The relationship between everyday functioning and cerebral tau burden in cognitively normal older adults. (20th December 2022)

• Record Type: Journal Article
• Authors: Dubbelman, Mark A.; Sanchez, Justin S; Schultz, Aaron P.; Rentz, Dorene M.; Amariglio, Rebecca E.; Sikkes, Sietske A.M.; Sperling, Reisa A.; Johnson, Keith A.; Marshall, Gad A
• Is Part Of: Alzheimer's & dementia. Volume 18(2022)Supplement 7
• Page Start: n/a
• Page End: n/a
• Publication Date: 2022-12-20
• Subjects: Alzheimer's disease -- Periodicals; Alzheimer Disease -- Periodicals; Dementia -- Periodicals; Démence; Maladie d'Alzheimer; Périodique électronique (Descripteur de forme); Ressource Internet (Descripteur de forme); 616.83
• DOI: 10.1002/alz.062840
• Languages: English
• ISSNs: 1552-5260

Abstract

Abstract: Background: Alzheimer's disease is characterized by accumulation of amyloid and tau in the brain. While amyloid is hypothesized to accumulate earlier, tau has been shown to be more strongly related to clinical outcomes. Higher‐order cognitive functioning in daily life is a clinically meaningful outcome that has been shown to decline, even in early disease stages. We aimed to understand the cross‐sectional relationship between regional cerebral tau accumulation and everyday functioning in cognitively normal older adults. Method: We used data from the A4 and LEARN Studies and included participants who underwent tau positron emission tomography (PET) scans using 18 F‐flortaucipir ( n = 447, age 71.9±4.9 years, 57.5% female). Everyday functioning was reported by both participant and study partner using the Alzheimer's Disease Cooperative Study Activities of Daily Living‐Prevention Instrument (ADCS ADL‐PI). We dichotomized ADCS ADL‐PI total scores as ≤44 vs 45 (the maximum score). Additionally, based on previous analyses, we focused on four items and dichotomized scores as no difficulty vs. some/a lot of difficulty. We performed logistic regressions adjusting for age, sex and education. Result: Participants (median 45, range 33–45) and study partners (median 45, range 23–45) reported high levels of everyday functioning. Neither entorhinal nor inferior temporal tau was associated with overall self‐ or study partner‐reported everyday functioning (Table; Figure1). Greater entorhinal tau was associated with study partner‐reported difficulties remembering important dates (odds ratio (OR) = 1.24, 95% confidence interval (95%CI) = [1.06, 1.45], p = 0.008). Greater inferior temporal tau was associated with self‐reported difficulties managing to find personal belongings (OR = 1.23, 95%CI = [1.04, 1.46], p = 0.018). Greater entorhinal and inferior temporal tau were associated with study partner‐reported difficulties remembering the details of TV programs and movies (OR = 1.32, 95%CI = [1.08, 1.61], p = 0.007 and OR = 1.39, 95%CI = [1.11, 1.75], p = 0.005, respectively). Tau was not associated with difficulties remembering current events (Table; Figure2). Conclusion: Our results suggest a weak cross‐sectional relationship between everyday functioning and tau in cognitively normal older adults. These findings are likely driven by the restricted variability in scores on the ADCS ADL‐PI, which could improve with longitudinal data. Moreover, future work should incorporate a measurement of everyday functioning that has a wider range of performance in this population even at baseline.