Cerebrospinal fluid β-amyloid 1-42 concentration may predict cognitive decline in older women
Cerebrospinal fluid β-amyloid 1-42 concentration may predict cognitive decline in older women
复制标题
DOI：
10.1136/jnnp.2006.100529
复制
发表时间：
2007-05-01
影响因子：
11
通讯作者：
Blennow, Kaj
中科院分区：
文献类型：
--
作者：
Gustafson, Deborah R.;Skoog, Ingmar;Blennow, Kaj
背景资料：低水平的脑脊液（CSF）β-淀粉样蛋白1-42（A β 42）和高总tau蛋白（T-tau）可诊断明显的阿尔茨海默病。然而，目前尚不清楚这些生物标志物是否可能是健康老年人认知能力下降的风险指标。方法：1992年测量的CSF标志物A β 42和T-tau与简易精神状态检查变化之间的纵向关系对1992 ~ 2002年55例女性患者进行Delta MMSE评分（年龄70-84岁，平均（SD）MMSE评分= 28.3（1.5）），他们是瑞典哥德堡妇女前瞻性人群研究的参与者。结果：在8年的随访期内，Delta MMSE（范围= +3至221分）与A β 42相关（斯皮尔曼r = 0.40，p = 0.002），A β 42水平越低，下降越大。在排除了1992年至2002年期间患痴呆症的4名妇女后，也观察到了这一点（斯皮尔曼r = 0.34，p = 0.019）。多变量逻辑回归模型预测MMSE下降>= 5分（在6名女性中观察到），或在8年随访期内发生痴呆症的风险（在4名女性中观察到），包括年龄、教育、A β 42和T-tau作为协变量，表明A β 42是显著认知能力下降或痴呆的唯一预测因子（OR/100 pg/ml A β 42 = 2.24，95%CI 1.19 ~ 4.22，p = 0.013）结论：低水平CSF A β 42可预测无痴呆老年妇女的认知功能下降。
Background: Low levels of cerebrospinal fluid (CSF) beta-amyloid 1-42 (A beta 42) and high total tau (T-tau) are diagnostic for manifest Alzheimer's disease. It is not known, however, whether these biomarkers may be risk indicators for cognitive decline in otherwise healthy older people.Methods: The longitudinal relationship between CSF markers, A beta 42 and T-tau, measured in 1992, and change in Mini-Mental State Examination (Delta MMSE) score between 1992 and 2002 were investigated in 55 women (aged 70-84 years, mean (SD) MMSE score = 28.3 (1.5)), who were participants in the Prospective Population Study of Women in Gothenburg, Sweden. These women did not have dementia when they experienced lumbar puncture in 1992-3.Results: Over the 8-year follow-up period, Delta MMSE (range = +3 to 221 points) was correlated with A beta 42 (Spearman's r = 0.40, p = 0.002), such that lower levels of A beta 42 were related to greater decline. This was also observed after excluding 4 women who developed dementia between 1992 and 2002 (Spearman's r = 0.34, p = 0.019). A multivariate logistic regression model predicting a decline of >= 5 points on the MMSE (observed in six women), or a risk of developing dementia over the 8-year follow-up period (observed in four women), including age, education, A beta 42 and T-tau as covariates, showed that A beta 42 was the sole predictor of significant cognitive decline or dementia (OR per 100 pg/ml A beta 42 = 2.24, 95% CI 1.19 to 4.22, p = 0.013).Conclusions: Low levels of CSF A beta 42 may predict cognitive decline among older women without dementia.