Episodic Memory Decline Predicts Cortical Amyloid Status in Community-Dwelling Older Adults
Episodic Memory Decline Predicts Cortical Amyloid Status in Community-Dwelling Older Adults
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DOI：
10.3233/jad-2011-110818
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发表时间：
2011-01-01
影响因子：
4
通讯作者：
Rowe, Christopher
中科院分区：
文献类型：
--
作者：
Darby, David G.;Brodtmann, Amy;Rowe, Christopher
个体内记忆和认知的下降是前驱阿尔茨海默病（AD）的特征，并且可以允许检测非常早期的AD病理。在基线和基线后3个月、6个月、9个月、12个月和24个月，前瞻性评价了简短计算机认知成套测验（CogState）的情景记忆任务评分。采用线性混合模型计算年龄校正斜率。对斜率下降>= 90百分位数的受试者（“记忆下降者”）和年龄和性别匹配的没有这种下降的受试者（“非下降者”）进行临床、神经心理学和神经影像学评估。在195名完成24个月评估（年龄51至80岁）的患者中，确定了15名记忆下降者（平均年龄62.7岁，SD 7.6），并与33名非下降者（平均年龄63.3岁，SD 8.2）相匹配。淀粉样蛋白PET成像定性异常，7名记忆减退者（46.7%）和4名记忆未减退者（12.1%）皮质淀粉样蛋白过度积聚（优势比6.34），定量异常，5名记忆减退者（33.3%）和2名记忆未减退者（6.1%）标准化摄取值比值>1.4（优势比8.3）。其中一名记忆力下降者和无记忆力下降者符合轻度认知障碍的标准，但两组在主观记忆障碍、情景记忆障碍的神经心理学证据或MRI成像异常方面没有差异。个体内情景记忆的下降可以使用一种简单的计算机化认知性能测试来检测，该测试被优化用于检测社区居住的非痴呆老年人的变化，并且似乎预测了这些人中约一半人的大脑淀粉样蛋白的存在。这种方法可能有助于在更大规模的社区筛查项目中检测早期前驱AD病理。
Intra-individual decline in memory and cognition is characteristic of prodromal Alzheimer's disease (AD) and may allow detection of very early AD pathology. Episodic memory task scores on a brief computerized cognitive battery (CogState) were prospectively evaluated at baseline, and 3-, 6-, 9-, 12-, and 24-months post-baseline. Linear mixed models were conducted to compute age-adjusted slopes. Subjects with slopes declining >= 90th percentile ("memory decliners") and age-and gender-matched subjects without such decline ("non-decliners") were studied with clinical, neuropsychological, and neuroimaging evaluations. Of 195 who completed 24-month evaluation (age 51 to 80 years), 15 memory decliners (mean age 62.7 years, SD 7.6) were identified, and matched with 33 non-decliners (mean age 63.3 years, SD 8.2). Amyloid-PET imaging was qualitatively abnormal with excess cortical amyloid accumulation in 7 memory decliners (46.7%) and 4 (12.1%) non-decliners (odds ratio 6.34), and quantitatively abnormal with standardized uptake value ratios >1.4 in 5 memory decliners (33.3%) and 2 (6.1%) non-decliners (odds ratio 8.3). One of the memory decliners and none of the non-decliners fulfilled criteria for mild cognitive impairment, but the groups did not differ with respect to subjective memory impairment, neuropsychological evidence of episodic memory impairment, or MRI imaging abnormalities. Intra-individual decline in episodic memory can be detected using a brief computerized cognitive performance test optimized to detect change in community-dwelling non-demented older persons and appears predictive of the presence of cerebral amyloid in about half of these persons. This approach may help detect early prodromal AD pathology in wider-scale community screening programs.