哈佛自动电话任务与认知正常老年人阿尔茨海默病病理的关联：初步研究结果。
Associations of the Harvard Automated Phone Task and Alzheimer's Disease Pathology in Cognitively Normal Older Adults: Preliminary Findings.
机构信息
Department of Psychology, Illinois Institute of Technology, Chicago, IL, USA.
Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
出版信息
J Alzheimers Dis. 2023;94(1):217-226. doi: 10.3233/JAD-220885.
BACKGROUND
Detecting clinically meaningful changes in instrumental activities of daily living (IADL) at the earliest stages of Alzheimer's disease (AD) is critical.
OBJECTIVE
The objective of this exploratory study was to examine the cross-sectional relationship between a performance-based IADL test, the Harvard Automated Phone Task (APT), and cerebral tau and amyloid burden in cognitively normal (CN) older adults.
METHODS
Seventy-seven CN participants underwent flortaucipir tau and Pittsburgh Compound B amyloid PET. IADL were assessed using the three Harvard APT tasks: prescription refill (APT-Script), health insurance company call (APT-PCP), and bank transaction (APT-Bank). Linear regression models were used to determine associations between each APT task and entorhinal cortex, inferior temporal, or precuneus tau with or without an interaction with amyloid.
RESULTS
Significant associations were found between APT-Bank task rate and interaction between amyloid and entorhinal cortex tau, and APT-PCP task and interactions between amyloid and inferior temporal and precuneus tau. No significant associations were found between the APT tasks and tau or amyloid alone.
CONCLUSION
Our preliminary findings suggest an association between a simulated real-life IADL test and interactions of amyloid and several regions of early tau accumulation in CN older adults. However, some analyses were underpowered due to the small number of participants with elevated amyloid, and findings should be interpreted with caution. Future studies will further explore these associations cross-sectionally and longitudinally in order to determine whether the Harvard APT can serve as a reliable IADL outcome measure for preclinical AD prevention trials and ultimately in the clinic setting.
背景
在阿尔茨海默病（AD）的早期阶段，检测工具性日常生活活动（IADL）的临床有意义变化至关重要。
目的
本探索性研究的目的是检查认知正常（CN）老年人中基于表现的 IADL 测试——哈佛自动电话任务（APT）与大脑 tau 和淀粉样蛋白负担之间的横断面关系。
方法
77 名 CN 参与者接受了 flortaucipir tau 和匹兹堡化合物 B 淀粉样蛋白 PET 检查。使用三个哈佛 APT 任务评估 IADL：处方续配（APT-Script）、医疗保险公司电话（APT-PCP）和银行交易（APT-Bank）。使用线性回归模型确定每个 APT 任务与内嗅皮质、下颞叶或楔前叶 tau 之间的关联，以及是否存在与淀粉样蛋白的相互作用。
结果
发现 APT-Bank 任务率与淀粉样蛋白和内嗅皮质 tau 之间的相互作用以及 APT-PCP 任务与淀粉样蛋白和下颞叶和楔前叶 tau 之间的相互作用之间存在显著关联。未发现 APT 任务与 tau 或淀粉样蛋白单独之间存在显著关联。
结论
我们的初步发现表明，模拟现实生活中的 IADL 测试与 CN 老年人中淀粉样蛋白和几个早期 tau 积累区域之间的相互作用之间存在关联。然而，由于具有高淀粉样蛋白的参与者数量较少，一些分析的功效不足，因此应谨慎解释这些发现。未来的研究将进一步在横断面和纵向研究中探讨这些关联，以确定哈佛 APT 是否可以作为临床前 AD 预防试验的可靠 IADL 结局测量指标，最终在临床环境中使用。
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