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Association of plasma GFAP with elevated brain amyloid is dependent on severity of white matter lesions in an Asian cognitively impaired cohort 在亚洲认知障碍人群中,血浆 GFAP 与脑淀粉样蛋白升高的关系取决于白质病变的严重程度
Pub Date : 2024-04-01 DOI: 10.1002/dad2.12576
Joyce R. Chong, Yuek Ling Chai, Amelia T. Y. Yam, S. Hilal, Henri Vrooman, Narayanaswamy Venketasubramanian, K. Blennow, Henrik Zetterberg, N. Ashton, Christopher P Chen, Mitchell Kim Peng Lai
Abstract INTRODUCTION While elevated blood glial fibrillary acidic protein (GFAP) has been associated with brain amyloid pathology, whether this association occurs in populations with high cerebral small vessel disease (CSVD) concomitance remains unclear. METHODS Using a Singapore‐based cohort of cognitively impaired subjects, we assessed associations between plasma GFAP and neuroimaging measures of brain amyloid and CSVD, including white matter hyperintensities (WMH). We also examined the diagnostic performance of plasma GFAP in detecting brain amyloid beta positivity (Aβ+). RESULTS When stratified by WMH status, elevated brain amyloid was associated with higher plasma GFAP only in the WMH– group (β = 0.383; P < 0.001). The diagnostic performance of plasma GFAP in identifying Aβ+ was significantly higher in the WMH– group (area under the curve [AUC] = 0.896) than in the WMH+ group (AUC = 0.712, P = 0.008). DISCUSSION The biomarker utility of plasma GFAP in detecting brain amyloid pathology is dependent on the severity of concomitant WMH. Highlight Glial fibrillary acidic protein (GFAP)’s association with brain amyloid is unclear in populations with high cerebral small vessel disease (CSVD). Plasma GFAP was measured in a cohort with CSVD and brain amyloid. Plasma GFAP was better in detecting amyloid in patients with low CSVD versus high CSVD. Biomarker utility of GFAP in detecting brain amyloid depends on the severity of CSVD.
摘要 引言 虽然血液胶质纤维酸性蛋白(GFAP)的升高与脑淀粉样病理有关,但这种关联是否发生在脑小血管疾病(CSVD)伴随率高的人群中仍不清楚。方法:我们利用新加坡的认知障碍受试者队列,评估了血浆 GFAP 与脑淀粉样蛋白和 CSVD(包括白质高密度(WMH))的神经影像学测量之间的关联。我们还考察了血浆 GFAP 在检测脑淀粉样蛋白 beta 阳性(Aβ+)方面的诊断性能。结果 按 WMH 状态分层时,只有 WMH- 组的脑淀粉样蛋白升高与血浆 GFAP 升高相关(β = 0.383;P < 0.001)。血浆 GFAP 识别 Aβ+ 的诊断性能在 WMH- 组(曲线下面积 [AUC] = 0.896)明显高于 WMH+ 组(AUC = 0.712,P = 0.008)。讨论 血浆 GFAP 在检测脑淀粉样变性病理方面的生物标记作用取决于同时存在的 WMH 的严重程度。亮点 神经胶质纤维酸性蛋白(GFAP)与脑淀粉样蛋白在脑小血管疾病(CSVD)高发人群中的关系尚不清楚。在患有 CSVD 和脑淀粉样蛋白的人群中测量了血浆 GFAP。低CSVD患者与高CSVD患者血浆GFAP检测淀粉样蛋白的效果更好。GFAP在检测脑淀粉样蛋白方面的生物标记作用取决于CSVD的严重程度。
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引用次数: 0
Distinct patterns of voxel‐ and connection‐based white matter hyperintensity distribution and associated factors in early‐onset and late‐onset Alzheimer's disease 早发性和晚发性阿尔茨海默氏症患者基于体素和连接的白质高密度分布的不同模式及相关因素
Pub Date : 2024-04-01 DOI: 10.1002/dad2.12585
Hui Hong, Yutong Chen, Weiran Liu, Xiao Luo, Minming Zhang
Abstract Introduction The distribution of voxel‐ and connection‐based white matter hyperintensity (WMH) patterns in early‐onset Alzheimer's disease (EOAD) and late‐onset Alzheimer's disease (LOAD), as well as factors associated with these patterns, remain unclear. Method We analyzed the WMH distribution patterns in EOAD and LOAD at the voxel and connection levels, each compared with their age‐matched cognitively unimpaired participants. Linear regression assessed the independent effects of amyloid and vascular risk factors on WMH distribution patterns in both groups. Results Patients with EOAD showed increased WMH burden in the posterior region at the voxel level, and in occipital region tracts and visual network at the connection level, compared to controls. LOAD exhibited extensive involvement across various brain areas in both levels. Amyloid accumulation was associated WMH distribution in the early‐onset group, whereas the late‐onset group demonstrated associations with both amyloid and vascular risk factors. Discussion EOAD showed posterior‐focused WMH distribution pattern, whereas LOAD was with a wider distribution. Amyloid accumulation was associated with connection‐based WMH patterns in both early‐onset and late‐onset groups, with additional independent effects of vascular risk factors in late‐onset group. Highlights Both early‐onset Alzheimer's disease (EOAD) and late‐onset AD (LOAD) showed increased white matter hyperintensity (WMH) volume compared with their age‐matched cognitively unimpaired participants. EOAD and LOAD exhibited distinct patterns of WMH distribution, with EOAD showing a posterior‐focused pattern and LOAD displaying a wider distribution across both voxel‐ and connection‐based levels. In both EOAD and LOAD, amyloid accumulation was associated with connection‐based WMH patterns, with additional independent effects of vascular risk factors observed in LOAD.
