Early Markers Of Alzheimer Disease

工作总结：阿尔茨海默病（AD）是主要发生在较晚年龄的几种神经退行性疾病（痴呆）中最普遍的，偶尔在60岁之前，但更频繁地在70岁之后。本研究探讨了前瞻性的心理，神经和神经心理学的变化，参与者从巴尔的摩纵向研究老化（BLSA）。对60岁及以上的参与者进行神经学和神经心理学检查，重复在早期对这些受试者进行的许多测试。可能的阿尔茨海默病的诊断遵循NINCDS-ADRDA标准。 部分研究人员检查了血压（BP）的横向和纵向关系（线性和非线性）及其与人口统计学和生活方式变量的相互作用，以广泛的认知功能。来自巴尔的摩老龄化纵向研究的847名参与者（503名男性和344名女性）在11年的时间里完成了语言和非语言记忆、注意力、知觉-运动速度、执行功能和对抗命名的测试，以及1至7次BP的临床评估。混合效应回归模型，调整了年龄，教育，性别，饮酒，吸烟状况，抑郁评分和抗高血压药物的使用，显示收缩压与非语言记忆和对抗命名测试的纵向变化的非线性关系;认知能力下降在收缩压较高的老年人（80岁以上）中很明显。跨测试阶段的横截面研究结果表明，BP和认知功能之间存在适度的U形和J形关系。高舒张压和低舒张压都与执行功能和对抗命名测试中受教育程度较低的人的表现较差相关;与未用药（抗高血压药）个体的感知运动速度和对抗命名测试相关;与老年个体的执行功能相关。横截面的线性关系包括较高的收缩压和非文字记忆较差的非饮酒者，较高的舒张压和较差的工作记忆受教育程度较低的个人。结果表明，横截面和纵向的BP认知功能的关系主要是非线性和年龄，教育和抗高血压药物的调节。因此，有一些亚组的个体可能是降低血压或维持足够脑灌注的目标。

Summary of work: Alzheimer's disease (AD) is the most widespread among several neurological degenerative diseases (dementias) that occur principally at later ages, occasionally before 60, but more frequently after age 70. This study examines prospective psychological, neurological, and neuropsychological changes in participants from the Baltimore Longitudinal Study of Aging (BLSA). Neurological and neuropsychological examinations are administered to participants aged 60 and older, repeating many of the tests that were administered to these subjects at earlier ages. Diagnoses of probable Alzheimer's disease follow the NINCDS-ADRDA criteria. Section investigators examined cross-sectional and longitudinal relations, both linear and nonlinear, of blood pressure (BP) and its interaction with demographic and lifestyle variables to a broad spectrum of cognitive functions. Eight hundred forty-seven participants (503 men and 344 women) from the Baltimore Longitudinal Study of Aging completed tests of verbal and nonverbal memory, attention, perceptuo-motor speed, executive functions, and confrontation naming, and clinical assessment of BP on one to seven occasions over 11 years. Mixed-effects regression models, adjusted for age, education, gender, alcohol consumption, smoking status, depression scores, and use of antihypertensive medications, revealed nonlinear relations of systolic BP with longitudinal change on tests of nonverbal memory and confrontation naming; cognitive decline was apparent among older (80+ years) individuals with higher systolic BP. Cross-sectional findings, across testing sessions, indicated moderated U- and J- shaped relations between BP and cognitive function. Both high and low diastolic BP was associated with poorer performance on tests of executive function and confrontation naming among less-educated persons; with tests of perceptuo-motor speed and confrontation naming among unmedicated (antihypertensives) individuals; and with executive function among older individuals. Cross-sectional linear relations included higher systolic BP and poorer nonverbal memory in non-drinkers, and higher diastolic BP and poorer working memory among less-educated individuals. Results indicate that cross-sectional and longitudinal relations of BP to cognitive function are predominantly nonlinear and moderated by age, education, and antihypertensive medications. Thus, there are subgroups of individuals who might be targeted for BP reduction or perhaps maintenance of adequate cerebral perfusion.