Roberts Rosebud O, Knopman David S, Syrjanen Jeremy A, Aakre Jeremiah A, Vassilaki Maria, Kremers Walter K, Mielke Michelle M, Machulda Mary M, Graff-Radford Jonathan, Geda Yonas E, Vemuri Prashanthi, Lowe Val, Jack Clifford R, Petersen Ronald C
From the Divisions of Epidemiology (R.O.R., M.V., M.M. Mielke, R.C.P.) and Biomedical Statistics and Informatics (J.A.S., J.A.A., W.K.K.), Department of Health Sciences Research, Department of Neurology (R.O.R., D.S.K., M.M. Mielke, J.G.-R., R.C.P.), Department of Psychiatry and Psychology (M.M. Machulda), and Department of Radiology (P.V., V.L., C.R.J.), Mayo Clinic, Rochester, MN; and Departments of Psychiatry and Psychology and Neurology (Y.E.G.), Mayo Clinic, Scottsdale, AZ.
Neurology. 2017 Nov 14;89(20):2039-2048. doi: 10.1212/WNL.0000000000004652. Epub 2017 Oct 13.
To estimate the prevalence of elevated brain amyloid and reduced cortical thickness (as a marker for neurodegeneration) in a defined population.
Mayo Clinic Study of Aging participants underwent MRI to assess a composite Alzheimer disease (AD) signature cortical thickness measure and PET to assess brain amyloid accumulation. Participants were characterized as having elevated amyloid (A+/A-), reduced cortical thickness (N+/N-), and A+N+, A+N-, A-N+, or A-N-. The prevalence of AD biomarkers was derived by adjusting for nonparticipation and standardizing to the Olmsted County, Minnesota, population.
Among 1,646 participants without dementia (mean age 70.8 years; 53.2% men), the prevalence (95% confidence interval) of amyloidosis was 21.1% (19.1%-23.2%): women, 24.3%; men, 17.5%. The prevalence of reduced cortical thickness was 28.9% (26.4%-31.5%): women, 27.9%; men, 30.2%. The prevalence estimates of biomarker categories were as follows: A-N-: 61.4%; A+N-: 9.7%; A-N+: 17.4%; and A+N+: 11.5%, and varied by sex and by ε4 carrier status. In men, prevalence estimates were as follows: A-N-: 62.6%; A+N-: 7.3%; A-N+: 19.9%; and A+N+: 10.2%. In women, prevalence estimates were as follows: A-N-: 60.4%; A+N-: 11.7%; A-N+: 15.3%; and A+N+: 12.6%. In ε4 carriers, prevalence estimates were as follows: A-N-: 54.6%; A+N-: 16.6%; A-N+: 12.4%; and A+N+: 16.4%. In non-ε4 carriers, prevalence estimates were as follows: A-N-: 63.3%; A+N-: 6.9%; A-N+: 19.9%; and A+N+: 10.0%.
These prevalence estimates are important for understanding age-related trends in amyloid positivity and AD signature cortical thickness in the population, and for potentially projecting the future burden of biomarkers in elderly persons.
评估特定人群中脑淀粉样蛋白升高和皮质厚度降低（作为神经退行性变的标志物）的患病率。
梅奥诊所衰老研究的参与者接受了磁共振成像（MRI）以评估复合阿尔茨海默病（AD）特征性皮质厚度测量值，并接受了正电子发射断层扫描（PET）以评估脑淀粉样蛋白积累情况。参与者被分为淀粉样蛋白升高（A+/A-）、皮质厚度降低（N+/N-）以及A+N+、A+N-、A-N+或A-N-。通过对未参与者进行校正并标准化至明尼苏达州奥姆斯特德县的人群，得出AD生物标志物的患病率。
在1646名无痴呆症的参与者中（平均年龄70.8岁；男性占53.2%），淀粉样变性的患病率（95%置信区间）为21.1%（19.1%-23.2%）：女性为24.3%；男性为17.5%。皮质厚度降低的患病率为28.9%（26.4%-31.5%）：女性为27.9%；男性为30.2%。生物标志物类别的患病率估计如下：A-N-：61.4%；A+N-：9.7%；A-N+：17.4%；A+N+：11.5%，且因性别和ε4携带者状态而异。在男性中，患病率估计如下：A-N-：62.6%；A+N-：7.3%；A-N+：19.9%；A+N+：10.2%。在女性中，患病率估计如下：A-N-：60.4%；A+N-：11.7%；A-N+：15.3%；A+N+：12.6%。在ε4携带者中，患病率估计如下：A-N-：54.6%；A+N-：16.6%；A-N+：12.4%；A+N+：16.4%。在非ε4携带者中，患病率估计如下：A-N-：63.3%；A+N-：6.9%；A-N+：19.9%；A+N+：10.0%。
这些患病率估计值对于理解人群中与年龄相关的淀粉样蛋白阳性和AD特征性皮质厚度趋势，以及潜在预测老年人未来生物标志物负担具有重要意义。
