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Extending the phenotypic spectrum assessed by the CDR plus NACC FTLD in genetic frontotemporal dementia 扩展遗传性额颞叶痴呆的 CDR 加 NACC FTLD 评估表型谱
Pub Date : 2024-04-01 DOI: 10.1002/dad2.12571
K. Samra, Georgia Peakman, Amy Macdougall, A. Bouzigues, C. Greaves, R. Convery, J. V. van Swieten, L. Jiskoot, H. Seelaar, F. Moreno, R. Sánchez-Valle, R. Laforce, Caroline Graff, M. Masellis, M. Tartaglia, James B. Rowe, B. Borroni, E. Finger, M. Synofzik, Daniela Galimberti, R. Vandenberghe, A. de Mendonça, Christopher R. Butler, Alexander Gerhard, S. Ducharme, I. Ber, Pietro Tiraboschi, Isabel Santana, F. Pasquier, J. Levin, M. Otto, S. Sorbi, J. Rohrer, L. Russell
Abstract INTRODUCTION We aimed to expand the range of the frontotemporal dementia (FTD) phenotypes assessed by the Clinical Dementia Rating Dementia Staging Instrument plus National Alzheimer's Coordinating Center Behavior and Language Domains (CDR plus NACC FTLD). METHODS Neuropsychiatric and motor domains were added to the standard CDR plus NACC FTLD generating a new CDR plus NACC FTLD‐NM scale. This was assessed in 522 mutation carriers and 310 mutation‐negative controls from the Genetic Frontotemporal dementia Initiative (GENFI). RESULTS The new scale led to higher global severity scores than the CDR plus NACC FTLD: 1.4% of participants were now considered prodromal rather than asymptomatic, while 1.3% were now considered symptomatic rather than asymptomatic or prodromal. No participants with a clinical diagnosis of an FTD spectrum disorder were classified as asymptomatic using the new scales. DISCUSSION Adding new domains to the CDR plus NACC FTLD leads to a scale that encompasses the wider phenotypic spectrum of FTD with further work needed to validate its use more widely. Highlights The new Clinical Dementia Rating Dementia Staging Instrument plus National Alzheimer's Coordinating Center Behavior and Language Domains neuropsychiatric and motor (CDR plus NACC FTLD‐NM) rating scale was significantly positively correlated with the original CDR plus NACC FTLD and negatively correlated with the FTD Rating Scale (FRS). No participants with a clinical diagnosis in the frontotemporal dementia spectrum were classified as asymptomatic with the new CDR plus NACC FTLD‐NM rating scale. Individuals had higher global severity scores with the addition of the neuropsychiatric and motor domains. A receiver operating characteristic analysis of symptomatic diagnosis showed nominally higher areas under the curve for the new scales.
摘要 引言 我们旨在扩大临床痴呆评级痴呆分期工具加美国国家阿尔茨海默氏症协调中心行为和语言领域(CDR 加 NACC FTLD)所评估的额颞叶痴呆(FTD)表型的范围。方法 在标准 CDR 加 NACC FTLD 的基础上增加了神经精神和运动领域,形成了新的 CDR 加 NACC FTLD-NM 量表。对遗传性额颞叶痴呆倡议(GENFI)的 522 名突变携带者和 310 名突变阴性对照者进行了评估。结果 新量表的总体严重性评分高于 CDR 加 NACC FTLD:1.4% 的参与者现在被认为是前驱而非无症状,而 1.3% 的参与者现在被认为是有症状而非无症状或前驱。使用新量表后,没有临床诊断为FTD谱系障碍的参与者被归类为无症状。讨论 在 CDR 和 NACC FTLD 的基础上增加了新的领域,从而使量表涵盖了更广泛的 FTD 表型谱,但还需要进一步的工作来验证其更广泛的应用。亮点 新的临床痴呆评级痴呆分期工具加国家阿尔茨海默氏症协调中心行为和语言领域神经精神和运动(CDR加NACC FTLD-NM)评级量表与原始的CDR加NACC FTLD呈显著正相关,而与FTD评级量表(FRS)呈负相关。在新的 CDR 加 NACC FTLD-NM 评定量表中,没有临床诊断为额颞叶痴呆的参与者被归类为无症状。增加神经精神和运动领域后,患者的总体严重程度得分更高。对无症状诊断的接收器操作特征分析表明,新量表的曲线下面积明显更高。
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引用次数: 0
From understanding to action: Exploring molecular connections of Down syndrome to Alzheimer's disease for targeted therapeutic approach 从理解到行动:探索唐氏综合征与阿尔茨海默病之间的分子联系,寻找靶向治疗方法
Pub Date : 2024-04-01 DOI: 10.1002/dad2.12580
Sonal Sukreet, M. Rafii, R. Rissman
