Brain Amyloid Deposition and Longitudinal Cognitive Decline in Nondemented Older Subjects: Results from a Multi-Ethnic Population.
Brain Amyloid Deposition and Longitudinal Cognitive Decline in Nondemented Older Subjects: Results from a Multi-Ethnic Population.
复制标题
脑淀粉样蛋白的沉积和纵向认知的纵向下降：多种族人口的结果。
DOI：
10.1371/journal.pone.0123743
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Stern Y
中科院分区：
文献类型：
--
作者：
Gu Y;Razlighi QR;Zahodne LB;Janicki SC;Ichise M;Manly JJ;Devanand DP;Brickman AM;Schupf N;Mayeux R;Stern Y
我们的目标是研究表面上健康的老年人大脑中异常高的淀粉样蛋白(Aβ，Aβ)水平是否与轻微的认知缺陷和/或加速的认知下降有关。华盛顿高地因伍德哥伦比亚老龄化项目的116名无痴呆症参与者(平均年龄84.5岁)完成了18F-Florbetaben PET成像。目测脑Aβ沉积阳性或阴性。以小脑皮质为参照区，用预先建立的感兴趣区的标准摄取值比率来计算大脑Aβ的定量负荷。使用神经心理学组合来确定认知，并使用探索性因素分析将选定的测试分数组合成四个综合分数(记忆、语言、执行/速度和视觉空间)。我们使用潜伏期生长曲线模型，控制了年龄、教育程度、种族和载脂蛋白E(β)基因，研究了大脑A-apoE水平与纵向认知变化之间的关系，直到PET扫描前20年。在116名个体中有41名(35%)Aβ读数为阳性。扫描时的认知分数与Aβ无关。所有的认知分数都随着时间的推移而下降。β阳性读数(B=-0.034，p=0.02)和颞区较高的A-β负荷(B=-0.080，p=0.02)与执行/速度下降较快相关。分层分析表明，在非裔美国人或载脂蛋白Eβ4携带者中，Aε沉积较高与平均认知、语言和执行/速度的纵向下降速度更快相关，而在载脂蛋白ε4携带者中与记忆下降更快相关。排除轻度认知障碍参与者后，相关性仍然显著。在神经成像之前的十年里，健康老年人的高Aβ沉积与执行力/速度的下降有关，这种联系主要在非裔美国人和载脂蛋白Eε4携带者中观察到。我们的结果表明，测量大脑Aβ可能为我们在认知正常的老年人进行扫描前几年的认知状况提供重要的见解。
We aimed to whether the abnormally high amyloid-β (Aβ) level in the brain among apparently healthy elders is related with subtle cognitive deficits and/or accelerated cognitive decline. A total of 116 dementia-free participants (mean age 84.5 years) of the Washington Heights Inwood Columbia Aging Project completed 18F-Florbetaben PET imaging. Positive or negative cerebral Aβ deposition was assessed visually. Quantitative cerebral Aβ burden was calculated as the standardized uptake value ratio in pre-established regions of interest using cerebellar cortex as the reference region. Cognition was determined using a neuropsychological battery and selected tests scores were combined into four composite scores (memory, language, executive/speed, and visuospatial) using exploratory factor analysis. We examined the relationship between cerebral Aβ level and longitudinal cognition change up to 20 years before the PET scan using latent growth curve models, controlling for age, education, ethnicity, and Apolipoprotein E (APOE) genotype. Positive reading of Aβ was found in 41 of 116 (35%) individuals. Cognitive scores at scan time was not related with Aβ. All cognitive scores declined over time. Aβ positive reading (B = -0.034, p = 0.02) and higher Aβ burden in temporal region (B = -0.080, p = 0.02) were associated with faster decline in executive/speed. Stratified analyses showed that higher Aβ deposition was associated with faster longitudinal declines in mean cognition, language, and executive/speed in African-Americans or in APOE ε4 carriers, and with faster memory decline in APOE ε4 carriers. The associations remained significant after excluding mild cognitive impairment participants. High Aβ deposition in healthy elders was associated with decline in executive/speed in the decade before neuroimaging, and the association was observed primarily in African-Americans and APOE ε4 carriers. Our results suggest that measuring cerebral Aβ may give us important insights into the cognitive profile in the years prior to the scan in cognitively normal elders.