Amyloid-PET imaging offers small improvements in predictions of future cognitive trajectories
Background: Amyloid β (Aβ) is thought to initiate a cascade of pathology culminating in Alzheimer’s disease-related cognitive decline. Aβ accumulation in brain tissues may begin one to two decades prior to clinical diagnosis of Alzheimer’s disease. Prior studies have demonstrated that Aβ detected in...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2021-01-01
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| Series: | NeuroImage: Clinical |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213158221001571 |
| _version_ | 1818601276340961280 |
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| author | Sarah F. Ackley Eleanor Hayes-Larson Willa D. Brenowitz Kaitlin Swinnerton Dan Mungas Evan Fletcher Baljeet Singh Rachel A. Whitmer Charles DeCarli M. Maria Glymour |
| author_facet | Sarah F. Ackley Eleanor Hayes-Larson Willa D. Brenowitz Kaitlin Swinnerton Dan Mungas Evan Fletcher Baljeet Singh Rachel A. Whitmer Charles DeCarli M. Maria Glymour |
| author_sort | Sarah F. Ackley |
| collection | DOAJ |
| description | Background: Amyloid β (Aβ) is thought to initiate a cascade of pathology culminating in Alzheimer’s disease-related cognitive decline. Aβ accumulation in brain tissues may begin one to two decades prior to clinical diagnosis of Alzheimer’s disease. Prior studies have demonstrated that Aβ detected in vivo with positron emission tomography with amyloid ligands (amyloid-PET) predicts contemporaneously measured cognition and future cognitive trajectories. Prior studies have not evaluated the added value of Aβ measures in predicting future cognition when repeated past cognitive measures are available. We evaluated the extent to which amyloid-PET improves prediction of future cognitive changes over and above predictions based only on sociodemographics and past cognitive measures. Methods: We used data from participants in the University of California Davis Alzheimer’s Disease Research cohort who were cognitively normal at baseline, participated in amyloid-PET imaging, and completed at least three cognitive assessments prior to amyloid-PET imaging (N = 132 for memory andN = 135 for executive function). We used sociodemographic and cognitive measures taken prior to amyloid-PET imaging to predict cognitive trajectory after amyloid-PET imaging and assessed whether measures of amyloid burden improved predictions of subsequent cognitive change. Improvements in prediction were characterized as percent reduction in the mean squared error (MSE) in predicted cognition post amyloid-PET and increase in percent variance explained. Results: The base model using only sociodemographics and past cognitive performance explained the majority of variance in both predicted memory measures (55.6%) and executive function measures (74.5%) following amyloid-PET. Adding amyloid positivity to the model reduced the MSE for memory by 0.2%, 95% CI: (0%, 2.6%), p = 0.48 and for executive function by 3.4%, 95% CI: (0.6%, 10.2%), p = 0.002. This corresponded to an increase in the percent variance explained of 0.1%, 95% CI: (0%, 1.2%) for memory and 0.9%, 95% CI: (0.1%, 2.8%) for executive function. Similar results were obtained using a continuous measure of amyloid burden. Conclusion: In this cohort, the addition of amyloid burden slightly improved predictions of executive function compared to models based only on past cognitive assessments and sociodemographics. When repeated cognitive assessments are available, the additional utility of amyloid-PET in predicting future cognitive impairment may be limited. |
| first_indexed | 2024-12-16T12:48:49Z |
| format | Article |
| id | doaj.art-c7a1f022e308495dad77034c563cbdfc |
| institution | Directory Open Access Journal |
| issn | 2213-1582 |
| language | English |
| last_indexed | 2024-12-16T12:48:49Z |
| publishDate | 2021-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | NeuroImage: Clinical |
| spelling | doaj.art-c7a1f022e308495dad77034c563cbdfc2022-12-21T22:31:13ZengElsevierNeuroImage: Clinical2213-15822021-01-0131102713Amyloid-PET imaging offers small improvements in predictions of future cognitive trajectoriesSarah F. Ackley0Eleanor Hayes-Larson1Willa D. Brenowitz2Kaitlin Swinnerton3Dan Mungas4Evan Fletcher5Baljeet Singh6Rachel A. Whitmer7Charles DeCarli8M. Maria Glymour9Department of Epidemiology and Biostatistics, University of California San Francisco, United StatesDepartment of Epidemiology, University of California Los Angeles, Fielding School of Public Health, United StatesDepartment of Epidemiology and Biostatistics, University of California San Francisco, United StatesDepartment of Epidemiology and