Abstract Down syndrome (DS) is caused by a third copy of chromosome 21. Alzheimer's disease (AD) is a neurodegenerative condition characterized by the deposition of amyloid‐beta (Aβ) plaques and neurofibrillary tangles in the brain. Both disorders have elevated Aβ, tau, dysregulated immune response, and inflammation. In people with DS, Hsa21 genes like APP and DYRK1A are overexpressed, causing an accumulation of amyloid and neurofibrillary tangles, and potentially contributing to an increased risk of AD. As a result, people with DS are a key demographic for research into AD therapeutics and prevention. The molecular links between DS and AD shed insights into the underlying causes of both diseases and highlight potential therapeutic targets. Also, using biomarkers for early diagnosis and treatment monitoring is an active area of research, and genetic screening for high‐risk individuals may enable earlier intervention. Finally, the fundamental mechanistic parallels between DS and AD emphasize the necessity for continued research into effective treatments and prevention measures for DS patients at risk for AD. Genetic screening with customized therapy approaches may help the DS population in current clinical studies and future biomarkers.
摘要 唐氏综合征(DS)是由 21 号染色体的第三个拷贝引起的。阿尔茨海默病(AD)是一种神经退行性疾病,其特征是淀粉样β(Aβ)斑块和神经纤维缠结在大脑中沉积。这两种疾病都有 Aβ、tau 增高、免疫反应失调和炎症等症状。在 DS 患者中,APP 和 DYRK1A 等 Hsa21 基因过度表达,导致淀粉样蛋白和神经纤维缠结的积累,并有可能导致 AD 风险的增加。因此,DS患者是研究注意力缺失症治疗和预防的关键人群。DS和AD之间的分子联系揭示了这两种疾病的根本原因,并突出了潜在的治疗目标。此外,利用生物标志物进行早期诊断和治疗监测也是一个活跃的研究领域,而对高危人群进行基因筛查则可以实现早期干预。最后,DS 和 AD 在基本机理上的相似性强调了继续研究针对有 AD 风险的 DS 患者的有效治疗和预防措施的必要性。在当前的临床研究和未来的生物标志物研究中,基因筛查和定制治疗方法可能会对 DS 患者有所帮助。
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引用次数: 0
Cardiometabolic disease, cognitive decline, and brain structure in middle and older age 中老年人的心脏代谢疾病、认知能力下降和大脑结构
Pub Date : 2024-04-01 DOI: 10.1002/dad2.12566
Abigail Dove, Jie Guo, Jiao Wang, D. L. Vetrano, Sakura Sakakibara, E. Laukka, David A. Bennett, Weili Xu
Abstract INTRODUCTION The presence of multiple cardiometabolic diseases (CMDs) has been linked to increased dementia risk, but the combined influence of CMDs on cognition and brain structure across the life course is unclear. METHODS In the UK Biobank, 46,562 dementia‐free participants completed a cognitive test battery at baseline and a follow‐up visit 9 years later, at which point 39,306 also underwent brain magnetic resonance imaging. CMDs (diabetes, heart disease, and stroke) were ascertained from medical records. Data were analyzed using age‐stratified (middle age [< 60] versus older [≥ 60]) mixed‐effects models and linear regression. RESULTS A higher number of CMDs was associated with significantly steeper global cognitive decline in older (β = –0.008; 95% confidence interval: −0.012, −0.005) but not middle age. Additionally, the presence of multiple CMDs was related to smaller total brain volume, gray matter volume, white matter volume, and hippocampal volume and larger white matter hyperintensity volume, even in middle age. DISCUSSION CMDs are associated with cognitive decline in older age and poorer brain structural health beginning already in middle age. Highlights We explored the association of CMDs with cognitive decline and brain MRI measures. CMDs accelerated cognitive decline in older (≥60y) but not middle (<60) age. CMDs were associated with poorer brain MRI parameters in both middle and older age. Results highlight the connection between CMDs and cognitive/brain aging.
