Symptomatic Clusters Related to Amyloid Positivity in Cognitively Unimpaired Individuals

Sannemann, Lena; Bartels, Claudia; Brosseron, Frederic; Buerger, Katharina ; Fliessbach, Klaus; Freiesleben, Silka Dawn; Frommann, Ingo; Glanz, Wenzel; Heneka, Michael T.; Janowitz, Daniel; Kilimann, Ingo; Kleineidam, Luca; Lammerding, Dominik; Laske, Christoph; Munk, Matthias H.J.; Perneczky, Robert ; Peters, Oliver; Priller, Josef; Rauchmann, Boris-Stephan; Rostamzadeh, Ayda; Roy-Kluth, Nina; Schild, Ann-Katrin; Schneider, Anja; Schneider, Luisa-Sophie; Spottke, Annika; Spruth, Eike Jakob; Teipel, Stefan; Wagner, Michael; Wiltfang, Jens; Wolfsgruber, Steffen; Duezel, Emrah und Jessen, Frank (2024): Symptomatic Clusters Related to Amyloid Positivity in Cognitively Unimpaired Individuals. In: Journal of Alzheimer's Disease, Bd. 100, Nr. 1: S. 193-205

Abstract

Background: The NIA-AA Research Framework on Alzheimer’s disease (AD) proposes a transitional stage (stage 2) characterized by subtle cognitive decline, subjective cognitive decline (SCD) and mild neurobehavioral symptoms (NPS).

Objective:To identify participant clusters based on stage 2 features and assess their association with amyloid positivity in cognitively unimpaired individuals.

Methods: We included baseline data of N = 338 cognitively unimpaired participants from the DELCODE cohort with data on cerebrospinal fluid biomarkers for AD. Classification into the AD continuum (i.e., amyloid positivity, A+) was based on Aβ42/40 status. Neuropsychological test data were used to assess subtle objective cognitive dysfunction (OBJ), the subjective cognitive decline interview (SCD-I) was used to detect SCD, and the Neuropsychiatric Inventory Questionnaire (NPI-Q) was used to assess NPS. A two-step cluster analysis was carried out and differences in AD biomarkers between clusters were analyzed.

Results: We identified three distinct participant clusters based on presented symptoms. The highest rate of A+ participants (47.6%) was found in a cluster characterized by both OBJ and SCD. A cluster of participants that presented with SCD and NPS (A+:26.6%) and a cluster of participants with overall few symptoms (A+:19.7%) showed amyloid positivity in a range that was not higher than the expected A+ rate for the age group. Across the full sample, participants with a combination of SCD and OBJ in the memory domain showed a lower Aβ42/ptau181 ratio compared to those with neither SCD nor OBJ.

Conclusions:The cluster characterized by participants with OBJ and concomitant SCD was enriched for amyloid pathology.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin > Munich Cluster for Systems Neurology (SyNergy) ; Medizin > Institut für Schlaganfall- und Demenzforschung (ISD) ; Medizin > Klinikum der LMU München > Klinik und Poliklink für Psychiatrie und Psychotherapie
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 13872877
• Bemerkung: for the DELCODE Study Group
• Sprache: Englisch
• DFG: Gefördert durch die Deutsche Forschungsgemeinschaft (DFG) - 390857198