Mary M Machulda1, Clint E Hagen2, Heather J Wiste2, Michelle M Mielke3,4, David S Knopman4, Rosebud O Roberts3,4, Prashanthi Vemuri5, Val J Lowe5, Clifford R Jack5, Ronald C Petersen4. 1. a Division of Neurocognitive Disorders, Department of Psychiatry and Psychology , College of Medicine, Mayo Clinic , Rochester , MN , USA. 2. b Division of Biomedical Statistics and Informatics, Department of Health Sciences Research , College of Medicine, Mayo Clinic , Rochester , MN , USA. 3. c Division of Epidemiology, Department of Health Sciences Research , College of Medicine, Mayo Clinic , Rochester , MN , USA. 4. d Department of Neurology , College of Medicine, Mayo Clinic , Rochester , MN , USA. 5. e Department of Radiology , College of Medicine, Mayo Clinic , Rochester , MN , USA.
Abstract
OBJECTIVE: The objective of this study was to examine practice effects and longitudinal cognitive change in 190 clinically normal elderly classified according to a two-feature biomarker model for Alzheimer's disease. METHODS: All participants completed neuropsychological testing, MRI, FDG-PET, and PiB-PET at their baseline evaluation. We divided participants into four groups based on neuroimaging measures of amyloid (A+ or A-) and neurodegeneration (N+ or N-) and reexamined cognition at 15- and 30-month intervals. RESULTS: The A-N- group showed significant improvements in the memory and global scores. The A+N- group also showed significant improvements in the memory and global scores as well as attention. The A-N+ group showed a significant decline in attention at 30 months. The A+N+ group showed significant improvements in memory and the global score at 15 months followed by a significant decline in the global score at 30 months. CONCLUSION: Amyloidosis in the absence of neurodegeneration did not have an adverse impact on practice effects or the 30-month cognitive trajectories. In contrast, participants with neurodegeneration (either A-N+ or A+N+) had worse performance at the 30-month follow-up. Our results show that neurodegeneration has a more deleterious effect on cognition than amyloidosis in clinically normal individuals.
OBJECTIVE: The objective of this study was to examine practice effects and longitudinal cognitive change in 190 clinically normal elderly classified according to a two-feature biomarker model for Alzheimer's disease. METHODS: All participants completed neuropsychological testing, MRI, FDG-PET, and PiB-PET at their baseline evaluation. We divided participants into four groups based on neuroimaging measures of amyloid (A+ or A-) and neurodegeneration (N+ or N-) and reexamined cognition at 15- and 30-month intervals. RESULTS: The A-N- group showed significant improvements in the memory and global scores. The A+N- group also showed significant improvements in the memory and global scores as well as attention. The A-N+ group showed a significant decline in attention at 30 months. The A+N+ group showed significant improvements in memory and the global score at 15 months followed by a significant decline in the global score at 30 months. CONCLUSION:Amyloidosis in the absence of neurodegeneration did not have an adverse impact on practice effects or the 30-month cognitive trajectories. In contrast, participants with neurodegeneration (either A-N+ or A+N+) had worse performance at the 30-month follow-up. Our results show that neurodegeneration has a more deleterious effect on cognition than amyloidosis in clinically normal individuals.
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