摘要 引言 多种心脏代谢疾病(CMDs)的存在与痴呆症风险的增加有关,但CMDs在整个生命过程中对认知和大脑结构的综合影响尚不清楚。方法 在英国生物库中,46,562 名未患痴呆症的参与者在基线和 9 年后的随访中完成了认知测试,39,306 名参与者还接受了脑磁共振成像检查。CMD(糖尿病、心脏病和中风)是根据医疗记录确定的。数据采用年龄分层(中年[<60]与老年[≥60])混合效应模型和线性回归进行分析。结果 老年患者(β = -0.008;95% 置信区间:-0.012, -0.005)而中年患者(β = -0.008;95% 置信区间:-0.012, -0.005)的CMD数量越多,其整体认知能力下降越明显。此外,即使在中年,存在多个 CMD 也与较小的总脑体积、灰质体积、白质体积和海马体积以及较大的白质高密度体积有关。讨论 CMD 与老年认知能力下降和中年开始的脑结构健康状况较差有关。亮点 我们探讨了 CMDs 与认知能力下降和脑磁共振成像测量的关系。CMD会加速老年(≥60岁)认知能力的衰退,但不会加速中年(<60岁)认知能力的衰退。在中老年,CMDs 与较差的脑磁共振成像参数有关。研究结果凸显了CMD与认知/脑衰老之间的联系。
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引用次数: 0
Awareness, attitudes, and beliefs of dementia in Indonesia 印度尼西亚对痴呆症的认识、态度和观念
Pub Date : 2024-04-01 DOI: 10.1002/dad2.12570
Nicolas Farina, Esra Hassan, I. Theresia, F. Fitri, Ika Suswanti, T. P. Sani, Sara Evans-Lacko, Sube Banerjee, Y. Turana
Abstract INTRODUCTION Tackling dementia stigma is a policy priority. In Indonesia, we have little insight into the general public's knowledge and attitudes about dementia. METHODS Cross‐sectional study of 4430 Indonesian adults recruited from Jakarta and North Sumatra, Indonesia. Measures included dementia knowledge and attitudes. RESULTS A total of 86.3% (n = 3,803) of adults had not heard of the terms dementia or Alzheimer's disease, and commonly viewed dementia as a normal part of aging. Being older, incorrect knowledge about etiology, not having heard of the terms dementia and/or Alzheimer's disease, having less than primary education, and being from North Sumatra were associated with more negative attitudes (p‐values < 0.05). DISCUSSION Misconceptions and lack of awareness about dementia are common in Indonesia. Attitudes tended not to be negative, but our research highlights factors associated with dementia attitudes. Future research should use this information to better tailor and target potential anti‐stigma strategies. Highlights Most Indonesians had not heard of the terms dementia and/or Alzheimer's disease and thought it was caused by normal aging. The majority of participants held mixed or positive attitudes towards dementia. A series of demographic factors alongside poor awareness were associated with negative attitudes towards dementia.