摘要 引言 早发性阿尔茨海默病(EOAD)和晚发性阿尔茨海默病(LOAD)中基于象素和连接的白质高密度(WMH)分布模式以及与这些模式相关的因素仍不清楚。方法 我们分析了EOAD和LOAD患者在体素和连接水平上的WMH分布模式,并分别与年龄匹配的认知功能未受损的参与者进行了比较。线性回归评估了淀粉样蛋白和血管风险因素对两组 WMH 分布模式的独立影响。结果 与对照组相比,EOAD 患者在体素水平上显示后部区域的 WMH 负荷增加,在连接水平上显示枕区束和视觉网络的 WMH 负荷增加。LOAD患者在这两个层面上都表现出大脑各区域的广泛受累。早期发病组的淀粉样蛋白积累与WMH分布有关,而晚期发病组则与淀粉样蛋白和血管风险因素有关。讨论 EOAD表现为后部集中的WMH分布模式,而LOAD则分布较广。在早发组和晚发组中,淀粉样蛋白的积累都与以连接为基础的WMH模式有关,在晚发组中,血管风险因素具有额外的独立影响。研究要点 早发性阿尔茨海默病(EOAD)和晚发性阿尔茨海默病(LOAD)患者的白质高密度(WMH)体积都比年龄匹配的认知功能未受损的患者有所增加。EOAD和LOAD表现出不同的WMH分布模式,EOAD表现出以后部为中心的模式,而LOAD则在体素和连接水平上表现出更广泛的分布。在EOAD和LOAD中,淀粉样蛋白的积累都与基于连接的WMH模式有关,在LOAD中还观察到了血管风险因素的独立影响。
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引用次数: 0
Cognitive and functional performance and plasma biomarkers of early Alzheimer's disease in Down syndrome 唐氏综合征早期阿尔茨海默病的认知和功能表现及血浆生物标志物
Pub Date : 2024-04-01 DOI: 10.1002/dad2.12582
E. Schworer, B. Handen, Melissa E. Petersen, S. O'Bryant, Jamie C. Peven, D. Tudorascu, Laisze Lee, S. Krinsky-McHale, C. Hom, Isabel Clare, Bradley T. Christian, N. Schupf, Joseph H. Lee, Elizabeth Head, M. Mapstone, Ira T. Lott, B. Ances, Shahid H. Zaman, Adam M. Brickman, F. Lai, H. D. Rosas, S. Hartley
Abstract INTRODUCTION People with Down syndrome (DS) have a 75% to 90% lifetime risk of Alzheimer's disease (AD). AD pathology begins a decade or more prior to onset of clinical AD dementia in people with DS. It is not clear if plasma biomarkers of AD pathology are correlated with early cognitive and functional impairments in DS, and if these biomarkers could be used to track the early stages of AD in DS or to inform inclusion criteria for clinical AD treatment trials. METHODS This large cross‐sectional cohort study investigated the associations between plasma biomarkers of amyloid beta (Aβ)42/40, total tau, and neurofilament light chain (NfL) and cognitive (episodic memory, visual–motor integration, and visuospatial abilities) and functional (adaptive behavior) impairments in 260 adults with DS without dementia (aged 25–81 years). RESULTS In general linear models lower plasma Aβ42/40 was related to lower visuospatial ability, higher total tau was related to lower episodic memory, and higher NfL was related to lower visuospatial ability and lower episodic memory. DISCUSSION Plasma biomarkers may have utility in tracking AD pathology associated with early stages of cognitive decline in adults with DS, although associations were modest. Highlights Plasma Alzheimer's disease (AD) biomarkers correlate with cognition prior to dementia in Down syndrome. Lower plasma amyloid beta 42/40 was related to lower visuospatial abilities. Higher plasma total tau and neurofilament light chain were associated with lower cognitive performance. Plasma biomarkers show potential for tracking early stages of AD symptomology.