Biostatistics, University of California San Francisco, United StatesDepartment of Neurology, Center for Neuroscience, University of California, Davis, Davis, CA, United StatesDepartment of Neurology, Center for Neuroscience, University of California, Davis, Davis, CA, United StatesDepartment of Neurology, Center for Neuroscience, University of California, Davis, Davis, CA, United StatesKaiser Permanente Division of Research, Oakland, CA, United States; Department of Public Health Sciences, UC Davis, United StatesDepartment of Neurology, Center for Neuroscience, University of California, Davis, Davis, CA, United StatesDepartment of Epidemiology and Biostatistics, University of California San Francisco, United States; Corresponding author at: 550 16th Street, San Francisco, United States.Background: Amyloid β (Aβ) is thought to initiate a cascade of pathology culminating in Alzheimer’s disease-related cognitive decline. Aβ accumulation in brain tissues may begin one to two decades prior to clinical diagnosis of Alzheimer’s disease. Prior studies have demonstrated that Aβ detected in vivo with positron emission tomography with amyloid ligands (amyloid-PET) predicts contemporaneously measured cognition and future cognitive trajectories. Prior studies have not evaluated the added value of Aβ measures in predicting future cognition when repeated past cognitive measures are available. We evaluated the extent to which amyloid-PET improves prediction of future cognitive changes over and above predictions based only on sociodemographics and past cognitive measures. Methods: We used data from participants in the University of California Davis Alzheimer’s Disease Research cohort who were cognitively normal at baseline, participated in amyloid-PET imaging, and completed at least three cognitive assessments prior to amyloid-PET imaging (N = 132 for memory andN = 135 for executive function). We used sociodemographic and cognitive measures taken prior to amyloid-PET imaging to predict cognitive trajectory after amyloid-PET imaging and assessed whether measures of amyloid burden improved predictions of subsequent cognitive change. Improvements in prediction were characterized as percent reduction in the mean squared error (MSE) in predicted cognition post amyloid-PET and increase in percent variance explained. Results: The base model using only sociodemographics and past cognitive performance explained the majority of variance in both predicted memory measures (55.6%) and executive function measures (74.5%) following amyloid-PET. Adding amyloid positivity to the model reduced the MSE for memory by 0.2%, 95% CI: (0%, 2.6%), p = 0.48 and for executive function by 3.4%, 95% CI: (0.6%, 10.2%), p = 0.002. This corresponded to an increase in the percent variance explained of 0.1%, 95% CI: (0%, 1.2%) for memory and 0.9%, 95% CI: (0.1%, 2.8%) for executive function. Similar results were obtained using a continuous measure of amyloid burden. Conclusion: In this cohort, the addition of amyloid burden slightly improved predictions of executive function compared to models based only on past cognitive assessments and sociodemographics. When repeated cognitive assessments are available, the additional utility of amyloid-PET in predicting future cognitive impairment may be limited.http://www.sciencedirect.com/science/article/pii/S2213158221001571Alzheimer’s diseaseamyloid-PETPredictionCognitive changeLongitudinal studies |
| spellingShingle | Sarah F. Ackley Eleanor Hayes-Larson Willa D. Brenowitz Kaitlin Swinnerton Dan Mungas Evan Fletcher Baljeet Singh Rachel A. Whitmer Charles DeCarli M. Maria Glymour Amyloid-PET imaging offers small improvements in predictions of future cognitive trajectories NeuroImage: Clinical Alzheimer’s disease amyloid-PET Prediction Cognitive change Longitudinal studies |
| title | Amyloid-PET imaging offers small improvements in predictions of future cognitive trajectories |
| title_full | Amyloid-PET imaging offers small improvements in predictions of future cognitive trajectories |
| title_fullStr | Amyloid-PET imaging offers small improvements in predictions of future cognitive trajectories |
| title_full_unstemmed | Amyloid-PET imaging offers small improvements in predictions of future cognitive trajectories |
| title_short | Amyloid-PET imaging offers small improvements in predictions of future cognitive trajectories |
| title_sort | amyloid pet imaging offers small improvements in predictions of future cognitive trajectories |
| topic | Alzheimer’s disease amyloid-PET Prediction Cognitive change Longitudinal studies |
| url | http://www.sciencedirect.com/science/article/pii/S2213158221001571 |
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