Which features of subjective cognitive decline are related to amyloid pathology? Findings from the DELCODE study
Which features of subjective cognitive decline are related to amyloid pathology? Findings from the DELCODE study
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DOI：
10.1186/s13195-019-0515-y
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发表时间：
2019-07-31
影响因子：
9
通讯作者：
Wagner, Michael
中科院分区：
文献类型：
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作者：
Miebach, Lisa;Wolfsgruber, Steffen;Wagner, Michael
背景主观性认知功能下降(SCD)被认为是阿尔茨海默病(AD)的一种前MCI高危状态。目前的研究集中于对SCD-plus标准中建议的与AD风险增加相关的特定SCD特征的精细评估。我们开发了结构化访谈(SCD-I)来评估这些特征，并测试了它们与AD生物标记物的关系。方法我们分析了205名认知正常的DELCODE研究参与者(平均年龄=68.9岁；52%女性)的数据，以及可用的脑脊液AD生物标记物(Aβ-42，p-Tau181，Aβ-42/Tau比率，总Tau)。对于五个认知领域(包括记忆、语言、注意力、计划和其他)，一名研究医生询问参与者以下SCD+特征：主观衰退的存在、相关的担忧、SCD的发病、感觉比同年龄段的其他人表现更差，以及告密者的确认。我们比较了支持每个问题的受试者和不支持这些问题的受试者的AD生物标记物，并控制了年龄。SCD还通过两个汇总分数来量化：满足SCD+功能的数量，以及经历下降的域名数量。结果较低的Aβ-42水平与报告的记忆和语言能力下降有关，并与以下SCD+特征有关：5年内出现主观能力下降，被告密者确认认知能力下降，以及与下降相关的担忧。此外，定量SCD评分与较低的Aβ42和较低的Aβ42/Tau比值相关，但与总Tau或p-Tau181无关。结论支持基于标准的访谈方法评估和量化AD中的SCD，并验证当前SCD+特征作为AD病理预测因子的有效性。虽然一些特征似乎比其他特征与AD生物标志物更密切相关，但几个SCD+特征或SCD域的聚合得分可能是AD病理的最佳预测因子。
BackgroundSubjective cognitive decline (SCD) has been proposed as a pre-MCI at-risk condition of Alzheimer's disease (AD). Current research is focusing on a refined assessment of specific SCD features associated with increased risk for AD, as proposed in the SCD-plus criteria. We developed a structured interview (SCD-I) for the assessment of these features and tested their relationship with AD biomarkers.MethodsWe analyzed data of 205 cognitively normal participants of the DELCODE study (mean age=68.9years; 52% female) with available CSF AD biomarkers (A beta-42, p-Tau181, A beta-42/Tau ratio, total Tau). For each of five cognitive domains (including memory, language, attention, planning, others), a study physician asked participants about the following SCD-plus features: the presence of subjective decline, associated worries, onset of SCD, feeling of worse performance than others of the same age group, and informant confirmation. We compared AD biomarkers of subjects endorsing each of these questions with those who did not, controlling for age. SCD was also quantified by two summary scores: the number of fulfilled SCD-plus features, and the number of domains with experienced decline. Covariate-adjusted linear regression analyses were used to test whether these SCD scores predicted abnormality in AD biomarkers.ResultsLower A beta-42 levels were associated with a reported decline in memory and language abilities, and with the following SCD-plus features: onset of subjective decline within 5years, confirmation of cognitive decline by an informant, and decline-related worries. Furthermore, both quantitative SCD scores were associated with lower A beta 42 and lower A beta 42/Tau ratio, but not with total Tau or p-Tau181.ConclusionsFindings support the usefulness of a criterion-based interview approach to assess and quantify SCD in the context of AD and validate the current SCD-plus features as predictors of AD pathology. While some features seem to be more closely associated with AD biomarkers than others, aggregated scores over several SCD-plus features or SCD domains may be the best predictors of AD pathology.