摘要 简介 唐氏综合症(DS)患者一生中患阿尔茨海默病(AD)的风险高达 75% 至 90%。在唐氏综合征患者出现临床阿兹海默症痴呆症之前十年或更早,阿兹海默症的病理变化就已经开始了。目前尚不清楚AD病理的血浆生物标志物是否与DS患者的早期认知和功能障碍相关,也不清楚这些生物标志物是否可用于追踪DS患者AD的早期阶段或为临床AD治疗试验的纳入标准提供依据。方法 该大型横断面队列研究调查了 260 名无痴呆症的 DS 成人(年龄在 25-81 岁之间)的血浆淀粉样 beta (Aβ)42/40、总 tau 和神经丝轻链 (NfL) 生物标志物与认知(情节记忆、视觉-运动整合和视觉空间能力)和功能(适应行为)损伤之间的关系。结果 在一般线性模型中,较低的血浆 Aβ42/40 与较低的视觉空间能力有关,较高的总 tau 与较低的外显记忆有关,较高的 NfL 与较低的视觉空间能力和较低的外显记忆有关。讨论 血浆生物标志物可能有助于追踪与DS成人认知能力下降早期阶段相关的AD病理变化,尽管相关性不大。亮点 血浆阿尔茨海默病(AD)生物标志物与唐氏综合征患者痴呆前的认知能力相关。较低的血浆淀粉样β42/40与较低的视觉空间能力有关。较高的血浆总tau和神经丝轻链与较低的认知能力有关。血浆生物标志物显示出追踪早期老年痴呆症状的潜力。
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引用次数: 0
Reversal of the concreteness effect can be detected in the natural speech of older adults with amnestic, but not non‐amnestic, mild cognitive impairment 在患有轻度认知障碍的失忆老年人的自然言语中可以检测到具体性效应的逆转,而在非失忆老年人的自然言语中则无法检测到这种效应
Pub Date : 2024-04-01 DOI: 10.1002/dad2.12588
Luwen Cao, Kunmei Han, Li Lin, J. Hing, Vincent Ooi, Nick Huang, Junhong Yu, Ted Kheng Siang Ng, Lei Feng, Rathi Mahendran, E. Kua, Zhiming Bao
Abstract INTRODUCTION Patients with Alzheimer's disease present with difficulty in lexical retrieval and reversal of the concreteness effect in nouns. Little is known about the phenomena before the onset of symptoms. We anticipate early linguistic signs in the speech of people who suffer from amnestic mild cognitive impairment (MCI). Here, we report the results of a corpus‐linguistic approach to the early detection of cognitive impairment. METHODS One hundred forty‐eight English‐speaking Singaporeans provided natural speech data, on topics of their choice; 74 were diagnosed with single‐domain MCI (38 amnestic, 36 non‐amnestic), 74 cognitively healthy. The recordings yield 267,310 words, which are tagged for parts of speech. We calculate the per‐minute word counts and concreteness scores of all tagged words, nouns, and verbs in the dataset. RESULTS Compared to controls, subjects with amnestic MCI produce fewer but more abstract nouns. Verbs are not affected. DISCUSSION Slower retrieval of nouns and the reversal of the concreteness effect in nouns are manifested in natural speech and can be detected early through corpus‐based analysis. Highlights Reversal of the concreteness effect is manifested in patients with Alzheimer's disease (AD) and semantic dementia. The paper reports a corpus‐based analysis of natural speech by people with amnestic and non‐amnestic mild cognitive impairment (MCI) and cognitively healthy controls. People with amnestic MCI produce fewer and more abstract nouns than people with non‐amnestic MCI and healthy controls. Verbs appear to be unaffected. The imageability problem can be detected in natural everyday speech by people with amnestic MCI, which carries a higher risk of conversion to AD.
摘要 引言 阿尔茨海默病患者表现为词汇检索困难和名词的具体性效应逆转。人们对发病前的这些现象知之甚少。我们希望在患有失忆性轻度认知障碍(MCI)的人的言语中发现早期语言迹象。在此,我们报告了通过语料库语言学方法早期检测认知障碍的结果。方法 148 名讲英语的新加坡人提供了自然语音数据,话题由他们自己选择;其中 74 人被诊断为单域 MCI(38 人失忆,36 人非失忆),74 人认知健康。录音共产生 267,310 个单词,这些单词已标记为语篇。我们计算了数据集中所有标记词、名词和动词的每分钟词数和具体化得分。结果 与对照组相比,患有失忆性 MCI 的受试者产生的抽象名词更少,但更抽象。动词则不受影响。讨论 在自然语音中,名词检索速度较慢,名词的具体性效应发生逆转,这些现象可以通过基于语料库的分析及早发现。亮点 具体化效应的逆转在阿尔茨海默病(AD)和语义痴呆症患者中有所表现。本文报告了基于语料库对有记忆障碍和无记忆障碍的轻度认知障碍(MCI)患者以及认知健康对照组的自然语音进行的分析。与非忆性轻度认知障碍患者和健康对照组相比,忆性轻度认知障碍患者产生的名词更少、更抽象。动词似乎不受影响。失忆型 MCI 患者在日常自然言语中可以发现形象性问题,而这种情况转化为注意力缺失症的风险较高。
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引用次数: 0
Risk of depression in persons with Alzheimer's disease: A national cohort study 阿尔茨海默病患者患抑郁症的风险:全国队列研究
Pub Date : 2024-04-01 DOI: 10.1002/dad2.12584
C. Crump, W. Sieh, Barbara G Vickrey, Alexis C Edwards, J. Sundquist, Kristina Sundquist
Abstract INTRODUCTION Depression is a risk factor and possible prodromal symptom of Alzheimer's disease (AD), but little is known about subsequent risk of developing depression in persons with AD. METHODS National matched cohort study was conducted of all 129,410 persons diagnosed with AD and 390,088 with all‐cause dementia during 1998–2017 in Sweden, and 3,900,880 age‐ and sex‐matched controls without dementia, who had no prior depression. Cox regression was used to compute hazard ratios (HRs) for major depression through 2018. RESULTS Cumulative incidence of major depression was 13% in persons with AD and 3% in controls. Adjusting for sociodemographic factors and comorbidities, risk of major depression was greater than two‐fold higher in women with AD (HR, 2.21; 95% confidence interval [CI], 2.11–2.32) or men with AD (2.68; 2.52–2.85), compared with controls. Similar results were found for all‐cause dementia. DISCUSSION Persons diagnosed with AD or related dementias need close follow‐up for timely detection and treatment of depression. Highlights In a large cohort, women and men with AD had >2‐fold subsequent risk of depression. Risks were highest in the first year (>3‐fold) but remained elevated ≥3 years later. Risk of depression was highest in persons aged ≥85 years at AD diagnosis. Persons with AD need close follow‐up for detection and treatment of depression.
