Subjective cognitive concerns, amyloid-β, and neurodegeneration in clinically normal elderly
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Abstract
Objective: To determine whether neuroimaging biomarkers of amyloid-β (Aβ) and neurodegeneration (ND) are associated with greater self-reported subjective cognitive concerns (SCC) in clinically normal older individuals.
Methods: A total of 257 participants underwent Pittsburgh compound B PET, PET with fluorodeoxyglucose 18F, and structural MRI, as well as a battery of neuropsychological measures including several questionnaires regarding SCC. Individuals were classified into 4 biomarker groups: biomarker negative (Aβ−/ND−), amyloidosis alone (Aβ+/ND−), amyloidosis plus ND (Aβ+/ND+), and ND alone (Aβ−/ND+).
Results: Both Aβ and ND were independently associated with greater SCC controlling for objective memory performance. By contrast, neither Aβ nor ND was associated with objective memory performance controlling for SCC. Further examination revealed greater SCC in individuals with Aβ or ND positivity compared to biomarker-negative individuals. In addition, greater SCC predicted Aβ positivity when controlling for ND status.
Conclusions: When individuals were grouped by biomarker status, those who were positive on Aβ or ND had the highest report of SCC compared to biomarker-negative individuals. Findings were consistent when SCC was used to predict Aβ positivity. Taken together, results suggest that both Aβ and ND are associated with SCC, independent of objective memory performance. Enrichment of individuals with SCC may increase likelihood of Aβ and ND markers in potential participants for secondary prevention trials.
GLOSSARY
- Aβ=
- amyloid-β;
- AD=
- Alzheimer disease;
- E-Cog=
- Everyday Cognition scale;
- eTIV=
- estimated total intracranial volume;
- FDG-PET=
- 18F fluorodeoxyglucose;
- GDS=
- Geriatric Depression Scale;
- HV=
- hippocampal volume;
- MCI=
- mild cognitive impairment;
- MFQ=
- Memory Functioning Questionnaire;
- MMSE=
- Mini-Mental State Examination;
- ND−=
- neurodegeneration-negative;
- ND+=
- neurodegeneration-positive;
- PiB-PET=
- PET with Pittsburgh compound B;
- ROI=
- region of interest;
- SCC=
- subjective cognitive concerns;
- SCD=
- subjective cognitive decline;
- SNAP=
- suspected non–Alzheimer disease pathophysiology;
- SPM=
- statistical parametric mapping;
- STIDA=
- Structured Telephone Interview for Dementia Assessment
Footnotes
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
- Received December 5, 2014.
- Accepted in final form March 13, 2015.
- © 2015 American Academy of Neurology
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