Cued memory decline in biomarker-defined preclinical Alzheimer disease. (11th April 2017)

• Record Type: Journal Article
• Authors: Papp, Kathryn V.; Rentz, Dorene M.; Mormino, Elizabeth C.; Schultz, Aaron P.; Amariglio, Rebecca E.; Quiroz, Yakeel; Johnson, Keith A.; Sperling, Reisa A.
• Is Part Of: Neurology. Volume 88:Number 15(2017)
• Publication Date: 2017-04-11
• Subjects: Neurology -- Periodicals; Neurology -- Periodicals; Neurologie -- Périodiques; 616.8
• DOI: 10.1212/WNL.0000000000003812
• Languages: English
• ISSNs: 0028-3878

Abstract

Abstract : Objective: To determine whether a decline in cued recall is observable in the preclinical stage of Alzheimer disease (AD) in clinically normal older adults with elevated β-amyloid (Aβ) burden on PET imaging. Methods: Clinically normal older adults underwent baseline neuroimaging (PET to assess Aβ +/− status and MRI) and annual neuropsychological testing. Cox proportional hazards models were used to assess the relative risk of cued memory decline (drop of 1, 2, 3, or 4 points on the total score of the Free and Cued Selective Reminding Test) in relation to neuroimaging measures, functional status, age, sex, and education. Results: A total of 276 older adults (Clinical Dementia Rating = 0, mean Mini-Mental State Examination score = 29 ± 1.06) were followed up for a mean of 3.6 ± 1.2 years. Despite the infrequency of cued memory decline (only 19% of participants scored ⩽46/48 in total recall by year 3), Aβ + participants were 3.55 times (95% confidence interval = 1.77–7.12) more likely to exhibit decline in total recall (⩽46/48) compared with their Aβ − peers. Furthermore, Aβ + participants who scored ⩽46/48 had smaller hippocampal volumes ( t = 3.37, p = 0.001) and evidence of early functional decline, i.e., greater risk of progression to global Clinical Dementia Rating of 0.5 (χ 2 = 14.30, p < 0.001), compared with their Aβ + peers with intact total recall. Conclusions: Cued memory decline in healthy older adults may be particularly indicative of Aβ-related decline during the preclinical stage of AD and useful for identifying Aβ + clinically normal individuals at greatest risk of short-term clinical progression.