Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota.
Department of Neurology, Mayo Clinic, Rochester, Minnesota.
Ann Clin Transl Neurol. 2020 Apr;7(4):474-485. doi: 10.1002/acn3.51010. Epub 2020 Apr 21.
To examine the association of baseline elevated brain amyloid and neurodegeneration with changes in activities of daily living in participants without dementia (ND; i.e., cognitively unimpaired and participants with mild cognitive impairment) at baseline in the population-based Mayo Clinic Study of Aging.
We included 1747 ND participants with C-PiB PET and MR imaging in the study, with data on activities of daily living (as assessed by the Functional Activities Questionnaire (FAQ) and the Clinical Dementia Rating scale Sum of Boxes for functional domains (CDR-SOB (functional)), with a median (range) of 4.3 (0.0-12.7) years of follow-up. Abnormal (elevated; A+) C-PiB-PET retention ratio was defined as standardized uptake value ratio ≥ 1.48, and abnormal (reduced) AD signature cortical thickness as ≤ 2.68 mm (neurodegeneration; N+). Associations were examined with mixed effects models, adjusting for age, sex, education, apolipoprotein E ε4 allele carrier status, and global cognitive z-score.
Mean age (SD) was 71.4 years (10.1), 46.7% were females, 195 (11.2%) had A+N-, 442 (25.3%) had A-N+, and 339 (19.4%) had A+N+ biomarkers. The A+N+ group had the largest annualized change in the FAQ score from baseline (difference in annual change A+N+ vs. A-N-; ß (SE): 0.80 (0.07)); associations were substantially attenuated when a time-varying global cognitive composite was included in the model (A+N+ vs. A-N-; ß (SE): 0.31 (0.05)). CDR-SOB (functional) findings partly agreed with FAQ score findings.
The longitudinal increase in functional limitations is greater for individuals with abnormal neuroimaging biomarkers, especially for those with both elevated brain amyloid and neurodegeneration.
在 Mayo 诊所老龄化研究的人群中，研究基线时脑淀粉样蛋白升高和神经退行性变与基线时无痴呆（ND；即认知正常和轻度认知障碍参与者）参与者日常生活活动变化的关系。
我们纳入了 1747 名接受 C-PiB PET 和磁共振成像检查的 ND 参与者，这些参与者的数据包括日常生活活动（由功能活动问卷（FAQ）和临床痴呆评定量表用于功能域的总和量表（CDR-SOB（功能））评估），中位（范围）随访时间为 4.3（0.0-12.7）年。异常（升高；A+）C-PiB-PET 保留率定义为标准化摄取比值≥1.48，异常（降低）AD 特征皮质厚度定义为≤2.68mm（神经退行性变；N+）。采用混合效应模型，调整年龄、性别、教育程度、载脂蛋白 E ε4 等位基因携带状态和全球认知 z 分数后，对这些关联进行了检查。
平均年龄（SD）为 71.4（10.1）岁，46.7%为女性，195（11.2%）人有 A+N-，442（25.3%）人有 A-N+，339（19.4%）人有 A+N+生物标志物。A+N+组从基线开始的 FAQ 评分的年化变化最大（A+N+与 A-N-的年度变化差异；β（SE）：0.80（0.07））；当模型中包含时变全球认知综合评分时，关联大大减弱（A+N+与 A-N-；β（SE）：0.31（0.05））。CDR-SOB（功能）的发现与 FAQ 评分的发现部分一致。
对于有异常神经影像学生物标志物的个体，尤其是那些同时存在脑淀粉样蛋白升高和神经退行性变的个体，其功能受限的纵向增加更大。
