Abstract:
OBJECTIVES:We compared the ability of molecular biomarkers for Alzheimer disease (AD), including amyloid imaging and CSF biomarkers (Aβ42, tau, ptau181, tau/Aβ42, ptau181/Aβ42), to predict time to incident cognitive impairment among cognitively normal adults aged 45 to 88 years and followed for up to 7.5 years. METHODS:Longitudinal data from Knight Alzheimer's Disease Research Center participants (N = 201) followed for a mean of 3.70 years (SD = 1.46 years) were used. Participants with amyloid imaging and CSF collection within 1 year of a clinical assessment indicating normal cognition were eligible. Cox proportional hazards models tested whether the individual biomarkers were related to time to incident cognitive impairment. "Expanded" models were developed using the biomarkers and participant demographic variables. The predictive values of the models were compared. RESULTS:Abnormal levels of all biomarkers were associated with faster time to cognitive impairment, and some participants with abnormal biomarker levels remained cognitively normal for up to 6.6 years. No differences in predictive value were found between the individual biomarkers (p > 0.074), nor did we find differences between the expanded biomarker models (p > 0.312). Each expanded model better predicted incident cognitive impairment than the model containing the biomarker alone (p < 0.005). CONCLUSIONS:Our results indicate that all AD biomarkers studied here predicted incident cognitive impairment, and support the hypothesis that biomarkers signal underlying AD pathology at least several years before the appearance of dementia symptoms.
journal_name
Neurologyjournal_title
Neurologyauthors
Roe CM,Fagan AM,Grant EA,Hassenstab J,Moulder KL,Maue Dreyfus D,Sutphen CL,Benzinger TL,Mintun MA,Holtzman DM,Morris JCdoi
10.1212/WNL.0b013e3182918ca6subject
Has Abstractpub_date
2013-05-07 00:00:00pages
1784-91issue
19eissn
0028-3878issn
1526-632Xpii
WNL.0b013e3182918ca6journal_volume
80pub_type
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