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Difference in trajectories according to early amyloid accumulation in cognitively unimpaired elderly

Authors
 Young Ju Kim  ;  Jihwan Yun  ;  Sang Won Seo  ;  Jun Pyo Kim  ;  Hyemin Jang  ;  Hee Jin Kim  ;  Duk L Na  ;  Sookyoung Woo  ;  Min Young Chun  ;  Alzheimer's Disease Neuroimaging Initiative 
Citation
 EUROPEAN JOURNAL OF NEUROLOGY, Vol.31(12) : e16482, 2024-12 
Journal Title
EUROPEAN JOURNAL OF NEUROLOGY
ISSN
 1351-5101 
Issue Date
2024-12
MeSH
Aged ; Aged, 80 and over ; Alzheimer Disease / diagnostic imaging ; Alzheimer Disease / genetics ; Alzheimer Disease / metabolism ; Amyloid beta-Peptides* / metabolism ; Aniline Compounds ; Apolipoproteins E / genetics ; Brain / diagnostic imaging ; Brain / metabolism ; Cognition / physiology ; Cognitive Dysfunction / diagnostic imaging ; Cognitive Dysfunction / metabolism ; Disease Progression ; Ethylene Glycols ; Female ; Humans ; Longitudinal Studies ; Magnetic Resonance Imaging ; Male ; Neuropsychological Tests ; Positron-Emission Tomography*
Keywords
Alzheimer's disease ; amyloid ; cognition ; latent class growth analysis ; longitudinal study ; positron emission tomography ; trajectory
Abstract
Background and purpose: Amyloid β (Aβ), a major biomarker of Alzheimer's disease, leads to tau accumulation, neurodegeneration and cognitive decline. Modelling the trajectory of Aβ accumulation in cognitively unimpaired (CU) individuals is crucial, as treatments targeting Aβ are anticipated. The evolution of Aβ levels was investigated to determine whether it could lead to classification into different groups by studying longitudinal Aβ changes in older CU individuals, and differences between the groups were compared.

Methods: A total of 297 CU participants were included from the Alzheimer's Disease Neuroimaging Initiative database, and these participants underwent apolipoprotein E (APOE) genotyping, neuropsychological testing, brain magnetic resonance imaging, and an average of 3.03 follow-up 18F-florbetapir positron emission tomography scans. Distinct Aβ trajectory patterns were classified using latent class growth analysis, and longitudinal cognitive performances across these patterns were assessed with a linear mixed effects model.

Results: The optimal model consisted of three classes, with a high entropy value of 0.947. The classes were designated as follows: class 1, non-accumulation group (n = 197); class 2, late accumulation group (n = 70); and class 3, early accumulation group (n = 30). The late accumulation and early accumulation groups had more APOE ε4 carriers than the non-accumulation group. The longitudinal analysis of cognitive performance revealed that the early accumulation group showed the steepest decline (modified Preclinical Alzheimer's Cognitive Composite with digit symbol substitution [mPACCdigit], p < 0.001; modified Preclinical Alzheimer's Cognitive Composite with trails B [mPACCtrailsB], p < 0.001) and the late accumulation group showed a steeper decline (mPACCdigit, p = 0.014; mPACCtrailsB, p = 0.007) compared to the non-accumulation group.

Conclusions: Our study showed the heterogeneity of Aβ accumulation trajectories in CU older individuals. The prognoses for cognitive decline differ according to the Aβ trajectory patterns.
Files in This Item:
T202407432.pdf Download
DOI
10.1111/ene.16482
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
Yonsei Authors
Chun, Min Young(전민영)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/201534
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