Mendes Aline, Tezenas du Montcel Sophie, Levy Marcel, Bertrand Anne, Habert Marie-Odile, Bertin Hugo, Dubois Bruno, Epelbaum Stéphane
Geriatrics Division, Department of Internal Medicine, Rehabilitation, and Geriatrics, Geneva University Hospitals, Geneva, Switzerland.
Institut de la Mémoire et de la Maladie d'Alzheimer, Département de Neurologie, Hôpital Pitié-Salpêtrière, Paris, France.
Dement Geriatr Cogn Disord. 2018;45(5-6):272-281. doi: 10.1159/000489007. Epub 2018 Jun 28.
Identifying comorbidities that influence preclinical Alzheimer's disease (AD) can give some insight into the AD early stages trajectories to allow new treatment venues and to guide public health systems to prevent subsequent dementia.
To examine the association of multimorbidity with AD neuroimaging markers in cognitively normal older adults.
This study had a cross-sectional design. Data regarding 14 comorbidities were obtained for all 318 adults aged 70-85 years, recruited from the community to an ongoing prospective monocentric cohort. They underwent standardized neuropsychological and neuroimaging assessment with automated methods that measured hippocampal volumes, white matter hyperintensity volumes, fluorodeoxyglucose positron emission tomography (FDG-PET) standardized uptake values (SUV) in AD signature regions, and amyloid positron emission tomography (amyloid-PET) SUV ratios. Linear regression was used to assess the association of multimorbidity with AD neuroimaging biomarkers.
Multimorbidity is signif icantly associated with lower hippocampal volumes (-0.03 ± 0.01; p = 0.012; R2 = 0.017) and lower FDG-PET SUV (-0.027 ± 0.009; p = 0.005; R2 = 0.022), with no association with amyloid deposition (0.001 ± 0.007; p = 0.884; R2 = 0.0001). Taken individually, obesity and excessive alcohol use are associated with lower FDG-PET values, whereas obstructive sleep apnea and mood disorders are related to lower amyloid-PET SUV ratios.
Multimorbidity is associated with preclinical AD imaging markers of neurodegeneration, but not with amyloid.
识别影响临床前阿尔茨海默病(AD)的合并症,有助于深入了解AD早期阶段的发展轨迹,从而开辟新的治疗途径,并指导公共卫生系统预防后续痴呆症。
研究认知功能正常的老年人中多种疾病共存与AD神经影像学标志物之间的关联。
本研究采用横断面设计。从社区招募了318名年龄在70 - 85岁的成年人,纳入一个正在进行的前瞻性单中心队列,获取了关于14种合并症的数据。他们接受了标准化的神经心理学和神经影像学评估,采用自动化方法测量海马体积、白质高信号体积、AD特征区域的氟脱氧葡萄糖正电子发射断层扫描(FDG - PET)标准化摄取值(SUV)以及淀粉样蛋白正电子发射断层扫描(amyloid - PET)SUV比值。采用线性回归评估多种疾病共存与AD神经影像学生物标志物之间的关联。
多种疾病共存与较小的海马体积显著相关(-0.03±0.01;p = 0.012;R2 = 0.017)以及较低的FDG - PET SUV(-0.027±0.009;p = 0.005;R2 = 0.022),与淀粉样蛋白沉积无关联(0.001±0.007;p = 0.884;R2 = 0.0001)。单独来看,肥胖和过度饮酒与较低的FDG - PET值相关,而阻塞性睡眠呼吸暂停和情绪障碍与较低的淀粉样蛋白 - PET SUV比值相关。
多种疾病共存与临床前AD神经退行性变的影像学标志物相关,但与淀粉样蛋白无关。