MedicalResearch.com Interview with:
Willemijn Jansen, PhD
Department of Psychiatry & Neuropsychology
Maastricht University Medical Center
School for Mental Health and Neuroscience
Alzheimer Center Limburg
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Cerebral amyloid-β aggregation is an early pathological event in Alzheimer’s disease (AD), starting decades prior to dementia onset. About 25% of cognitively normal elderly and 50% of patients with mild cognitive impairment (MCI) have biomarker evidence of amyloid pathology. These persons are at increased risk for developing AD-type dementia, but the extent to which amyloid-β aggregation affects cognitive function in persons without dementia is unclear. This is important to know for a better understanding of the course of Alzheimer’s disease and for the design of AD prevention trials.
We here investigate the association between amyloid plaques and memory scores, using data from 53 international studies included in the Amyloid Biomarker study. Cognitively healthy elderly people with plaques have a low memory score twice as often as these persons without plaques. MCI patients with plaques had 20% more often low memory and low global cognition scores than MCI patients without plaques.
We further observed 10- to 15-year intervals between the onset of amyloid positivity and emergence of low memory scores in cognitively healthy persons.
MedicalResearch.com: What should clinicians and patients take away from your report?
Response: Amyloid positivity in persons without dementia is not benign but may be a first sign of Alzheimer’s disease. Although low memory scores are an early marker of amyloid positivity, their value as a screening measure for early AD among persons without dementia is limited.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: These findings are important for the design of secondary Alzheimer’s disease prevention trials. Since amyloid positivity has become a requirement for enrollment in many Alzheimer’s disease prevention trials, cognitive screening would be an inexpensive and noninvasive alternative to screen for amyloid positivity. Our however study shows that a low cognitive score for screening of amyloid positivity had only limited utility. Future research could identify more sensitive cognitive measures to increase screening potential.
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Willemijn J. Jansen, Rik Ossenkoppele, Betty M. Tijms, Anne M. Fagan, Oskar Hansson, William E. Klunk, Wiesje M. van der Flier, Victor L. Villemagne, Giovanni B. Frisoni, Adam S. Fleisher, Alberto Lleó, Mark A. Mintun, Anders Wallin, Sebastiaan Engelborghs, Duk L. Na, Gäel Chételat, José Luis Molinuevo, Susan M. Landau, Niklas Mattsson, Johannes Kornhuber, Osama Sabri, Christopher C. Rowe, Lucilla Parnetti, Julius Popp, Tormod Fladby, William J. Jagust, Pauline Aalten, Dong Young Lee, Rik Vandenberghe, Catarina Resende de Oliveira, Elisabeth Kapaki, Lutz Froelich, Adrian Ivanoiu, Tomasz Gabryelewicz, Marcel M. Verbeek, Páscual Sanchez-Juan, Helmut Hildebrandt, Vincent Camus, Marzena Zboch, David J. Brooks, Alexander Drzezga, Juha O. Rinne, Andrew Newberg, Alexandre de Mendonça, Marie Sarazin, Gil D. Rabinovici, Karine Madsen, Milica G. Kramberger, Agneta Nordberg, Vincent Mok, Barbara Mroczko, David A. Wolk, Philipp T. Meyer, Magda Tsolaki, Philip Scheltens, Frans R. J. Verhey, Pieter Jelle Visser, . Association of Cerebral Amyloid-β Aggregation With Cognitive Functioning in Persons Without Dementia. JAMA Psychiatry. Published online November 29, 2017. doi:10.1001/jamapsychiatry.2017.3391
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