Stephen Ruth, Liu Yawu, Ngandu Tiia, Rinne Juha O, Kemppainen Nina, Parkkola Riitta, Laatikainen Tiina, Paajanen Teemu, Hänninen Tuomo, Strandberg Timo, Antikainen Riitta, Tuomilehto Jaakko, Keinänen Kiukaanniemi Sirkka, Vanninen Ritva, Helisalmi Seppo, Levälahti Esko, Kivipelto Miia, Soininen Hilkka, Solomon Alina
Institute of Clinical Medicine/Neurology, University of Eastern Finland, Kuopio, Finland.
Neurocenter, Neurology, Kuopio University Hospital, Kuopio, Finland.
J Alzheimers Dis. 2017;59(2):695-705. doi: 10.3233/JAD-170092.
CAIDE Dementia Risk Score is the first validated tool for estimating dementia risk based on a midlife risk profile.
This observational study investigated longitudinal associations of CAIDE Dementia Risk Score with brain MRI, amyloid burden evaluated with PIB-PET, and detailed cognition measures.
FINGER participants were at-risk elderly without dementia. CAIDE Risk Score was calculated using data from previous national surveys (mean age 52.4 years). In connection to baseline FINGER visit (on average 17.6 years later, mean age 70.1 years), 132 participants underwent MRI scans, and 48 underwent PIB-PET scans. All 1,260 participants were cognitively assessed (Neuropsychological Test Battery, NTB). Neuroimaging assessments included brain cortical thickness and volumes (Freesurfer 5.0.3), visually rated medial temporal atrophy (MTA), white matter lesions (WML), and amyloid accumulation.
Higher CAIDE Dementia Risk Score was related to more pronounced deep WML (OR 1.22, 95% CI 1.05-1.43), lower total gray matter (β-coefficient -0.29, p = 0.001) and hippocampal volume (β-coefficient -0.28, p = 0.003), lower cortical thickness (β-coefficient -0.19, p = 0.042), and poorer cognition (β-coefficients -0.31 for total NTB score, -0.25 for executive functioning, -0.33 for processing speed, and -0.20 for memory, all p < 0.001). Higher CAIDE Dementia Risk Score including APOE genotype was additionally related to more pronounced MTA (OR 1.15, 95% CI 1.00-1.30). No associations were found with periventricular WML or amyloid accumulation.
The CAIDE Dementia Risk Score was related to indicators of cerebrovascular changes and neurodegeneration on MRI, and cognition. The lack of association with brain amyloid accumulation needs to be verified in studies with larger sample sizes.
CAIDE痴呆风险评分是首个基于中年风险概况来评估痴呆风险的经过验证的工具。
这项观察性研究调查了CAIDE痴呆风险评分与脑磁共振成像（MRI）、用匹兹堡化合物B正电子发射断层扫描（PIB-PET）评估的淀粉样蛋白负荷以及详细认知测量指标之间的纵向关联。
芬兰预防认知功能障碍和残疾老年干预研究（FINGER）的参与者为有患痴呆风险的非痴呆老年人。CAIDE风险评分使用之前全国性调查的数据（平均年龄52.4岁）计算得出。在与FINGER基线访视相关时（平均17.6年后，平均年龄70.1岁），132名参与者接受了MRI扫描，48名参与者接受了PIB-PET扫描。所有1260名参与者都接受了认知评估（神经心理测试组合，NTB）。神经影像学评估包括脑皮质厚度和体积（FreeSurfer 5.0.3）、视觉评定的内侧颞叶萎缩（MTA）、白质病变（WML）以及淀粉样蛋白积累情况。
较高的CAIDE痴呆风险评分与更明显的深部白质病变相关（比值比1.22，95%置信区间1.05 - 1.43）、总灰质体积较低（β系数 - 0.29，p = 0.001）和海马体体积较低（β系数 - 0.28，p = 0.003）、皮质厚度较低（β系数 - 0.19，p = 0.042）以及认知较差（NTB总分的β系数为 - 0.31，执行功能的β系数为 - 0.25，处理速度的β系数为 - 0.33，记忆的β系数为 - 0.20，所有p < 0.001）。包含载脂蛋白E（APOE）基因型的较高CAIDE痴呆风险评分还与更明显的MTA相关（比值比1.15，95%置信区间1.00 - 1.30）。未发现与脑室周围白质病变或淀粉样蛋白积累有关联。
CAIDE痴呆风险评分与MRI上脑血管变化和神经退行性变的指标以及认知相关。与脑淀粉样蛋白积累缺乏关联这一情况需要在更大样本量的研究中加以验证。
