V.P., D.M.R., R.A.S., K.A.J.), Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; and Department of Neurology (B.J.H.), Cliniques Universitaires Saint-Luc, Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium
| | - Bernard J Hanseeuw
- From the Department of Radiology (H.I.L.J., A.P.S., K.A.J.), Division of Nuclear Medicine and Molecular Imaging, Department of Radiology (H.I.L.J., J.C.A., A.P.S., B.J.H., R.A.S.), The Athinoula A. Martinos Center for Biomedical Imaging, and Department of Neurology/Biostatistics (J.L., R.A.S., K.A.J.), Massachusetts General Hospital/Harvard Medical School, Boston; Faculty of Health, Medicine and Life Sciences (H.I.L.J.), School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, the Netherlands; Department of Neurology (B.J.H., R.A.E., K.V.P., D.M.R., R.A.S., K.A.J.), Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; and Department of Neurology (B.J.H.), Cliniques Universitaires Saint-Luc, Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium
| | - Joseph Locascio
- From the Department of Radiology (H.I.L.J., A.P.S., K.A.J.), Division of Nuclear Medicine and Molecular Imaging, Department of Radiology (H.I.L.J., J.C.A., A.P.S., B.J.H., R.A.S.), The Athinoula A. Martinos Center for Biomedical Imaging, and Department of Neurology/Biostatistics (J.L., R.A.S., K.A.J.), Massachusetts General Hospital/Harvard Medical School, Boston; Faculty of Health, Medicine and Life Sciences (H.I.L.J.), School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, the Netherlands; Department of Neurology (B.J.H., R.A.E., K.V.P., D.M.R., R.A.S., K.A.J.), Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; and Department of Neurology (B.J.H.), Cliniques Universitaires Saint-Luc, Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium
| | - Rebecca E Amariglio
- From the Department of Radiology (H.I.L.J., A.P.S., K.A.J.), Division of Nuclear Medicine and Molecular Imaging, Department of Radiology (H.I.L.J., J.C.A., A.P.S., B.J.H., R.A.S.), The Athinoula A. Martinos Center for Biomedical Imaging, and Department of Neurology/Biostatistics (J.L., R.A.S., K.A.J.), Massachusetts General Hospital/Harvard Medical School, Boston; Faculty of Health, Medicine and Life Sciences (H.I.L.J.), School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, the Netherlands; Department of Neurology (B.J.H., R.A.E., K.V.P., D.M.R., R.A.S., K.A.J.), Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; and Department of Neurology (B.J.H.), Cliniques Universitaires Saint-Luc, Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium
| | - Kathryn V Papp
- From the Department of Radiology (H.I.L.J., A.P.S., K.A.J.), Division of Nuclear Medicine and Molecular Imaging, Department of Radiology (H.I.L.J., J.C.A., A.P.S., B.J.H., R.A.S.), The Athinoula A. Martinos Center for Biomedical Imaging, and Department of Neurology/Biostatistics (J.L., R.A.S., K.A.J.), Massachusetts General Hospital/Harvard Medical School, Boston; Faculty of Health, Medicine and Life Sciences (H.I.L.J.), School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, the Netherlands; Department of Neurology (B.J.H., R.A.E., K.V.P., D.M.R., R.A.S., K.A.J.), Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; and Department of Neurology (B.J.H.), Cliniques Universitaires Saint-Luc, Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium
| | - Dorene M Rentz
- From the Department of Radiology (H.I.L.J., A.P.S., K.A.J.), Division of Nuclear Medicine and Molecular Imaging, Department of Radiology (H.I.L.J., J.C.A., A.P.S., B.J.H., R.A.S.), The Athinoula A. Martinos Center for Biomedical Imaging, and Department of Neurology/Biostatistics (J.L., R.A.S., K.A.J.), Massachusetts General Hospital/Harvard Medical School, Boston; Faculty of Health, Medicine and Life Sciences (H.I.L.J.), School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, the Netherlands; Department of Neurology (B.J.H., R.A.E., K.V.P., D.M.R., R.A.S., K.A.J.), Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; and Department of Neurology (B.J.H.), Cliniques Universitaires Saint-Luc, Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium
| | - Reisa A Sperling
- From the Department of Radiology (H.I.L.J., A.P.S., K.A.J.), Division of Nuclear Medicine and Molecular Imaging, Department of Radiology (H.I.L.J., J.C.A., A.P.S., B.J.H., R.A.S.), The Athinoula A. Martinos Center for Biomedical Imaging, and Department of Neurology/Biostatistics (J.L., R.A.S., K.A.J.), Massachusetts General Hospital/Harvard Medical School, Boston; Faculty of Health, Medicine and Life Sciences (H.I.L.J.), School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, the Netherlands; Department of Neurology (B.J.H., R.A.E., K.V.P., D.M.R., R.A.S., K.A.J.), Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; and Department of Neurology (B.J.H.), Cliniques Universitaires Saint-Luc, Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium
| | - Keith A Johnson
- From the Department of Radiology (H.I.L.J., A.P.S., K.A.J.), Division of Nuclear Medicine and Molecular Imaging, Department of Radiology (H.I.L.J., J.C.A., A.P.S., B.J.H., R.A.S.), The Athinoula A. Martinos Center for Biomedical Imaging, and Department of Neurology/Biostatistics (J.L., R.A.S., K.A.J.), Massachusetts General Hospital/Harvard Medical School, Boston; Faculty of Health, Medicine and Life Sciences (H.I.L.J.), School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, the Netherlands; Department of Neurology (B.J.H., R.A.E., K.V.P., D.M.R., R.A.S., K.A.J.), Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; and Department of Neurology (B.J.H.), Cliniques Universitaires Saint-Luc, Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium
