Risk factors for cognitive decline in non-demented elders with amyloid-beta positivity.

IF 7.9 1区 医学 Q1 CLINICAL NEUROLOGY Alzheimer's Research & Therapy Pub Date : 2024-08-19 DOI:10.1186/s13195-024-01554-0
An-Yi Wang, He-Ying Hu, Liang-Yu Huang, Chu-Yun Xiao, Qiong-Yao Li, Lan Tan, Hao Hu
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Abstract

Background: As a currently incurable but preventable disease, the prevention and early diagnosis of Alzheimer's disease (AD) has long been a research hotspot. Amyloid deposition has been shown to be a major pathological feature of AD. Notably, not all the people with amyloid-beta (Aβ) pathology will have significant cognitive declines and eventually develop AD. Therefore, the aim of this study was to explore the risk factors for cognitive decline in Aβ-positive participants.

Methods: We included 650 non-demented participants who were Aβ-positive at baseline from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database. Mixed effects and COX regression models were applied to assess 37 potential risk factors. Mixed effects models were employed to assess the temporal associations between potential risk factors and four cognitive assessment scales. COX regression models were used to assess the impact of potential risk factors on cognitive diagnosis conversion. Univariate and multivariate analyses were applied to the above models. Additionally, we used the Cochran-Armitage trend test to examine whether the incidence of cognitive decline increased with the number concurrent of risk factors.

Results: Six factors (low diastolic pressure, low body mass index, retired status, a history of drug abuse, Parkinsonism, and depression) were the identified risk factors and four factors (a history of urinary disease, musculoskeletal diseases, no major surgical history, and no prior dermatologic-connective tissue diseases) were found to be suggestive risk factors. The incidence of cognitive decline in the Aβ-positive participants gradually increased as the number of concurrent risk factors increased (p for trend = 0.0005).

Conclusions: Our study may facilitate the understanding of the potential pathological processes in AD and provide novel targets for the prevention of cognitive decline among participants with Aβ positivity.

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淀粉样蛋白-β阳性非痴呆老人认知能力下降的风险因素。
背景:阿尔茨海默病(AD)是一种目前无法治愈但可以预防的疾病,其预防和早期诊断一直是研究热点。淀粉样蛋白沉积已被证明是阿尔茨海默病的主要病理特征。值得注意的是,并非所有出现淀粉样蛋白-β(Aβ)病理变化的人都会出现明显的认知能力下降,并最终发展为阿兹海默症。因此,本研究旨在探讨Aβ阳性参与者认知能力下降的风险因素:我们从阿尔茨海默病神经影像学倡议(ADNI)数据库中纳入了 650 名基线时 Aβ 阳性的非痴呆参与者。采用混合效应和 COX 回归模型评估了 37 个潜在风险因素。混合效应模型用于评估潜在风险因素与四个认知评估量表之间的时间关联。COX 回归模型用于评估潜在风险因素对认知诊断转换的影响。对上述模型进行了单变量和多变量分析。此外,我们还使用 Cochran-Armitage 趋势检验法来检测认知能力下降的发生率是否会随着风险因素并发数量的增加而增加:结果:六个因素(低舒张压、低体重指数、退休状态、药物滥用史、帕金森病和抑郁症)是已确定的危险因素,四个因素(泌尿系统疾病史、肌肉骨骼疾病史、无重大手术史和无皮肤-结缔组织疾病史)是提示性危险因素。随着并发风险因素数量的增加,Aβ阳性参与者认知能力下降的发生率逐渐增加(趋势 p = 0.0005):我们的研究可能有助于了解注意力缺失症的潜在病理过程,并为预防Aβ阳性参与者的认知能力下降提供新的靶点。
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来源期刊
Alzheimer's Research & Therapy
Alzheimer's Research & Therapy 医学-神经病学
CiteScore
13.10
自引率
3.30%
发文量
172
审稿时长
>12 weeks
期刊介绍: Alzheimer's Research & Therapy is an international peer-reviewed journal that focuses on translational research into Alzheimer's disease and other neurodegenerative diseases. It publishes open-access basic research, clinical trials, drug discovery and development studies, and epidemiologic studies. The journal also includes reviews, viewpoints, commentaries, debates, and reports. All articles published in Alzheimer's Research & Therapy are included in several reputable databases such as CAS, Current contents, DOAJ, Embase, Journal Citation Reports/Science Edition, MEDLINE, PubMed, PubMed Central, Science Citation Index Expanded (Web of Science) and Scopus.
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