Buckley Rachel F, Sikkes Sietske, Villemagne Victor L, Mormino Elizabeth C, Rabin Jennifer S, Burnham Samantha, Papp Kathryn V, Doré Vincent, Masters Colin L, Properzi Michael J, Schultz Aaron P, Johnson Keith A, Rentz Dorene M, Sperling Reisa A, Amariglio Rebecca E
The Florey Institute, The University of Melbourne, Melbourne, Victoria, Australia.
Melbourne School of Psychological Science, University of Melbourne, Melbourne, Victoria, Australia.
Alzheimers Dement (Amst). 2019 Sep 25;11:670-678. doi: 10.1016/j.dadm.2019.08.004. eCollection 2019 Dec.
We aimed to examine the contribution of subjective cognitive decline (SCD) to reduce the number of β-amyloid (Aβ) positron emission tomography scans required for recruiting Aβ+ clinically normal individuals in clinical trials.
Three independent cohorts (890 clinically normal: 72 yrs ± 6.7; Female: 43.4%; SCD+: 24%; apolipoprotein E [] ε4+: 28.5%; Aβ+: 32%) were used. SCD was dichotomized from one question. Using logistic regression, we classified Aβ+ using the SCD dichotomy, ε4, sex, and age.
SCD increased odds of Aβ+ by 1.58 relative to non-SCD. Female ε4 carriers with SCD exhibited higher odds of Aβ+ (OR = 3.34), whereas male carriers with SCD showed a weaker, opposing effect (OR = 0.37). SCD endorsement reduces the number of Aβ positron emission tomography scans to recruit Aβ+ individuals by 13% and by 9% if ε4 status is known.
SCD helps to classify those with high Aβ, even beyond the substantial effect of genotype. Collecting SCD is a feasible method for targeting recruitment for those likely on the AD trajectory.
我们旨在研究主观认知下降（SCD）对减少临床试验中招募β淀粉样蛋白（Aβ）阳性临床正常个体所需的Aβ正电子发射断层扫描数量的作用。
使用了三个独立队列（890名临床正常个体：年龄72岁±6.7岁；女性占43.4%；SCD阳性占24%；载脂蛋白E [ε4] 阳性占28.5%；Aβ阳性占32%）。SCD通过一个问题进行二分法划分。我们使用逻辑回归，根据SCD二分法、ε4、性别和年龄对Aβ阳性进行分类。
与非SCD相比，SCD使Aβ阳性的几率增加了1.58倍。患有SCD的女性ε4携带者表现出更高的Aβ阳性几率（OR = 3.34），而患有SCD的男性携带者则表现出较弱的相反效应（OR = 0.37）。如果已知ε4状态，认可SCD可将招募Aβ阳性个体所需的Aβ正电子发射断层扫描数量减少13%，若不知ε4状态则减少9%。
SCD有助于对Aβ水平高的个体进行分类，甚至超越了基因型的显著影响。收集SCD是针对可能处于阿尔茨海默病轨迹的个体进行招募的一种可行方法。
