Biomarkers of preclinical Alzheimer disease and cognition

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 DESCRIPTION (provided by applicant): Gradual, consistent cognitive declines commonly found with advancing age, even in the absence of clinical disease, are often ascribed to "normal aging" processes in the brain. Age-related differences in cognition have also been attributed to physiological mechanisms beyond the aging process, including degenerative diseases such as Alzheimer's disease (AD). Yet until recently the pathophysiological brain differences associated with preclinical AD have been difficult to study in vivo directly, and the effects of such preclinial biomarkers on cognition have received limited investigation in normal cognitive aging. With the advent of positron emission tomography (PET) ligands that bind biomarkers of the AD pathological cascade (e.g., tau, amyloid-beta [Aβ]), tools now exist to permit direct examination. We hypothesize that, among cognitively normal elderly, preclinical biomarker differences associated with AD are linked with disrupted glucose metabolism and cognition. In particular, increased age and increased fibrillar Aβ accumulation in diffuse neocortical regions will influence tau accumulation in and beyond MTL subregions, respectively, and tau will directly affect brain metabolism measured using FDG PET, and indirectly affect cognitive function. We will also examine, using approaches including mediation and path analysis, how tau may mediate the effect of Aβ on cognition, and how glucose metabolism may mediate the effect of tau accumulation on cognitive performance. Preclinical progression along the AD pathological cascade may be inadvertently conflated with normal aging processes in many studies investigating gradual cognitive decline late in life. Therefore, our goal is to investigate effectsof tau and Aβ accumulation on cerebral glucose metabolism, which itself is known to change in preclinical AD, and the relative effects of these brain differences on cognitive performance across multiple domains. The proposed research will contribute to a model of how preclinical AD-related differences, in otherwise normal elderly, disrupt brain function and cognitive performance. This research holds promise for impacting public health, through eventual clinical applications to age-related cognitive decline and disorders associated with Aβ and tau accumulation. My proposed research will provide training integral to my development as a translational cognitive neuroscientist of aging and dementia. I will gain valuable experience in PET and MRI imaging and in cognitive aging research during my training with Dr. William Jagust, and gain valuable mentorship from the collaborators whose letters are included with this application, taking advantage of the rich academic resources available through UC Berkeley and Lawrence Berkeley National Laboratory and through collaboration with UC San Francisco.