摘要 引言 解决痴呆症污名化问题是一项优先政策。在印度尼西亚,我们对公众对痴呆症的了解和态度知之甚少。方法 对从印尼雅加达和北苏门答腊招募的 4430 名印尼成年人进行横断面研究。调查内容包括痴呆症知识和态度。结果 86.3% 的成年人(n = 3803)没有听说过痴呆症或阿尔茨海默病,他们普遍认为痴呆症是衰老的正常现象。年龄越大、对病因的认识不正确、未听说过痴呆症和/或阿尔茨海默病、未接受过初等教育以及来自北苏门答腊等因素与更消极的态度有关(P 值小于 0.05)。讨论 对痴呆症的误解和缺乏认识在印度尼西亚很常见。人们的态度往往并不消极,但我们的研究强调了与痴呆症态度相关的因素。未来的研究应利用这些信息来更好地定制和实施潜在的反羞辱策略。研究亮点 大多数印尼人没有听说过痴呆症和/或阿尔茨海默病,并认为这是正常衰老引起的。大多数参与者对痴呆症持混合或积极态度。一系列人口统计因素和认知不足与对痴呆症的消极态度有关。
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引用次数: 0
Normative data for the Digit Symbol Substitution for diverse Hispanic/Latino adults: Results from the Study of Latinos‐Investigation of Neurocognitive Aging (SOL‐INCA) 针对不同西班牙裔/拉美裔成年人的数字符号替换标准数据:拉美裔神经认知老化调查研究(SOL-INCA)的结果
Pub Date : 2024-04-01 DOI: 10.1002/dad2.12573
Alejandra Morlett Paredes, W. Tarraf, Kevin A. González, A. Stickel, Lisa V. Graves, David P. Salmon, Sonya Kaur, Linda C. Gallo, C. Isasi, Richard B. Lipton, Melissa Lamar, Zachary T. Goodman, Hector M. González
Abstract INTRODUCTION Executive functioning and processing speed are crucial elements of neuropsychological assessment. To meet the needs of the Hispanic/Latino population, we aimed to provide normative data for the Digit Symbol Substitution (DSS) test. METHODS The target population for the Study of Latinos‐Investigation of Neurocognitive Aging included six heritage backgrounds (n = 6177). Average age was 63.4 ± 8.3 years, 54.5% were female, and mean education was 11.0 ± 4.7 years. Participants were administered the DSS as part of a larger battery. Heritage‐adjusted DSS scores, and percentile cut‐points were created using survey‐adjusted regression and quantile regression models. RESULTS Age, education, sex, heritage, and language preference were associated with DSS scores. DISCUSSION Significant correlates of DSS performance should be considered when evaluating cognitive performance. Representative DSS norms for Hispanics/Latinos will advance assessment and accuracy of neurocognitive disorder diagnosis in clinical practice. To facilitate interpretation, we provide norms to reduce test biases and developed an online dashboard. Highlights Normative data for the Digit Symbol Substitution (DSS) for diverse Hispanic/Latino adults: Results from the Study of Latinos‐Investigation of Neurocognitive Aging (SOL‐INCA) This study is the first to develop norms for the DSS test across four regions of the United States. Factors such as age, education, sex, and Hispanic/Latino heritage and language preference are associated with differences in executive functioning and information processing speed. We created norms and an online dashboard (https://solincalab.shinyapps.io/dsst_shiny/) providing an easily accessible tool to evaluate processing speed and executive functioning in Hispanic/Latino adults.