摘要 引言 抑郁是阿尔茨海默病(AD)的一个风险因素和可能的前驱症状,但人们对AD患者随后罹患抑郁症的风险知之甚少。方法 对瑞典 1998 年至 2017 年期间确诊的 129,410 名阿尔茨海默病患者和 390,088 名全因痴呆患者,以及 3,900,880 名年龄和性别匹配的无痴呆对照者进行了全国匹配队列研究,这些对照者之前均未患过抑郁症。采用 Cox 回归计算了截至 2018 年的重度抑郁症危险比 (HR)。结果 AD 患者的重度抑郁症累积发病率为 13%,对照组为 3%。调整社会人口学因素和合并症后,与对照组相比,女性 AD 患者(HR,2.21;95% 置信区间 [CI],2.11-2.32)或男性 AD 患者(2.68;2.52-2.85)患重度抑郁症的风险高出两倍多。在全因痴呆症方面也发现了类似的结果。讨论 被诊断为注意力缺失症或相关痴呆症的患者需要密切随访,以便及时发现和治疗抑郁症。亮点 在一个大型队列中,女性和男性注意力缺失症患者随后患抑郁症的风险均大于2倍。第一年的风险最高(>3倍),但≥3年后风险仍然较高。诊断出患有注意力缺失症时年龄≥85岁的人患抑郁症的风险最高。发现和治疗抑郁症需要对注意力缺失症患者进行密切随访。
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引用次数: 0
Relationship of plasma biomarkers to digital cognitive tests in Alzheimer's disease 阿尔茨海默病血浆生物标志物与数字认知测试的关系
Pub Date : 2024-04-01 DOI: 10.1002/dad2.12590
Sofia Toniolo, Sijia Zhao, A. Scholcz, B. Amein, A. Ganse-Dumrath, A. Heslegrave, Sian Thompson, Sanjay Manohar, Henrik Zetterberg, Masud Husain
Abstract INTRODUCTION A major limitation in Alzheimer's disease (AD) research is the lack of the ability to measure cognitive performance at scale—robustly, remotely, and frequently. Currently, there are no established online digital platforms validated against plasma biomarkers of AD. METHODS We used a novel web‐based platform that assessed different cognitive functions in AD patients (N = 46) and elderly controls (N = 53) who were also evaluated for plasma biomarkers (amyloid beta 42/40 ratio, phosphorylated tau ([p‐tau]181, glial fibrillary acidic protein, neurofilament light chain). Their cognitive performance was compared to a second, larger group of elderly controls (N = 352). RESULTS Patients with AD were significantly impaired across all digital cognitive tests, with performance correlating with plasma biomarker levels, particularly p‐tau181. The combination of p‐tau181 and the single best‐performing digital test achieved high accuracy in group classification. DISCUSSION These findings show how online testing can now be deployed in patients with AD to measure cognitive function effectively and related to blood biomarkers of the disease. Highlights This is the first study comparing online digital testing to plasma biomarkers. Alzheimer's disease patients and two independent cohorts of elderly controls were assessed. Cognitive performance correlated with plasma biomarkers, particularly phosphorylated tau (p‐tau)181. Glial fibrillary acidic protein and neurofilament light chain, and less so the amyloid beta 42/40 ratio, were also associated with performance. The best cognitive metric performed at par to p‐tau181 in group classification.
摘要 引言 阿尔茨海默病(AD)研究的一个主要局限是缺乏大规模、远程和频繁测量认知能力的能力。目前,还没有针对阿尔茨海默病血浆生物标志物进行验证的成熟在线数字平台。方法 我们使用了一个新颖的网络平台,对注意力缺失症患者(46 人)和老年对照组(53 人)的不同认知功能进行评估,同时还对他们的血浆生物标记物(淀粉样 beta 42/40 比值、磷酸化 tau([p-tau]181、胶质纤维酸性蛋白、神经丝轻链)进行了评估。他们的认知表现与第二组更多的老年对照组(N = 352)进行了比较。结果 在所有数字认知测试中,注意力缺失症患者的认知能力明显受损,其表现与血浆生物标志物水平相关,尤其是p-tau181。结合 p-tau181 和表现最好的单项数字测试,可实现较高的组别分类准确性。讨论 这些研究结果表明,现在可以在注意力缺失症患者中使用在线测试来有效测量认知功能,并与该疾病的血液生物标记物相关联。亮点 这是第一项将在线数字测试与血浆生物标志物进行比较的研究。对阿尔茨海默病患者和两个独立的老年对照组进行了评估。认知表现与血浆生物标志物相关,尤其是磷酸化 tau(p-tau)181。胶质纤维酸性蛋白和神经丝蛋白轻链也与认知能力有关,而淀粉样β 42/40 比值与认知能力关系不大。最佳认知指标在组别分类中的表现与 p-tau181 相当。
{"title":"Relationship of plasma biomarkers to digital cognitive tests in Alzheimer's disease","authors":"Sofia Toniolo, Sijia Zhao, A. Scholcz, B. Amein, A. Ganse-Dumrath, A. Heslegrave, Sian Thompson, Sanjay Manohar, Henrik Zetterberg, Masud Husain","doi":"10.1002/dad2.12590","DOIUrl":"https://doi.org/10.1002/dad2.12590","url":null,"abstract":"Abstract INTRODUCTION A major limitation in Alzheimer's disease (AD) research is the lack of the ability to measure cognitive performance at scale—robustly, remotely, and frequently. Currently, there are no established online digital platforms validated against