背景:阿尔茨海默病和相关痴呆的血浆生物标志物可预测总体认知表现和随时间的下降;目前尚不清楚它们如何与影响不同认知领域的不同痴呆综合征的变化相关联。
方法:在对随机选择的基于人群的队列(n=787,中位年龄73)进行重复评估的前瞻性研究中,我们评估了长达8年的不同认知域的表现和下降与血浆淀粉样蛋白β42/40(Aβ42/40)比率的关系,磷酸化的tau181(p-tau181),神经丝轻链(NfL),和胶质纤维酸性蛋白(GFAP)。
结果:横截面,记忆与p-tau181和注意力的关联最强,Executive,以及具有NfL的视觉空间功能。纵向,根据数据驱动的截止值,所有生物标志物谱都可以区分记忆力下降,Aβ42/40最有效。GFAP和Aβ42/40是语言和视觉空间功能下降模式的最佳鉴别器,分别。
结论:这些相对非侵入性的测试可能有利于在其他人群中复制后进行临床筛查,并通过神经影像学或脑脊液分析进行验证。
结论:我们在随机选择的基于人群的队列中进行了长达8年的重复领域特异性认知评估和基线血浆阿尔茨海默病和相关痴呆生物标志物测量的前瞻性研究。通过添加二次时间和应用联合建模技术,我们考虑了不同认知域轨迹的不同增长曲线和缺失数据引起的生存偏差。跨领域,记忆显示与血浆磷酸化Tau181最强的关联,而注意力,Executive,视觉空间功能与神经丝轻链密切相关。纵向,在所有血浆生物标志物中,记忆和视觉空间下降通过二分法淀粉样β42/40谱最有效地区分,而语言是由二分法的胶质纤维酸性蛋白。这些相对非侵入性的测试可能对临床筛查有益;然而,它们需要在其他人群中复制,并通过神经影像学和/或脑脊液评估进行验证.
BACKGROUND: Plasma biomarkers of Alzheimer\'s disease and related dementias predict global cognitive performance and decline over time; it remains unclear how they associate with changes in different dementia syndromes affecting distinct cognitive domains.
METHODS: In a prospective study with repeated assessments of a randomly selected population-based cohort (n = 787, median age 73), we evaluated performance and decline in different cognitive domains over up to 8 years in relation to plasma concentrations of amyloid beta 42/40 (Aβ42/40) ratio, phosphorylated tau181 (p-tau181), neurofilament light chain (NfL), and glial fibrillary acidic protein (GFAP).
RESULTS: Cross-sectionally, memory showed the strongest associations with p-tau181, and attention, executive, and visuospatial functions with NfL. Longitudinally, memory decline was distinguishable with all biomarker profiles dichotomized according to data-driven cutoffs, most efficiently with Aβ42/40. GFAP and Aβ42/40 were the best discriminators of decline patterns in language and visuospatial functions, respectively.
CONCLUSIONS: These relatively non-invasive tests may be beneficial for clinical screening after replication in other populations and validation through neuroimaging or cerebrospinal fluid analysis.
CONCLUSIONS: We performed a prospective study with up to 8 years of repeated domain-specific cognitive assessments and baseline plasma Alzheimer\'s disease and related dementias biomarker measurements in a randomly selected population-based cohort. We considered distinct growth curves of trajectories of different cognitive domains and survival bias induced by missing data by adding quadratic time and applying joint modeling technique. Cross-sectionally, memory showed the strongest associations with plasma phosphorylated tau181, while attention, executive, and visuospatial functions were most strongly associated with neurofilament light chain. Longitudinally, memory and visuospatial declines were most efficiently distinguished by dichotomized amyloid beta 42/40 profile among all plasma biomarkers, while language was by dichotomized glial fibrillary acidic protein. These relatively non-invasive tests may be beneficial for clinical screening; however, they will need replication in other populations and validation through neuroimaging and/or cerebrospinal fluid assessments.