摘要 引言 执行功能和处理速度是神经心理学评估的关键要素。为了满足西班牙裔/拉美裔人群的需求,我们旨在提供数字符号替换(DSS)测试的标准数据。方法 拉丁美洲人--神经认知老化调查研究的目标人群包括六种传统背景(n = 6177)。平均年龄为 63.4 ± 8.3 岁,54.5% 为女性,平均受教育年限为 11.0 ± 4.7 年。对参与者进行的 DSS 测试是一个大型测试的一部分。使用调查调整回归和定量回归模型创建了遗产调整后的 DSS 分数和百分位切点。结果 年龄、教育程度、性别、遗产和语言偏好与 DSS 分数相关。讨论 在评估认知表现时,应考虑 DSS 表现的重要相关因素。具有代表性的西班牙裔/拉美裔 DSS 标准将促进临床实践中神经认知障碍诊断的评估和准确性。为了便于解释,我们提供了减少测试偏差的标准,并开发了一个在线仪表板。亮点:针对不同的西班牙裔/拉美裔成年人的数字符号替换(DSS)标准数据:拉美裔神经认知老化调查研究(SOL-INCA)的结果 这项研究首次为美国四个地区的 DSS 测试制定了标准。年龄、教育程度、性别、西班牙裔/拉美裔血统和语言偏好等因素与执行功能和信息处理速度的差异有关。我们创建了标准和在线仪表板 (https://solincalab.shinyapps.io/dsst_shiny/),为评估西班牙裔/拉美裔成年人的处理速度和执行功能提供了一个易于使用的工具。
{"title":"Normative data for the Digit Symbol Substitution for diverse Hispanic/Latino adults: Results from the Study of Latinos‐Investigation of Neurocognitive Aging (SOL‐INCA)","authors":"Alejandra Morlett Paredes, W. Tarraf, Kevin A. González, A. Stickel, Lisa V. Graves, David P. Salmon, Sonya Kaur, Linda C. Gallo, C. Isasi, Richard B. Lipton, Melissa Lamar, Zachary T. Goodman, Hector M. González","doi":"10.1002/dad2.12573","DOIUrl":"https://doi.org/10.1002/dad2.12573","url":null,"abstract":"Abstract INTRODUCTION Executive functioning and processing speed are crucial elements of neuropsychological assessment. To meet the needs of the Hispanic/Latino population, we aimed to provide normative data for the Digit Symbol Substitution (DSS) test. METHODS The target population for the Study of Latinos‐Investigation of Neurocognitive Aging included six heritage backgrounds (n = 6177). Average age was 63.4 ± 8.3 years, 54.5% were female, and mean education was 11.0 ± 4.7 years. Participants were administered the DSS as part of a larger battery. Heritage‐adjusted DSS scores, and percentile cut‐points were created using survey‐adjusted regression and quantile regression models. RESULTS Age, education, sex, heritage, and language preference were associated with DSS scores. DISCUSSION Significant correlates of DSS performance should be considered when evaluating cognitive performance. Representative DSS norms for Hispanics/Latinos will advance assessment and accuracy of neurocognitive disorder diagnosis in clinical practice. To facilitate interpretation, we provide norms to reduce test biases and developed an online dashboard. Highlights Normative data for the Digit Symbol Substitution (DSS) for diverse Hispanic/Latino adults: Results from the Study of Latinos‐Investigation of Neurocognitive Aging (SOL‐INCA) This study is the first to develop norms for the DSS test across four regions of the United States. Factors such as age, education, sex, and Hispanic/Latino heritage and language preference are associated with differences in executive functioning and information processing speed. We created norms and an online dashboard (https://solincalab.shinyapps.io/dsst_shiny/) providing an easily accessible tool to evaluate processing speed and executive functioning in Hispanic/Latino adults.","PeriodicalId":516929,"journal":{"name":"Alzheimer's & Dementia : Diagnosis, Assessment & Disease Monitoring","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140354095","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
Social relationships, amyloid burden, and dementia: The ARIC‐PET study 社会关系、淀粉样蛋白负担和痴呆症:ARIC-PET研究
Pub Date : 2024-04-01 DOI: 10.1002/dad2.12560
Renée C. Groechel, Albert C. Liu, Chelsea Liu, D. Knopman, S. Koton, Anna M. Kucharska‐Newton, P. Lutsey, Thomas H. Mosley, Priya Palta, A. R. Sharrett, Keenan A Walker, Dean F. Wong, Rebecca F. Gottesman
Abstract INTRODUCTION This study aimed to assess whether social relationships in mid‐life reduce the risk of dementia related to amyloid burden. METHODS Participants in the Atherosclerosis Risk in Communities (ARIC) study were assessed for social support and isolation (visit 2; 1990–1992). A composite measure, “social relationships,” was generated. Brain amyloid was evaluated with florbetapir positron emission tomography (PET); (visit 5; 2012–2014). Incident dementia cases were identified following visit 5 through 2019 using ongoing surveillance. Relative contributions of mid‐life social relationships and elevated brain amyloid to incident dementia were evaluated with Cox regression models. RESULTS Among 310 participants without dementia, strong mid‐life social relationships were associated independently with lower dementia risk. Elevated late‐life brain amyloid was associated with greater dementia risk. DISCUSSION Although mid‐life social relationships did not moderate the relationship between amyloid burden and dementia, these findings affirm the importance of strong social relationships as a potentially protective factor against dementia.
