无痴呆症个体的功能表现与阿尔茨海默病生物标志物的关联。
Association Between Functional Performance and Alzheimer's Disease Biomarkers in Individuals Without Dementia.
机构信息
Departments of Health Sciences Research, Mayo Clinic, Mayo Clinic, Rochester, Minnesota.
Departments of Neurology, Mayo Clinic, Rochester, Minnesota.
出版信息
J Am Geriatr Soc. 2018 Dec;66(12):2274-2281. doi: 10.1111/jgs.15577. Epub 2018 Nov 21.
OBJECTIVES
To examine the cross-sectional association between functional performance and Alzheimer's disease (AD) neuroimaging biomarkers in individuals without dementia (cognitively unimpaired (CU), and those with mild cognitive impairment (MCI)).
DESIGN
Cross-sectional.
SETTING
Olmsted County, Minnesota.
PARTICIPANTS
Population-based Mayo Clinic Study of Aging (MCSA) participants (aged ≥ 50, mean age 71.3 ± 10.2; 53.4% male; 28.3% apolipoprotein (APO)E ε4 allele carriers, 1,578 CU, 204 MCI) who underwent C-Pittsburgh compound B ( C-PiB) positron emission tomography (PET) (N=1,782).
MEASUREMENTS
We defined an abnormal (high) C-PiB-PET retention ratio as a standardized uptake value ratio greater than 1.42 (high amyloid; A+), abnormal (reduced) AD signature cortical thickness (neurodegeneration; N+) as less than 2.67 mm (MRI measurement), and biomarker groups according to the combination of abnormality (or not) for amyloid accumulation (A+/A-) and neurodegeneration (N+/N-). Functional performance was assessed using the Clinical Dementia Rating (CDR) Sum of Boxes (SOB) for functional domains and the Functional Activities Questionnaire (FAQ).
RESULTS
Participants with a CDR-SOB (functional) score greater than 0 were almost 4 times as likely to have N + (odds ratio (OR)=3.92, 95% confidence interval (CI)=1.77-8.67, adjusting for age, sex, education, global cognitive z-score, and APOE ε4 allele status; p<.001) and those with a FAQ score greater than 0 were 1.5 times as likely to have A + (OR=1.48, 95% CI=1.04-2.11, p=.03). Higher FAQ scores were associated with greater odds of A+N + and A-N + in CU participants.
CONCLUSION
The findings of this cross-sectional study supplement limited available information that supports an association between functional performance and AD neuroimaging biomarkers very early in the dementia pathophysiology. The associations should be validated in longitudinal studies. J Am Geriatr Soc 66:2274-2281, 2018.
目的
在没有痴呆症（认知正常（CU）和轻度认知障碍（MCI））的个体中，检查功能表现与阿尔茨海默病（AD）神经影像学生物标志物的横断面关联。
设计
横断面研究。
地点
明尼苏达州奥姆斯特德县。
参与者
基于人群的梅奥诊所衰老研究（MCSA）参与者（年龄≥50 岁，平均年龄 71.3±10.2；53.4%为男性；28.3%载脂蛋白（APO）E ε4 等位基因携带者，1578 名 CU，204 名 MCI），他们接受了 C-Pittsburgh 复合 B（C-PiB）正电子发射断层扫描（PET）（N=1782）。
测量方法
我们将异常（高）C-PiB-PET 保留率定义为标准化摄取值比大于 1.42（高淀粉样蛋白；A+），异常（减少）AD 特征性皮质厚度（神经退行性变；N+）定义为小于 2.67mm（MRI 测量），并根据淀粉样蛋白积累的异常（或不）（A+/A-）和神经退行性变（N+/N-）组合来确定生物标志物组。功能表现使用临床痴呆评定量表（CDR）总分（SOB）进行评估，用于功能域和功能活动问卷（FAQ）。
结果
CDR-SOB（功能）评分大于 0 的参与者发生 N+的可能性几乎是 CDR-SOB 评分小于 0 的参与者的 4 倍（优势比（OR）=3.92，95%置信区间（CI）=1.77-8.67，调整年龄、性别、教育、总体认知 z 分数和 APOE ε4 等位基因状态；p<.001），而 FAQ 评分大于 0 的参与者发生 A+的可能性是 FAQ 评分小于 0 的参与者的 1.5 倍（OR=1.48，95% CI=1.04-2.11，p=.03）。较高的 FAQ 评分与 CU 参与者中 A+N+和 A-N+的可能性增加相关。
结论
这项横断面研究的结果补充了有限的可用信息，支持在痴呆症发病机制的早期阶段，功能表现与 AD 神经影像学生物标志物之间存在关联。这些关联应在纵向研究中得到验证。J Am Geriatr Soc 66：2274-2281，2018。
Zotero 插件