Plasma β-Amyloid and Cognitive Decline
Plasma β-Amyloid and Cognitive Decline
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DOI：
10.1001/archneurol.2010.189
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发表时间：
2010-12-01
影响因子：
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通讯作者：
Mayeux, Richard P.
中科院分区：
文献类型：
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作者：
Cosentino, Stephanie A.;Stern, Yaakov;Mayeux, Richard P.
目的：为了确定血浆β-淀粉样蛋白（A β）水平（1）是否与构成阿尔茨海默病（AD）转化的特定认知变化有关，（2）是否对应于独立于痴呆的认知变化。（2000-2006年）。地点：北方曼哈顿社区。参与者：从一个种群中选出880个人-具有2次血浆A β测量值且在第一次A β样本时无痴呆的基于不同种族的样本; 481人保持认知健康，329人认知或功能受损，但在任何时候都没有痴呆，70人发展为AD。一般估计方程检验了血浆A β（基线和数值变化）和认知变化（综合评分和记忆、语言和视觉空间指数）。高基线血浆A β 42（P= 0.01）和A β 40（P= 0.01）以及A β 42（P= 0.01）值降低/相对稳定与多个认知领域的快速下降相关。在那些保持认知健康，高基线血浆A β 42（P= 0.01）和降低/相对稳定的血浆A β 42（P= 0.01）与更快的认知下降，主要是在memory.Conclusions：血浆A β和认知的多个方面之间的关联更清楚地说明了先前记录的血浆A β与AD发作的下降轨迹。仅在健康老年人中观察到的与记忆的主要关联也表明，血浆A β与甚至更早的神经系统变化有关，这些变化可能会或可能不会导致痴呆。
Objectives: To determine if plasma beta-amyloid (A beta) levels (1) can be linked to specific cognitive changes that constitute conversion to Alzheimer disease (AD) and (2) correspond to cognitive change independent of dementia.Design: Longitudinal study including 3 visits during approximately 41/2 years (2000-2006).Setting: Northern Manhattan community.Participants: Eight hundred eighty individuals from a population-based and ethnically diverse sample who had 2 plasma A beta measurements and were dementia free at the time of the first A beta sample; 481 remained cognitively healthy, 329 were cognitively or functionally impaired but not demented at any point, and 70 developed AD.Main Outcome Measures: General estimating equations tested the association between plasma A beta (baseline and change in values) and cognitive change (composite score and memory, language, and visuospatial indices).Results: High baseline plasma A beta 42 (P=.01) and A beta 40 (P=.01) and decreasing/relatively stable A beta 42 (P=.01) values were associated with faster decline in multiple cognitive domains. In those who remained cognitively healthy, high baseline plasma A beta 42 (P=.01) and decreasing/relatively stable plasma A beta 42 (P=.01) was associated with faster cognitive decline, primarily in memory.Conclusions: The association between plasma A beta and multiple aspects of cognition more clearly specifies the previously documented downward trajectory of plasma A beta with AD onset. The predominant association with memory seen only in healthy elderly individuals also suggests that plasma A beta is linked with even earlier neurologic changes that may or may not culminate in dementia.