摘要 本研究旨在评估中年时期的社会关系是否会降低与淀粉样蛋白负担有关的痴呆风险。方法 对社区动脉粥样硬化风险(ARIC)研究的参与者进行了社会支持和隔离评估(第 2 次访问;1990-1992 年)。得出了 "社会关系 "这一综合指标。使用氟贝他匹正电子发射断层扫描(PET)评估脑淀粉样蛋白(第 5 次;2012-2014 年)。在第 5 次就诊后至 2019 年期间,通过持续监测确定了痴呆症病例。通过 Cox 回归模型评估了中年社会关系和脑淀粉样蛋白升高对痴呆症发病的相对影响。结果 在 310 名未患痴呆症的参与者中,中年时期的牢固社会关系与较低的痴呆症风险独立相关。晚年脑淀粉样蛋白升高与痴呆症风险增加有关。讨论 尽管中年社会关系并不能调节淀粉样蛋白负担与痴呆症之间的关系,但这些发现肯定了稳固的社会关系作为潜在的痴呆症保护因素的重要性。
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引用次数: 0
Correction to “Retinal microvasculature and incident dementia over 10 years: The Three‐City‐Alienor cohort” 更正 "视网膜微血管与 10 年内发生的痴呆症:三城-阿利诺尔队列"
Pub Date : 2024-04-01 DOI: 10.1002/dad2.12575
[This corrects the article DOI: 10.1002/dad2.12480.].
[此处更正了文章 DOI:10.1002/dad2.12480]。
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引用次数: 0
Aβ oligomers peak in early stages of Alzheimer's disease preceding tau pathology Aβ 寡聚体在阿尔茨海默氏症早期阶段达到峰值,早于 tau 病理变化
Pub Date : 2024-04-01 DOI: 10.1002/dad2.12589
Lara Blömeke, Fabian Rehn, Victoria Kraemer-Schulien, J. Kutzsche, Marlene Pils, T. Bujnicki, P. Lewczuk, J. Kornhuber, S. D. Freiesleben, Luisa-Sophie Schneider, L. Preis, J. Priller, E. Spruth, S. Altenstein, A. Lohse, Anja Schneider, Klaus Fliessbach, Jens Wiltfang, Niels Hansen, A. Rostamzadeh, E. Düzel, W. Glanz, E. Incesoy, M. Butryn, K. Buerger, D. Janowitz, Michael Ewers, Robert Perneczky, B. Rauchmann, Stefan J Teipel, I. Kilimann, Doreen Goerss, C. Laske, M. Munk, C. Sanzenbacher, A. Spottke, Nina Roy-Kluth, Michael T. Heneka, F. Brosseron, Michael Wagner, S. Wolfsgruber, L. Kleineidam, Melina Stark, Matthias C Schmid, Frank Jessen, Oliver Bannach, Dieter Willbold, Oliver Peters
Abstract INTRODUCTION Soluble amyloid beta (Aβ) oligomers have been suggested as initiating Aβ related neuropathologic change in Alzheimer's disease (AD) but their quantitative distribution and chronological sequence within the AD continuum remain unclear. METHODS A total of 526 participants in early clinical stages of AD and controls from a longitudinal cohort were neurobiologically classified for amyloid and tau pathology applying the AT(N) system. Aβ and tau oligomers in the quantified cerebrospinal fluid (CSF) were measured using surface‐based fluorescence intensity distribution analysis (sFIDA) technology. RESULTS Across groups, highest Aβ oligomer levels were found in A+ with subjective cognitive decline and mild cognitive impairment. Aβ oligomers were significantly higher in A+T− compared to A−T− and A+T+. APOE ε4 allele carriers showed significantly higher Aβ oligomer levels. No differences in tau oligomers were detected. DISCUSSION The accumulation of Aβ oligomers in the CSF peaks early within the AD continuum, preceding tau pathology. Disease‐modifying treatments targeting Aβ oligomers might have the highest therapeutic effect in these disease stages. Highlights Using surface‐based fluorescence intensity distribution