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ABSTRACT: Objective
To determine whether a decline in cued recall is observable in the preclinical stage of Alzheimer disease (AD) in clinically normal older adults with elevated ?-amyloid (A?) burden on PET imaging.Methods
Clinically normal older adults underwent baseline neuroimaging (PET to assess A?+/- status and MRI) and annual neuropsychological testing. Cox proportional hazards models were used to assess the relative risk of cued memory decline (drop of 1, 2, 3, or 4 points on the total score of the Free and Cued Selective Reminding Test) in relation to neuroimaging measures, functional status, age, sex, and education.Results
A total of 276 older adults (Clinical Dementia Rating = 0, mean Mini-Mental State Examination score = 29 ± 1.06) were followed up for a mean of 3.6 ± 1.2 years. Despite the infrequency of cued memory decline (only 19% of participants scored ?46/48 in total recall by year 3), A?+ participants were 3.55 times (95% confidence interval = 1.77-7.12) more likely to exhibit decline in total recall (?46/48) compared with their A?- peers. Furthermore, A?+ participants who scored ?46/48 had smaller hippocampal volumes (t = 3.37, p = 0.001) and evidence of early functional decline, i.e., greater risk of progression to global Clinical Dementia Rating of 0.5 (?2 = 14.30, p < 0.001), compared with their A?+ peers with intact total recall.Conclusions
Cued memory decline in healthy older adults may be particularly indicative of A?-related decline during the preclinical stage of AD and useful for identifying A?+ clinically normal individuals at greatest risk of short-term clinical progression.
SUBMITTER: Papp KV
PROVIDER: S-EPMC5386436 | biostudies-literature | 2017 Apr
REPOSITORIES: biostudies-literature
Papp Kathryn V KV Rentz Dorene M DM Mormino Elizabeth C EC Schultz Aaron P AP Amariglio Rebecca E RE Quiroz Yakeel Y Johnson Keith A KA Sperling Reisa A RA
Neurology 20170310 15
<h4>Objective</h4>To determine whether a decline in cued recall is observable in the preclinical stage of Alzheimer disease (AD) in clinically normal older adults with elevated β-amyloid (Aβ) burden on PET imaging.<h4>Methods</h4>Clinically normal older adults underwent baseline neuroimaging (PET to assess Aβ<sup>+/-</sup> status and MRI) and annual neuropsychological testing. Cox proportional hazards models were used to assess the relative risk of cued memory decline (drop of 1, 2, 3, or 4 poin ...[more]