plasma biomarkers of AD. METHODS We used a novel web‐based platform that assessed different cognitive functions in AD patients (N = 46) and elderly controls (N = 53) who were also evaluated for plasma biomarkers (amyloid beta 42/40 ratio, phosphorylated tau ([p‐tau]181, glial fibrillary acidic protein, neurofilament light chain). Their cognitive performance was compared to a second, larger group of elderly controls (N = 352). RESULTS Patients with AD were significantly impaired across all digital cognitive tests, with performance correlating with plasma biomarker levels, particularly p‐tau181. The combination of p‐tau181 and the single best‐performing digital test achieved high accuracy in group classification. DISCUSSION These findings show how online testing can now be deployed in patients with AD to measure cognitive function effectively and related to blood biomarkers of the disease. Highlights This is the first study comparing online digital testing to plasma biomarkers. Alzheimer's disease patients and two independent cohorts of elderly controls were assessed. Cognitive performance correlated with plasma biomarkers, particularly phosphorylated tau (p‐tau)181. Glial fibrillary acidic protein and neurofilament light chain, and less so the amyloid beta 42/40 ratio, were also associated with performance. The best cognitive metric performed at par to p‐tau181 in group classification.","PeriodicalId":516929,"journal":{"name":"Alzheimer's & Dementia : Diagnosis, Assessment & Disease Monitoring","volume":"82 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140778141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Suboptimal self‐reported sleep efficiency and duration are associated with faster accumulation of brain amyloid beta in cognitively unimpaired older adults 自我报告的睡眠效率和持续时间不达标与认知能力未受损的老年人大脑淀粉样蛋白 beta 的快速积累有关
Pub Date : 2024-04-01 DOI: 10.1002/dad2.12579
Louise N Pivac, B. Brown, Kelsey R. Sewell, J. Doecke, V. Villemagne, V. Doré, M. Weinborn, H. Sohrabi, S. Gardener, R. Bucks, Simon M. Laws, K. Taddei, P. Maruff, Colin L. Masters, Christopher C. Rowe, Ralph N. Martins, S. Rainey-Smith
Abstract INTRODUCTION This study investigated whether self‐reported sleep quality is associated with brain amyloid beta (Aβ) accumulation. METHODS Linear mixed effect model analyses were conducted for 189 cognitively unimpaired (CU) older adults (mean ± standard deviation 74.0 ± 6.2; 53.2% female), with baseline self‐reported sleep data, and positron emission tomography‐determined brain Aβ measured over a minimum of three time points (range 33.3–72.7 months). Analyses included random slopes and intercepts, interaction for apolipoprotein E (APOE) ε4 allele status, and time, adjusting for sex and baseline age. RESULTS Sleep duration <6 hours, in APOE ε4 carriers, and sleep efficiency <65%, in the whole sample and APOE ε4 non‐carriers, is associated with faster accumulation of brain Aβ. DISCUSSION These findings suggest a role for self‐reported suboptimal sleep efficiency and duration in the accumulation of Alzheimer's disease (AD) neuropathology in CU individuals. Additionally, poor sleep efficiency represents a potential route via which individuals at lower genetic risk may progress to preclinical AD. Highlights In cognitively unimpaired older adults self‐report sleep is associated with brain amyloid beta (Aβ) accumulation. Across sleep characteristics, this relationship differs by apolipoprotein E (APOE) genotype. Sleep duration <6 hours is associated with faster brain Aβ accumulation in APOE ε4 carriers. Sleep efficiency < 65% is associated with faster brain Aβ accumulation in APOE ε4 non‐carriers. Personalized sleep interventions should be studied for potential to slow Aβ accumulation.
