Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands; Department of Neurology, Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands.
Mech Ageing Dev. 2020 Dec;192:111386. doi: 10.1016/j.mad.2020.111386. Epub 2020 Oct 19.
Previous research suggests the presence of subtle semantic decline in early stages of Alzheimer's disease. This study investigated associations between amyloid burden, a biomarker for Alzheimer's disease, and tasks of semantic impairment in older individuals without dementia. A systematic search in MEDLINE, PsycINFO, and Embase yielded 3691 peer-reviewed articles excluding duplicates. After screening, 41 studies with overall 7495 participants were included in the meta-analysis and quality assessment. The overall weighted effect size of the association between larger amyloid burden and larger semantic impairment was 0.10 (95% CI [-0.03; 0.22], p = 0.128) for picture naming, 0.19 (95% CI [0.11; 0.27], p < 0.001) for semantic fluency, 0.15 (95% CI [-0.15; 0.45], p = 0.326) for vocabulary, and 0.10 (95% CI [-0.14; 0.35], p = 0.405; 2 studies) for WAIS Information. Risk of bias was highest regarding comparability, as effect sizes were often not calculated on covariate-adjusted statistics. The relevance of the indicated amyloid-related decline in semantic fluency for research and clinical applications is likely negligible due to the effect's small magnitude. Future research should develop more sensitive metrics of semantic fluency to optimize its use for early detection of Alzheimer's disease-related cognitive impairment.
先前的研究表明，阿尔茨海默病早期存在微妙的语义衰退。本研究调查了无痴呆症的老年个体中阿尔茨海默病生物标志物——淀粉样蛋白负担与语义障碍任务之间的关联。在 MEDLINE、PsycINFO 和 Embase 中进行了系统搜索，排除重复项后得到 3691 篇同行评议文章。经过筛选，共有 41 项研究（共 7495 名参与者）纳入荟萃分析和质量评估。淀粉样蛋白负担越大与语义障碍越严重之间的总体加权效应大小为：图片命名为 0.10（95%CI [-0.03; 0.22]，p=0.128），语义流畅性为 0.19（95%CI [0.11; 0.27]，p<0.001），词汇量为 0.15（95%CI [-0.15; 0.45]，p=0.326），WAIS 信息为 0.10（95%CI [-0.14; 0.35]，p=0.405；2 项研究）。在可比性方面，偏倚风险最高，因为在调整协变量的统计数据上，通常未计算效应量。由于效应幅度较小，语义流畅性中所表明的与淀粉样蛋白相关的衰退对于研究和临床应用的相关性可能微不足道。未来的研究应开发更敏感的语义流畅性指标，以优化其用于早期检测与阿尔茨海默病相关的认知障碍。
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