Munro Catherine E, Buckley Rachel, Vannini Patrizia, DeMuro Carla, Sperling Reisa, Rentz Dorene M, Johnson Keith, Gatchel Jennifer R, Amariglio Rebecca
Center for Brain/Mind Medicine, Brigham and Women's Hospital, Boston, MA, United States.
Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States.
Front Aging Neurosci. 2022 Jan 31;13:806432. doi: 10.3389/fnagi.2021.806432. eCollection 2021.
Whereas discrepancies between participant- and study partner-reported cognitive concerns on the Alzheimer's disease (AD) continuum have been observed, more needs to be known regarding the longitudinal trajectories of participant- vs. study partner-reported concerns, particularly their relationship to AD biomarkers and mood symptomology. Additionally, it is unclear whether years of in-clinic data collection are needed to observe relationships with AD biomarkers, or whether more frequent, remote assessments over shorter periods of time would suffice. This study primarily sought to examine the relationships between longitudinal trajectories of participant- and study partner-rated cognitive decline and baseline biomarker levels [i.e., amyloid and tau positron emission tomography (PET)], in addition to how mood symptomatology may alter these trajectories of concerns over a 2-year period. Baseline mood was associated with longitudinal participant-rated concerns, such that participants with elevated depression and anxiety scores at baseline had decreasing concerns about cognitive decline over time (fixed estimate = -0.17, 95% CI [-0.29 to -0.05], = -2.75, df = 457, adj. = 0.012). A significant interaction between baseline amyloid (fixed estimate = 4.07, 95% CI [1.13-7.01], = 2.72, df = 353, adj. = 0.026) and tau (fixed estimate = 3.50, 95% CI [0.95-6.06], = 2.70, df = 331, adj. = 0.030) levels was associated with increasing study partner concerns, but not participant concerns, over time. The interaction between amyloid and study partner concerns remained significant when utilizing only the first year of concern-related data collection. Overall, these results suggest that frequent, remote assessment of study partner-reported concerns may offer additional insight into the AD clinical spectrum, as study partners appear to more accurately update their concerns over time with regard to pathology, with these concerns less influenced by participants' mood symptomatology.
尽管已观察到参与者与研究伙伴报告的阿尔茨海默病（AD）连续体认知问题之间存在差异，但关于参与者与研究伙伴报告的问题的纵向轨迹，尤其是它们与AD生物标志物和情绪症状学的关系，仍有更多需要了解的地方。此外，尚不清楚是否需要多年的临床数据收集来观察与AD生物标志物的关系，或者在较短时间内进行更频繁的远程评估是否足够。本研究主要旨在研究参与者和研究伙伴评定的认知衰退纵向轨迹与基线生物标志物水平[即淀粉样蛋白和tau正电子发射断层扫描（PET）]之间的关系，以及情绪症状学如何在两年期间改变这些关注轨迹。基线情绪与参与者评定的纵向关注相关，即基线时抑郁和焦虑评分升高的参与者对认知衰退的关注随时间减少（固定估计值=-0.17，95%置信区间[-0.29至-0.05]，t=-2.75，自由度=457，调整后p=0.012）。基线淀粉样蛋白（固定估计值=4.07，95%置信区间[1.13 - 7.01]，t=2.72，自由度=353，调整后p=0.026）和tau（固定估计值=3.50，95%置信区间[0.95 - 6.06]，t=2.70，自由度=331，调整后p=0.030）水平之间的显著交互作用与研究伙伴随时间增加的关注相关，但与参与者的关注无关。仅使用第一年与关注相关的数据收集时，淀粉样蛋白与研究伙伴关注之间的交互作用仍然显著。总体而言，这些结果表明，对研究伙伴报告的关注进行频繁的远程评估可能会为AD临床谱提供更多见解，因为研究伙伴似乎能更准确地随着时间更新他们对病理的关注，且这些关注受参与者情绪症状学的影响较小。
