Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA.
Division of Biostatistics, Washington University School of Medicine, St. Louis, Missouri, USA.
Alzheimers Dement. 2022 Oct;18(10):1754-1764. doi: 10.1002/alz.12505. Epub 2021 Dec 2.
As prevention trials advance with autosomal dominant Alzheimer disease (ADAD) participants, understanding the similarities and differences between ADAD and "sporadic" late-onset AD (LOAD) is critical to determine generalizability of findings between these cohorts. Cognitive trajectories of ADAD mutation carriers (MCs) and autopsy-confirmed LOAD individuals were compared to address this question. Longitudinal rates of change on cognitive measures were compared in ADAD MCs (n = 310) and autopsy-confirmed LOAD participants (n = 163) before and after symptom onset (estimated/observed). LOAD participants declined more rapidly in the presymptomatic (preclinical) period and performed more poorly at symptom onset than ADAD participants on a cognitive composite. After symptom onset, however, the younger ADAD MCs declined more rapidly. The similar but not identical cognitive trajectories (declining but at different rates) for ADAD and LOAD suggest common AD pathologies but with some differences.
随着常染色体显性阿尔茨海默病 (ADAD) 预防试验的推进，了解 ADAD 与“散发性”晚发性 AD (LOAD) 之间的异同对于确定这些队列之间的研究结果的可推广性至关重要。为了解决这个问题，比较了 ADAD 突变携带者 (MCs) 和尸检确诊的 LOAD 个体的认知轨迹。比较了 ADAD MCs (n=310) 和尸检确诊的 LOAD 参与者 (n=163) 在症状出现前后 (估计/观察到) 的认知测量的纵向变化率。LOAD 参与者在无症状前 (临床前) 期下降更快，在症状出现时的认知综合表现比 ADAD 参与者差。然而，在症状出现后，较年轻的 ADAD MCs 下降更快。ADAD 和 LOAD 的认知轨迹相似但不相同（下降但速度不同）表明存在共同的 AD 病理，但存在一些差异。