摘要 本研究调查了自我报告的睡眠质量是否与大脑淀粉样β(Aβ)的积累有关。方法 对189名认知功能未受损(CU)的老年人(平均值±标准差为74.0±6.2;53.2%为女性)进行线性混合效应模型分析,这些老年人提供了基线自我报告睡眠数据,并在至少三个时间点(范围为33.3-72.7个月)测量了正电子发射断层扫描测定的脑淀粉样β。分析包括随机斜率和截距、载脂蛋白 E (APOE) ε4等位基因状态与时间的交互作用,并对性别和基线年龄进行了调整。结果 在 APOE ε4 携带者中,睡眠持续时间小于 6 小时;在整个样本和 APOE ε4 非携带者中,睡眠效率小于 65%,这与大脑 Aβ 的快速积累有关。讨论 这些研究结果表明,自我报告的睡眠效率和持续时间不达标会导致阿尔茨海默病(AD)神经病理学在 CU 患者中的积累。此外,睡眠效率低下是遗传风险较低的个体发展为临床前阿尔茨海默病的潜在途径。要点 在认知能力未受损的老年人中,自我报告的睡眠与大脑淀粉样β(Aβ)的积累有关。在各种睡眠特征中,这种关系因载脂蛋白E(APOE)基因型而异。在 APOE ε4 携带者中,睡眠时间<6 小时与大脑淀粉样蛋白 beta 的快速积累有关。睡眠效率<65%与APOE ε4非携带者大脑Aβ积累速度加快有关。应研究个性化的睡眠干预措施是否有可能减缓Aβ的积累。
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引用次数: 0
Characterizing cognitive profiles in diverse middle‐aged and older Hispanics/Latinos: Study of Latinos‐Investigation of Neurocognitive Aging (HCHS/SOL) 不同中老年西班牙裔/拉美裔人的认知特征:拉美裔研究--神经认知老化调查(HCHS/SOL)
Pub Date : 2024-04-01 DOI: 10.1002/dad2.12592
Lisa V. Graves, W. Tarraf, Kevin A. González, M. Bondi, Linda C. Gallo, Carmen R. Isasi, Martha L Daviglus, Melissa Lamar, Donglin Zeng, Jianwen Cai, Hector M. González
Abstract Introduction We investigated cognitive profiles among diverse, middle‐aged and older Hispanic/Latino adults in the Study of Latinos–Investigation of Neurocognitive Aging (SOL‐INCA) cohort using a cross‐sectional observational study design. Methods Based on weighted descriptive statistics, the average baseline age of the target population was 56.4 years, slightly more than half were women (54.6%), and 38.4% reported less than a high school education. We used latent profile analysis of demographically adjusted z scores on SOL‐INCA neurocognitive tests spanning domains of verbal memory, language, processing speed, and executive function. Results Statistical fit assessment indices combined with clinical interpretation suggested five profiles: (1) a Higher Global group performing in the average‐to‐high‐average range across all cognitive and instrumental activity of daily living (IADL) tests (13.8%); (2) a Higher Memory group with relatively high performance on memory tests but average performance across all other cognitive/IADL tests (24.6%); (3) a Lower Memory group with relatively low performance on memory tests but average performance across all other cognitive/IADL tests (32.8%); (4) a Lower Executive Function group with relatively low performance on executive function and processing speed tests but average‐to‐low‐average performance across all other cognitive/IADL tests (16.6%); and (5) a Lower Global group performing low‐average‐to‐mildly impaired across all cognitive/IADL tests (12.1%). Discussion Our results provide evidence of heterogeneity in the cognitive profiles of a representative, community‐dwelling sample of diverse Hispanic/Latino adults. Our analyses yielded cognitive profiles that may assist efforts to better understand the early cognitive changes that may portend Alzheimer's disease and related dementias among diverse Hispanics/Latinos. Highlights The present study characterized cognitive profiles among diverse middle‐aged and older Hispanic/Latino adults. Latent profile analysis of neurocognitive test scores was the primary analysis conducted. The target population consists of middle‐aged and older Hispanic/Latino adults enrolled in the Hispanic Community Health Study/Study of Latinos and ancillary Study of Latinos ‐ Investigation of Neurocognitive Aging.
摘要 引言 我们采用横断面观察研究设计,调查了拉丁美洲人神经认知老化调查(SOL-INCA)队列中不同的西班牙裔/拉丁美洲裔中老年人的认知概况。方法 根据加权描述性统计,目标人群的平均基线年龄为 56.4 岁,女性略高于半数(54.6%),38.4% 的人接受过高中以下教育。我们对 SOL-INCA 神经认知测试中经过人口统计学调整的 z 分数进行了潜在特征分析,这些测试涵盖了言语记忆、语言、处理速度和执行功能等领域。结果 统计拟合评估指数与临床解释相结合,得出了五种特征:(1) 在所有认知和日常生活工具性活动(IADL)测试中表现处于平均水平至高平均水平的高全局感组(13.8%);(2) 在记忆测试中表现相对较高,但在所有其他认知/日常生活工具性活动测试中表现一般的高记忆力组(24.6%);(3)记忆力较低组,记忆力测试成绩相对较低,但在所有其他认知/日常生活能力测试中成绩一般(32.8%);(4)执行功能较低组,执行功能和处理速度测试成绩相对较低,但在所有其他认知/日常生活能力测试中成绩从平均水平到低平均水平(16.6%);以及(5)全面性较低组,在所有认知/日常生活能力测试中成绩从低平均水平到轻度受损(12.1%)。讨论 我们的研究结果提供了具有代表性的、居住在社区的西班牙裔/拉美裔成年人认知特征异质性的证据。我们的分析所得出的认知特征可能有助于更好地了解不同西语裔/拉美裔人群中可能预示着阿尔茨海默病和相关痴呆症的早期认知变化。研究重点 本研究描述了西班牙裔/拉美裔中老年人的认知特征。对神经认知测试分数进行的潜在特征分析是主要的分析方法。目标人群包括参加 "拉美裔社区健康研究"/"拉美裔研究 "和 "拉美裔辅助研究--神经认知老化调查 "的中老年拉美裔成年人。
{"title":"Characterizing cognitive profiles in diverse middle‐aged and older Hispanics/Latinos: Study of Latinos‐Investigation of Neurocognitive Aging (HCHS/SOL)","authors":"Lisa V. Graves, W. Tarraf, Kevin A. González, M. Bondi, Linda C. Gallo, Carmen R. Isasi, Martha L Daviglus, Melissa Lamar, Donglin Zeng, Jianwen Cai, Hector M. González","doi":"10.1002/dad2.12592","DOIUrl":"https://doi.org/10.1002/dad2.12592","url":null,"abstract":"Abstract Introduction We investigated cognitive profiles among diverse, middle‐aged and older Hispanic/Latino adults in the Study of Latinos–Investigation of Neurocognitive Aging (SOL‐INCA) cohort using a cross‐sectional observational study design. Methods Based on weighted descriptive statistics, the average baseline age of the target population was 56.4 years, slightly more than half were women (54.6%), and 38.4% reported less than a high school education. We used latent profile analysis of demographically adjusted z scores on SOL‐INCA neurocognitive tests spanning domains of verbal memory, language, processing speed, and executive function. Results Statistical fit assessment indices combined with clinical interpretation suggested five profiles: (1) a Higher Global group performing in the average‐to‐high‐average range across all cognitive and instrumental activity of daily living (IADL) tests (13.8%); (2) a Higher Memory group with relatively high performance on memory tests but average performance across all other cognitive/IADL tests (24.6%); (3) a Lower Memory group with relatively low performance on memory tests but average performance across all other cognitive/IADL tests (32.8%); (4) a Lower Executive Function group with relatively low performance on executive function and processing speed tests but average‐to‐low‐average performance across all other cognitive/IADL tests (16.6%); and (5) a Lower Global group performing low‐average‐to‐mildly impaired across all cognitive/IADL tests (12.1%). Discussion Our results provide evidence of heterogeneity in the cognitive profiles of a representative, community‐dwelling sample of diverse Hispanic/Latino adults. Our analyses yielded cognitive profiles that may assist efforts to better understand the early cognitive changes that may portend Alzheimer's disease and related dementias among diverse Hispanics/Latinos. Highlights The present study characterized cognitive profiles among diverse middle‐aged and older Hispanic/Latino adults. Latent profile analysis of neurocognitive test scores was the primary analysis conducted. The target population consists of middle‐aged and older Hispanic/Latino adults enrolled in the Hispanic Community Health Study/Study of Latinos and ancillary Study of Latinos ‐ Investigation of Neurocognitive Aging.","PeriodicalId":516929,"journal":{"name":"Alzheimer's & Dementia : Diagnosis, Assessment & Disease Monitoring","volume":"112 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140768925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Examining the propensity and nature of criminal risk behaviours in frontotemporal dementia syndromes and Alzheimer's disease 研究额颞叶痴呆综合症和阿尔茨海默病的犯罪风险行为倾向和性质
Pub Date : 2024-04-01 DOI: 10.1002/dad2.12577
F. Kumfor, G. Wei, Nola Ries, Hayley Bennett, M. D'Mello, C. Kaizik, Olivier Piguet, John R. Hodges
Abstract INTRODUCTION Some people with dementia develop changes in behaviour and cognition that may lead to interactions with police or the legal system. However, large, prospective case–control studies examining these behaviours are lacking. METHODS One hundred and forty‐four people with dementia and 53 controls completed the Misdemeanours and Transgressions Screener. RESULTS Criminal risk behaviours were reported in: 65.6% of behavioural‐variant frontotemporal dementia, 46.2% of right‐lateralised semantic dementia, and 27.0% of Alzheimer's disease patients. In 19.1% of patients these behaviours led to contact with police or authority figures. Compared to controls, people with dementia showed higher rates of physical assault (p = 0.024), financial/professional recklessness (p = 0.009), and inappropriate behaviours (p = 0.052). DISCUSSION Criminal risk behaviours are common across dementia subtypes and may be one of the first clinical signs of frontotemporal dementia. Further research to understand how to balance risk minimisation with an individual's liberties as well as the inappropriate criminalisation of people with dementia is needed. Highlights The Misdemeanours and Transgressions Screener is a new tool to assess criminal risk behaviours. Forty‐seven percent of patients with dementia show criminal risk behaviour after dementia onset. Behaviours included verbal abuse, traffic violations, physical assault. New onset of criminal risk behaviours >50 years is a clinical sign for frontotemporal dementia.
摘要 引言 一些痴呆症患者的行为和认知会发生变化,从而可能导致与警察或法律系统的互动。然而,目前还缺乏对这些行为进行研究的大型前瞻性病例对照研究。方法 144 名痴呆症患者和 53 名对照者完成了 "轻罪和越轨行为筛查"。结果 据报告,有犯罪风险行为的人占65.6%的行为变异型额颞叶痴呆症患者、46.2%的右侧化语义痴呆症患者和 27.0%的阿尔茨海默病患者有犯罪危险行为。19.1%的患者因这些行为而与警察或权威人士发生接触。与对照组相比,痴呆症患者的人身攻击(p = 0.024)、财务/职业鲁莽(p = 0.009)和不当行为(p = 0.052)发生率更高。讨论 犯罪危险行为在各种痴呆症亚型中都很常见,可能是额颞叶痴呆症的最初临床表现之一。需要进一步研究如何在风险最小化与个人自由之间取得平衡,以及如何避免对痴呆症患者进行不适当的刑事定罪。亮点 轻罪和过失筛选器是一种评估犯罪风险行为的新工具。47% 的痴呆症患者在痴呆症发病后会出现犯罪风险行为。这些行为包括辱骂、违反交通规则和人身攻击。犯罪危险行为的新发年龄大于 50 岁,是额颞叶痴呆症的临床征兆。
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引用次数: 0
Alzheimer's disease cerebrospinal fluid biomarkers and kidney function in normal and cognitively impaired older adults 正常和认知障碍老年人的阿尔茨海默病脑脊液生物标志物和肾功能
Pub Date : 2024-04-01 DOI: 10.1002/dad2.12581
I. Hajjar, Reem Neal, Zhiyi Yang, James Lah
Abstract INTRODUCTION Recent Alzheimer's disease (AD) clinical trials have used cerebrospinal fluid (CSF) biomarker levels for screening and enrollment. Preliminary evidence suggests that AD risk is related to impaired renal function. The impact of kidney function on commonly used AD biomarkers remains unknown. METHODS Participants in studies conducted at the Goizueta Alzheimer's Disease Research Center (N = 973) had measurements of serum creatinine and CSF AD biomarkers. General linear models and individual data were used to assess the relationships between biomarkers and eGFR. RESULTS Lower estimated glomerular filtration rate (eGFR) was associated with lower amyloid beta (Aβ)42/tau ratio (p < 0.0001) and Aβ42 (p = 0.002) and higher tau (p < 0.0001) and p‐tau (p = 0.0002). The impact of eGFR on AD biomarker levels was more robust in individuals with cognitive impairment (all p‐values were < 0.005). DISCUSSION The association between eGFR and CSF AD biomarkers has a significant impact that varies by cognitive status. Future studies exploring this impact on the pathogenesis of AD and related biomarkers are needed. Highlights There is a significant association between Alzheimer's disease (AD) cerebrospinal fluid (CSF) biomarkers and both estimated glomerular filtration rate (eGFR) and mild cognitive impairment (MCI). Kidney function influences CSF biomarker levels in individuals with normal cognitive function and those with MCI. The impact of kidney function on AD biomarker levels is more pronounced in individuals with cognitive impairment. The variation in CSF tau levels is independent of cardiovascular factors and is likely directly related to kidney function. Tau may have a possible role in both kidney and cognitive function.