analysis (sFIDA) technology, we quantified Aβ oligomers in cerebrospinal fluid (CSF) samples of the DZNE‐Longitudinal Cognitive Impairment and Dementia (DELCODE) cohort Aβ oligomers were significantly elevated in mild cognitive impairment (MCI) Amyloid‐positive subjects in the subjective cognitive decline (SCD) group increased compared to the amyloid‐negative control group Interestingly, levels of Aβ oligomers decrease at advanced stages of the disease (A+T+), which might be explained by altered clearing mechanisms
摘要 引言 可溶性淀粉样β(Aβ)低聚物被认为是阿尔茨海默病(AD)中与Aβ相关的神经病理学变化的起始物,但它们在AD连续过程中的定量分布和时间顺序仍不清楚。方法 采用AT(N)系统对526名处于AD早期临床阶段的参与者和来自纵向队列的对照者进行了淀粉样蛋白和tau病理的神经生物学分类。采用表面荧光强度分布分析(sFIDA)技术测量量化脑脊液(CSF)中的Aβ和tau寡聚体。结果 在各组中,主观认知功能下降和轻度认知功能障碍的 A+ 组 Aβ 寡聚体水平最高。与 A-T- 和 A+T+ 相比,A+T- 的 Aβ 寡聚体含量明显更高。APOE ε4等位基因携带者的Aβ寡聚体水平明显更高。未检测到 tau 寡聚体的差异。讨论 脑脊液中Aβ寡聚体的积累在AD病程的早期达到高峰,早于tau病理变化。针对 Aβ 寡聚体的疾病改变疗法可能会在这些疾病阶段产生最大的治疗效果。亮点 我们利用表面荧光强度分布分析(sFIDA)技术,对DZNE-纵向认知损害和痴呆(DELCODE)队列脑脊液(CSF)样本中的Aβ寡聚体进行了定量分析,发现轻度认知损害(MCI)组淀粉样蛋白阳性受试者的Aβ寡聚体明显高于淀粉样蛋白阴性对照组、在疾病晚期(A+T+),Aβ 寡聚体的水平降低,这可能是由于清除机制发生了改变
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引用次数: 0
Vision and hearing difficulty and effects of cognitive training in older adults 老年人的视力和听力困难以及认知训练的效果
Pub Date : 2024-04-01 DOI: 10.1002/dad2.12537
Alison R Huang, George W. Rebok, B. Swenor, Jennifer A. Deal
Abstract BACKGROUND Cognitive training is delivered visually and aurally. It is unknown whether self‐reported sensory difficulty modifies the effects of cognitive training on cognition. METHODS Participants (N = 2788) in the Advanced Cognitive Training for Independent and Vital Elderly Study were randomized to training in memory, reasoning, speed of processing, or control. Differences in the 10‐year effect of cognitive training on cognition by self‐reported vision and hearing difficulty were assessed using linear mixed effect models. RESULTS Benefit (intervention vs. control) of reasoning training was smaller among participants with versus without vision difficulty (difficulty: –0.25, 95% confidence interval: [–0.88, 0.39], no difficulty: 0.58 [0.28, 0.89]). Benefit of memory training was greater for participants with versus without hearing difficulty (difficulty: 0.17 [–0.37, 0.72], no difficulty: –0.20 [–0.65, 0.24]). DISCUSSION Older adults with sensory loss have increased risk for cognitive decline; benefits of cognitive training may be greater for these individuals. Sensory loss should be considered in training design. Highlights Memory training was more beneficial for participants with hearing loss. Participants with vision difficulties did not benefit as much from reasoning training. Low accessibility in design and learned compensation strategies may contribute. Consideration of sensory impairment in study design is needed. Inclusion of older adults with sensory impairment in cognitive training is needed.
