Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden.
Department of Neurology, Skåne University Hospital, Malmö, Sweden.
Alzheimers Res Ther. 2020 Mar 24;12(1):30. doi: 10.1186/s13195-020-00592-8.
As research in treatments for neurocognitive diseases progresses, there is an increasing need to identify cognitive decline in the earliest stages of disease for initiation of treatment in addition to determining the efficacy of treatment. For early identification, accurate cognitive tests cutoff values for cognitive impairment are essential.
We conducted a study on 297 cognitively healthy elderly people from the BioFINDER study and created subgroups excluding people with signs of underlying neuropathology, i.e., abnormal cerebrospinal fluid [CSF] β-amyloid or phosphorylated tau, CSF neurofilament light (neurodegeneration), or cerebrovascular pathology. We compared cognitive test results between groups and examined the age effect on cognitive test results.
In our subcohort without any measurable pathology (n = 120), participants achieved better test scores and significantly stricter cutoffs for cognitive impairment for almost all the examined tests. The age effect in this subcohort disappeared for all cognitive tests, apart from some attention/executive tests, predominantly explained by the exclusion of cerebrovascular pathology.
Our study illustrates a new approach to establish normative data that could be useful to identify earlier cognitive changes in preclinical dementias. Future studies need to investigate if there is a genuine effect of healthy aging on cognitive tests or if this age effect is a proxy for higher prevalence of preclinical neurodegenerative diseases.
随着神经认知疾病治疗研究的进展，除了确定治疗效果外，越来越需要在疾病的早期阶段识别认知能力下降，以便开始治疗。为了早期识别，准确的认知测试对于认知障碍的截断值是必不可少的。
我们对来自 BioFINDER 研究的 297 名认知健康的老年人进行了一项研究，并创建了排除有潜在神经病理学迹象的亚组，即异常脑脊液（CSF）β-淀粉样蛋白或磷酸化 tau、CSF 神经丝轻链（神经退行性变）或脑血管病理学。我们比较了不同组的认知测试结果，并检查了年龄对认知测试结果的影响。
在我们没有任何可测量病理学的亚组中（n=120），参与者在几乎所有检查的测试中都取得了更好的测试分数和更严格的认知障碍截断值。除了一些注意力/执行测试外，这个亚组的年龄效应在所有认知测试中都消失了，这主要是由于排除了脑血管病理学。
我们的研究说明了一种建立规范数据的新方法，这可能有助于识别前驱痴呆症中的早期认知变化。未来的研究需要调查认知测试中健康衰老是否有真正的影响，或者这种年龄效应是否是潜在神经退行性疾病更高患病率的替代指标。