摘要 引言 最近的阿尔茨海默病(AD)临床试验使用脑脊液(CSF)生物标志物水平进行筛查和入组。初步证据表明,阿尔茨海默病风险与肾功能受损有关。肾功能对常用的 AD 生物标志物的影响尚不清楚。方法 戈伊祖塔阿尔茨海默病研究中心(Goizueta Alzheimer's Disease Research Center)的研究参与者(N = 973)测量了血清肌酐和脑脊液 AD 生物标志物。一般线性模型和个体数据用于评估生物标志物与 eGFR 之间的关系。结果 肾小球滤过率(eGFR)越低,淀粉样β(Aβ)42/tau比值(p < 0.0001)和Aβ42(p = 0.002)越低,tau(p < 0.0001)和p-tau(p = 0.0002)越高。eGFR对AD生物标志物水平的影响在认知障碍患者中更为明显(所有p值均小于0.005)。讨论 eGFR 与脑脊液 AD 生物标志物之间的关联具有显著影响,且因认知状况而异。今后需要开展研究,探讨这种关系对 AD 发病机制和相关生物标志物的影响。要点 阿尔茨海默病(AD)脑脊液(CSF)生物标志物与估计肾小球滤过率(eGFR)和轻度认知障碍(MCI)之间存在明显的关联。肾功能会影响认知功能正常者和 MCI 患者的 CSF 生物标志物水平。肾功能对注意力缺失症生物标志物水平的影响在认知障碍患者中更为明显。CSF tau水平的变化与心血管因素无关,可能与肾功能直接相关。Tau可能对肾脏和认知功能都有影响。
{"title":"Alzheimer's disease cerebrospinal fluid biomarkers and kidney function in normal and cognitively impaired older adults","authors":"I. Hajjar, Reem Neal, Zhiyi Yang, James Lah","doi":"10.1002/dad2.12581","DOIUrl":"https://doi.org/10.1002/dad2.12581","url":null,"abstract":"Abstract INTRODUCTION Recent Alzheimer's disease (AD) clinical trials have used cerebrospinal fluid (CSF) biomarker levels for screening and enrollment. Preliminary evidence suggests that AD risk is related to impaired renal function. The impact of kidney function on commonly used AD biomarkers remains unknown. METHODS Participants in studies conducted at the Goizueta Alzheimer's Disease Research Center (N = 973) had measurements of serum creatinine and CSF AD biomarkers. General linear models and individual data were used to assess the relationships between biomarkers and eGFR. RESULTS Lower estimated glomerular filtration rate (eGFR) was associated with lower amyloid beta (Aβ)42/tau ratio (p < 0.0001) and Aβ42 (p = 0.002) and higher tau (p < 0.0001) and p‐tau (p = 0.0002). The impact of eGFR on AD biomarker levels was more robust in individuals with cognitive impairment (all p‐values were < 0.005). DISCUSSION The association between eGFR and CSF AD biomarkers has a significant impact that varies by cognitive status. Future studies exploring this impact on the pathogenesis of AD and related biomarkers are needed. Highlights There is a significant association between Alzheimer's disease (AD) cerebrospinal fluid (CSF) biomarkers and both estimated glomerular filtration rate (eGFR) and mild cognitive impairment (MCI). Kidney function influences CSF biomarker levels in individuals with normal cognitive function and those with MCI. The impact of kidney function on AD biomarker levels is more pronounced in individuals with cognitive impairment. The variation in CSF tau levels is independent of cardiovascular factors and is likely directly related to kidney function. Tau may have a possible role in both kidney and cognitive function.","PeriodicalId":516929,"journal":{"name":"Alzheimer's & Dementia : Diagnosis, Assessment & Disease Monitoring","volume":"586 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140773088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Alzheimer's & Dementia : Diagnosis, Assessment & Disease Monitoring
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