Exploring cognitive and neuroimaging profiles of dementia subtypes of individuals with dementia in the Democratic Republic of Congo.

IF 4.5 2区医学 Q2 GERIATRICS & GERONTOLOGY Frontiers in Aging Neuroscience Pub Date : 2025-02-12 eCollection Date: 2025-01-01 DOI:10.3389/fnagi.2025.1552348

Jean Ikanga, Saranya Sundaram Patel, Megan Schwinne, Caterina Obenauf, Emmanuel Epenge, Guy Gikelekele, Nathan Tshengele, Immaculee Kavugho, Samuel Mampunza, Lelo Mananga, Charlotte E Teunissen, Julio C Rojas, Brandon Chan, Argentina Lario Lago, Joel H Kramer, Adam L Boxer, Andreas Jeromin, Emile Omba, Alvaro Alonso, Alden L Gross

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Abstract

Objective: The 2024 Alzheimer's Association (AA) research diagnostic criteria for Alzheimer's Disease (AD) considers fluid biomarkers, including promising blood-based biomarkers for detecting AD. This study aims to identify dementia subtypes and their cognitive and neuroimaging profiles in older adults with dementia in the Democratic Republic of Congo (DRC) using biomarkers and clinical data.

Methods: Forty-five individuals with dementia over 65 years old were evaluated using the Community Screening Instrument for Dementia and the informant-based Alzheimer's Questionnaire. Core AD biomarkers (Aβ42/40 and p-tau181) and non-specific neurodegeneration biomarkers (NfL, GFAP) were measured in blood plasma. Neuroimaging structures were assessed using magnetic resonance imaging (MRI). Dementia subtypes were determined based on plasma biomarker pathology and vascular markers. Biomarker cutoff scores were identified to optimize sensitivity and specificity. Individuals were stratified into one of four dementia subtypes-AD only, non-AD vascular, non-AD other, or mixed - based on combinations of abnormalities in these markers.

Results: Among the 45 individuals with dementia, mixed dementia had the highest prevalence (42.4%), followed by AD-only (24.4%), non-AD other dementia (22.2%), and non-AD vascular dementia subtypes (11.1%). Both cognitive and neuroimaging profiles aligned poorly with biomarker classifications in the full sample. Cognitive tests varied across dementia subtypes. The cognitive profile of the AD-only and mixed groups suggested relatively low cognitive performance, while the non-AD and other groups had the best scores on average.

Conclusion: Consistent with studies in other settings, our preliminary findings suggest that neurodegenerative plasma biomarkers may help to identify dementia subtypes and provide insight into cognitive and neuroimaging profiles among older adults in the DRC.

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探索刚果民主共和国痴呆症患者痴呆亚型的认知和神经影像学特征。

目的：2024年阿尔茨海默病协会（AA）研究阿尔茨海默病（AD）的诊断标准，考虑液体生物标志物，包括有前途的基于血液的生物标志物来检测AD。本研究旨在利用生物标志物和临床数据识别刚果民主共和国（DRC）老年痴呆症患者的痴呆症亚型及其认知和神经影像学特征。方法：对45名65岁以上的痴呆症患者进行评估，采用社区痴呆症筛查工具和基于信息的阿尔茨海默氏症问卷。检测血浆中AD核心生物标志物（a - β42/40和p-tau181）和非特异性神经退行性生物标志物（NfL， GFAP）。采用磁共振成像（MRI）评估神经影像学结构。根据血浆生物标志物病理学和血管标志物确定痴呆亚型。确定生物标志物截止评分以优化敏感性和特异性。根据这些标志物的异常组合，将个体分为四种痴呆亚型之一-仅ad，非ad血管性，非ad其他或混合。结果：在45例痴呆患者中，混合型痴呆的患病率最高（42.4%），其次是单纯ad（24.4%）、非ad其他痴呆（22.2%）和非ad血管性痴呆亚型（11.1%）。在整个样本中，认知和神经影像学特征与生物标志物分类都不一致。认知测试因痴呆症亚型而异。单纯ad组和混合ad组的认知表现相对较低，而非ad组和其他组的平均得分最高。结论：与其他环境下的研究一致，我们的初步研究结果表明，神经退行性血浆生物标志物可能有助于识别痴呆症亚型，并为刚果民主共和国老年人的认知和神经影像学特征提供见解。

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来源期刊

Frontiers in Aging Neuroscience GERIATRICS & GERONTOLOGY-NEUROSCIENCES

CiteScore

6.30

自引率

8.30%

发文量

1426

期刊介绍： Frontiers in Aging Neuroscience is a leading journal in its field, publishing rigorously peer-reviewed research that advances our understanding of the mechanisms of Central Nervous System aging and age-related neural diseases. Specialty Chief Editor Thomas Wisniewski at the New York University School of Medicine is supported by an outstanding Editorial Board of international researchers. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide.