Dataset Information

Resilience to cognitive impairment in the oldest-old: design of the EMIF-AD 90+ study.

ABSTRACT:

Background

The oldest-old (subjects aged 90?years and older) population represents the fastest growing segment of society and shows a high dementia prevalence rate of up to 40%. Only a few studies have investigated protective factors for cognitive impairment in the oldest-old. The EMIF-AD 90+ Study aims to identify factors associated with resilience to cognitive impairment in the oldest-old. In this paper we reviewed previous studies on cognitive resilience in the oldest-old and described the design of the EMIF-AD 90+ Study.

Methods

The EMIF-AD 90+ Study aimed to enroll 80 cognitively normal subjects and 40 subjects with cognitive impairment aged 90?years or older. Cognitive impairment was operationalized as amnestic mild cognitive impairment (aMCI), or possible or probable Alzheimer's Disease (AD). The study was part of the European Medical Information Framework for AD (EMIF-AD) and was conducted at the Amsterdam University Medical Centers (UMC) and at the University of Manchester. We will test whether cognitive resilience is associated with cognitive reserve, vascular comorbidities, mood, sleep, sensory system capacity, physical performance and capacity, genetic risk factors, hallmarks of ageing, and markers of neurodegeneration. Markers of neurodegeneration included an amyloid positron emission tomography, amyloid ? and tau in cerebrospinal fluid/blood and neurophysiological measures.

Discussion

The EMIF-AD 90+ Study will extend our knowledge on resilience to cognitive impairment in the oldest-old by extensive phenotyping of the subjects and the measurement of a wide range of potential protective factors, hallmarks of aging and markers of neurodegeneration.

Trial registration

Nederlands Trial Register NTR5867 . Registered 20 May 2016.

SUBMITTER: Legdeur N

PROVIDER: S-EPMC6258163 | biostudies-literature | 2018 Nov

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Resilience to cognitive impairment in the oldest-old: design of the EMIF-AD 90+ study.

Legdeur Nienke N Badissi Maryam M Carter Stephen F SF de Crom Sophie S van de Kreeke Aleid A Vreeswijk Ralph R Trappenburg Marijke C MC Oudega Mardien L ML Koek Huiberdina L HL van Campen Jos P JP Keijsers Carolina J P W CJPW Amadi Chinenye C Hinz Rainer R Gordon Mark F MF Novak Gerald G Podhorna Jana J Serné Erik E Verbraak Frank F Yaqub Maqsood M Hillebrand Arjan A Griffa Alessandra A Pendleton Neil N Kramer Sophia E SE Teunissen Charlotte E CE Lammertsma Adriaan A Barkhof Frederik F van Berckel Bart N M BNM Scheltens Philip P Muller Majon M Maier Andrea B AB Herholz Karl K Visser Pieter Jelle PJ

BMC geriatrics 20181126 1

<h4>Background</h4>The oldest-old (subjects aged 90 years and older) population represents the fastest growing segment of society and shows a high dementia prevalence rate of up to 40%. Only a few studies have investigated protective factors for cognitive impairment in the oldest-old. The EMIF-AD 90+ Study aims to identify factors associated with resilience to cognitive impairment in the oldest-old. In this paper we reviewed previous studies on cognitive resilience in the oldest-old and describe ...[more]

PMID: 30477432

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Project description:BackgroundThere is an urgent need for novel, noninvasive biomarkers to diagnose Alzheimer's disease (AD) in the predementia stages and to predict the rate of decline. Therefore, we set up the European Medical Information Framework for Alzheimer's Disease Multimodal Biomarker Discovery (EMIF-AD MBD) study. In this report we describe the design of the study, the methods used and the characteristics of the participants.MethodsParticipants were selected from existing prospective multicenter and single-center European studies. Inclusion criteria were having normal cognition (NC) or a diagnosis of mild cognitive impairment (MCI) or AD-type dementia at baseline, age above 50 years, known amyloid-beta (A?) status, availability of cognitive test results and at least two of the following materials: plasma, DNA, magnetic resonance imaging (MRI) or cerebrospinal fluid (CSF). Targeted and untargeted metabolomic and proteomic analyses were performed in plasma, and targeted and untargeted proteomics were performed in CSF. Genome-wide SNP genotyping, next-generation sequencing and methylation profiling were conducted in DNA. Visual rating and volumetric measures were assessed on MRI. Baseline characteristics were analyzed using ANOVA or chi-square, rate of decline analyzed by linear mixed modeling.ResultsWe included 1221 individuals (NC n?=?492, MCI n?=?527, AD-type dementia n?=?202) with a mean age of 67.9 (SD 8.3) years. The percentage A?+ was 26% in the NC, 58% in the MCI, and 87% in the AD-type dementia groups. Plasma samples were available for 1189 (97%) subjects, DNA samples for 929 (76%) subjects, MRI scans for 862 (71%) subjects and CSF samples for 767 (63%) subjects. For 759 (62%) individuals, clinical follow-up data were available. In each diagnostic group, the APOE ?4 allele was more frequent amongst A?+ individuals (p?<?0.001). Only in MCI was there a difference in baseline Mini Mental State Examination (MMSE) score between the A groups (p?<?0.001). A?+ had a faster rate of decline on the MMSE during follow-up in the NC (p?<?0.001) and MCI (p?<?0.001) groups.ConclusionsThe characteristics of this large cohort of elderly subjects at various cognitive stages confirm the central roles of A? and APOE ?4 in AD pathogenesis. The results of the multimodal analyses will provide new insights into underlying mechanisms and facilitate the discovery of new diagnostic and prognostic AD biomarkers. All researchers can apply for access to the EMIF-AD MBD data by submitting a research proposal via the EMIF-AD Catalog.

Dataset Information

Resilience to cognitive impairment in the oldest-old: design of the EMIF-AD 90+ study.

Background

Methods

Discussion

Trial registration

Publications

Resilience to cognitive impairment in the oldest-old: design of the EMIF-AD 90+ study.

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