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Marshall GA, Gatchel JR, Donovan NJ, Muniz MC, Schultz AP, Becker JA, Chhatwal JP, Hanseeuw BJ, Papp KV, Amariglio RE, Rentz DM, Sperling RA, Johnson KA. Regional Tau Correlates of Instrumental Activities of Daily Living and Apathy in Mild Cognitive Impairment and Alzheimer's Disease Dementia. J Alzheimers Dis 2020; 67:757-768. [PMID: 30689584 DOI: 10.3233/jad-170578] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Instrumental activities of daily living (IADL) impairment and apathy occur in early-stage Alzheimer's disease (AD) and are associated with regional atrophy and hypometabolism in vivo and greater tau burden at autopsy. OBJECTIVE To explore the association between IADL impairment, apathy, and in vivo regional tau in mild cognitive impairment (MCI) and AD dementia. METHODS Forty participants (24 MCI, 16 AD dementia) underwent assessments of IADL (Functional Activities Questionnaire, FAQ) and apathy (Apathy Evaluation Scale Informant report, AES-I). Regional tau was assessed using flortaucipir positron emission tomography (PET) and amyloid using Pittsburgh Compound B PET. Regions with unadjusted associations of p≤0.01 were entered into regression models assessing the relationship between tau and FAQ or AES-I, adjusting for age, sex, and cognition, with/without a tau by amyloid interaction. RESULTS Unadjusted IADL impairment but not apathy was associated with greater tau in multiple regions. After adjusting for covariates, for medial orbitofrontal and entorhinal cortex the interaction between tau and amyloid was associated with IADL impairment and for anterior cingulate it was not but independent associations with both tau and amyloid were retained. With whole brain analyses, similar results were seen for IADL, while for apathy tau in small clusters within the right anterior cingulate and dorsolateral prefrontal cortices were seen, which were more pronounced in individuals with greater amyloid. CONCLUSIONS This exploratory study suggests that IADL impairment in AD is associated with medial temporal and frontal tau, especially in individuals with elevated amyloid, while apathy may be associated with right frontal tau.
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Affiliation(s)
- Gad A Marshall
- Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Jennifer R Gatchel
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Division of Geriatric Psychiatry, McLean Hospital, Harvard Medical School, Belmont, MA, USA
| | - Nancy J Donovan
- Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Martha C Muniz
- Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Aaron P Schultz
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - J Alex Becker
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Jasmeer P Chhatwal
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Bernard J Hanseeuw
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Department of Neurology, Cliniques Universitaires Saint-Luc, Institute of Neurosciences, Université Catholique de Louvain, Brussels, Belgium
| | - Kathryn V Papp
- Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Rebecca E Amariglio
- Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Dorene M Rentz
- Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Reisa A Sperling
- Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Keith A Johnson
- Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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Papp KV, Buckley R, Mormino E, Maruff P, Villemagne VL, Masters C, Johnson KA, Rentz DM, Sperling RA, Amariglio RE. Clinical meaningfulness of subtle cognitive decline on longitudinal testing in preclinical AD. Alzheimers Dement 2020; 16:552-560. [PMID: 31759879 PMCID: PMC7067681 DOI: 10.1016/j.jalz.2019.09.074] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Demonstrating the "clinical meaningfulness" of slowing early cognitive decline in clinically normal (CN) older adults with elevated amyloid-β (Aβ+) is critical for Alzheimer's disease secondary prevention trials and for understanding early cognitive progression. METHODS Cox regression analyses were used to determine whether 3-year slopes on the preclinical Alzheimer's cognitive composite predicted MCI diagnosis and global Clinical Dementia Rating>0 in 267 Aβ+ CN individuals participating in the Harvard Aging Brain Study, Australian Imaging, Biomarker and Lifestyle Study, and Alzheimer's Disease Neuroimaging Initiative. RESULTS Steeper preclinical Alzheimer's cognitive composite decline over 3 years was associated with increased risk for MCI diagnosis and global Clinical Dementia Rating>0 in the following years across all cohorts. Hazard ratios using meta-analytic estimates were 5.47 (95% CI: 3.25-9.18) for MCI diagnosis and 4.49 (95% CI: 2.84-7.09) for Clinical Dementia Rating>0 in those with subtle decline (>-.14 to -.26 preclinical Alzheimer's cognitive composite standard deviations/year) on longitudinal cognitive testing. DISCUSSION Early "subtle cognitive decline" among Aβ+ CN on a sensitive cognitive composite demonstrably increases risk for imminent clinical disease progression and functional impairment.
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Affiliation(s)
- Kathryn V. Papp
- Department of Neurology, Brigham and Women’s Hospital, Boston, Massachusetts, USA
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Rachel Buckley
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Elizabeth Mormino
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Paul Maruff
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia
- CogState, Ltd, Melbourne, Victoria, Australia
| | - Victor L. Villemagne
- Department of Nuclear Medicine and Centre for PET, Austin Health, Victoria, Australia
| | - Colin Masters
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - Keith A. Johnson
- Department of Neurology, Brigham and Women’s Hospital, Boston, Massachusetts, USA
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Dorene M. Rentz
- Department of Neurology, Brigham and Women’s Hospital, Boston, Massachusetts, USA
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Reisa A. Sperling
- Department of Neurology, Brigham and Women’s Hospital, Boston, Massachusetts, USA
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Rebecca E. Amariglio
- Department of Neurology, Brigham and Women’s Hospital, Boston, Massachusetts, USA
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
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