摘要 背景 认知训练是通过视觉和听觉进行的。目前还不清楚自我报告的感官困难是否会改变认知训练对认知的影响。方法 对 "独立和活力老人高级认知训练研究 "的参与者(N = 2788)随机进行记忆、推理、处理速度或控制训练。使用线性混合效应模型评估了自我报告的视力和听力困难对认知训练 10 年效果的差异。结果 有视力困难的参与者与没有视力困难的参与者相比,推理训练的收益(干预与对照)较小(难度:-0.25,95% 置信区间:[-0.88, 0.00, 0.00, 0.00, 0.00, 0.00]):0.25,95% 置信区间:[-0.88, 0.39],无困难:0.58 [0.28, 0.89])。有听力困难的参与者与无听力困难的参与者相比,记忆训练的收益更大(有困难:0.17 [-0.37, 0.72];无困难:-0.20 [-0.65, 0.24])。讨论 有感官障碍的老年人认知能力下降的风险更高;认知训练对这些人的益处可能更大。在设计训练时应考虑到感官损失。亮点 记忆训练对有听力损失的参与者更有益。有视力障碍的参与者从推理训练中获益不大。设计和学习补偿策略的低无障碍性可能是原因之一。在研究设计中需要考虑感官障碍。需要将有感官障碍的老年人纳入认知训练。
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引用次数: 0
Explaining variability in early stages of [18F]‐flortaucipir tau‐PET binding: Focus on sex differences 解释[18F]-flortaucipir tau-PET 结合早期阶段的变异:关注性别差异
Pub Date : 2024-03-07 DOI: 10.1002/dad2.12565
Dario Bachmann, Andreas Buchmann, Sandro Studer, A. Saake, Katrin Rauen, Esmeralda Gruber, R. Nitsch, Christoph Hock, A. Gietl, Valerie Treyer
Abstract INTRODUCTION Female sex is associated with increased [18F]‐flortaucipir signal, which may be affected by amyloid pathology, age, and off‐target binding in skull and meninges. METHODS In this cross‐sectional study comprising 52 females and 52 matched males, we examined sex‐related differences in regional tau‐positron emission tomography (PET) with and without considering off‐target binding. We assessed the respective contributions of sex, age, amyloid‐PET burden, and off‐target binding to tau‐PET signal. We explored associations between age at menopause and hormone replacement therapy (HRT) use with regional tau‐PET signals. RESULTS Female sex was associated with increased regional tau both independently and interactively with amyloid, but amyloid‐independent associations were largely reduced when controlling for off‐target binding. Age but not age*sex interactions explained a small but significant amount of tau‐PET signal in temporoparietal regions. Considering the sample size and limited range of amyloid‐PET burden, no clear associations between regional tau‐PET signals and age at menopause or HRT use could be found. DISCUSSION Female sex is associated with increased [18F]‐flortaucipir signal mainly through its interaction with amyloid.
摘要 引言 女性性别与[18F]-flortaucipir信号的增加有关,这可能受到淀粉样病理、年龄以及头骨和脑膜脱靶结合的影响。方法 在这项由 52 名女性和 52 名匹配男性组成的横断面研究中,我们研究了在考虑和不考虑脱靶结合的情况下,区域性 tau 正电子发射断层扫描(PET)与性别相关的差异。我们评估了性别、年龄、淀粉样蛋白-PET负担和脱靶结合对tau-PET信号的贡献。我们还探讨了绝经年龄和使用激素替代疗法(HRT)与区域 tau-PET 信号之间的关系。结果 女性性别与区域性 tau 增高相关,既独立于淀粉样蛋白,也与淀粉样蛋白相互作用,但在控制脱靶结合后,与淀粉样蛋白无关的相关性大大降低。年龄而非年龄*性别的相互作用解释了颞顶叶区域少量但重要的tau-PET信号。考虑到样本量和有限的淀粉样蛋白-PET负担范围,没有发现区域tau-PET信号与绝经年龄或使用HRT之间有明显的关联。讨论 女性性别与[18F]-flortaucipir信号增加有关,主要是通过其与淀粉样蛋白的相互作用。
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Alzheimer's & Dementia : Diagnosis, Assessment & Disease Monitoring
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