Rosebud O Roberts1, David S Knopman2, Jeremy A Syrjanen2, Jeremiah A Aakre2, Maria Vassilaki2, Walter K Kremers2, Michelle M Mielke2, Mary M Machulda2, Jonathan Graff-Radford2, Yonas E Geda2, Prashanthi Vemuri2, Val Lowe2, Clifford R Jack2, Ronald C Petersen2. 1. From the Divisions of Epidemiology (R.O.R., M.V., M.M. Mielke, R.C.P.) and Biomedical Statistics and Informatics (J.A.S., J.A.A., W.K.K.), Department of Health Sciences Research, Department of Neurology (R.O.R., D.S.K., M.M. Mielke, J.G.-R., R.C.P.), Department of Psychiatry and Psychology (M.M. Machulda), and Department of Radiology (P.V., V.L., C.R.J.), Mayo Clinic, Rochester, MN; and Departments of Psychiatry and Psychology and Neurology (Y.E.G.), Mayo Clinic, Scottsdale, AZ. roberts.rosebud@mayo.edu. 2. From the Divisions of Epidemiology (R.O.R., M.V., M.M. Mielke, R.C.P.) and Biomedical Statistics and Informatics (J.A.S., J.A.A., W.K.K.), Department of Health Sciences Research, Department of Neurology (R.O.R., D.S.K., M.M. Mielke, J.G.-R., R.C.P.), Department of Psychiatry and Psychology (M.M. Machulda), and Department of Radiology (P.V., V.L., C.R.J.), Mayo Clinic, Rochester, MN; and Departments of Psychiatry and Psychology and Neurology (Y.E.G.), Mayo Clinic, Scottsdale, AZ.
Abstract
OBJECTIVE: To estimate the prevalence of elevated brain amyloid and reduced cortical thickness (as a marker for neurodegeneration) in a defined population. METHODS: Mayo Clinic Study of Aging participants underwent MRI to assess a composite Alzheimer disease (AD) signature cortical thickness measure and PET to assess brain amyloid accumulation. Participants were characterized as having elevated amyloid (A+/A-), reduced cortical thickness (N+/N-), and A+N+, A+N-, A-N+, or A-N-. The prevalence of AD biomarkers was derived by adjusting for nonparticipation and standardizing to the Olmsted County, Minnesota, population. RESULTS: Among 1,646 participants without dementia (mean age 70.8 years; 53.2% men), the prevalence (95% confidence interval) of amyloidosis was 21.1% (19.1%-23.2%): women, 24.3%; men, 17.5%. The prevalence of reduced cortical thickness was 28.9% (26.4%-31.5%): women, 27.9%; men, 30.2%. The prevalence estimates of biomarker categories were as follows: A-N-: 61.4%; A+N-: 9.7%; A-N+: 17.4%; and A+N+: 11.5%, and varied by sex and by APOE ε4 carrier status. In men, prevalence estimates were as follows: A-N-: 62.6%; A+N-: 7.3%; A-N+: 19.9%; and A+N+: 10.2%. In women, prevalence estimates were as follows: A-N-: 60.4%; A+N-: 11.7%; A-N+: 15.3%; and A+N+: 12.6%. In ε4 carriers, prevalence estimates were as follows: A-N-: 54.6%; A+N-: 16.6%; A-N+: 12.4%; and A+N+: 16.4%. In non-ε4 carriers, prevalence estimates were as follows: A-N-: 63.3%; A+N-: 6.9%; A-N+: 19.9%; and A+N+: 10.0%. CONCLUSIONS: These prevalence estimates are important for understanding age-related trends in amyloid positivity and AD signature cortical thickness in the population, and for potentially projecting the future burden of biomarkers in elderly persons.
OBJECTIVE: To estimate the prevalence of elevated brain amyloid and reduced cortical thickness (as a marker for neurodegeneration) in a defined population. METHODS:Mayo Clinic Study of Aging participants underwent MRI to assess a composite Alzheimer disease (AD) signature cortical thickness measure and PET to assess brain amyloid accumulation. Participants were characterized as having elevated amyloid (A+/A-), reduced cortical thickness (N+/N-), and A+N+, A+N-, A-N+, or A-N-. The prevalence of AD biomarkers was derived by adjusting for nonparticipation and standardizing to the Olmsted County, Minnesota, population. RESULTS: Among 1,646 participants without dementia (mean age 70.8 years; 53.2% men), the prevalence (95% confidence interval) of amyloidosis was 21.1% (19.1%-23.2%): women, 24.3%; men, 17.5%. The prevalence of reduced cortical thickness was 28.9% (26.4%-31.5%): women, 27.9%; men, 30.2%. The prevalence estimates of biomarker categories were as follows: A-N-: 61.4%; A+N-: 9.7%; A-N+: 17.4%; and A+N+: 11.5%, and varied by sex and by APOE ε4 carrier status. In men, prevalence estimates were as follows: A-N-: 62.6%; A+N-: 7.3%; A-N+: 19.9%; and A+N+: 10.2%. In women, prevalence estimates were as follows: A-N-: 60.4%; A+N-: 11.7%; A-N+: 15.3%; and A+N+: 12.6%. In ε4 carriers, prevalence estimates were as follows: A-N-: 54.6%; A+N-: 16.6%; A-N+: 12.4%; and A+N+: 16.4%. In non-ε4 carriers, prevalence estimates were as follows: A-N-: 63.3%; A+N-: 6.9%; A-N+: 19.9%; and A+N+: 10.0%. CONCLUSIONS: These prevalence estimates are important for understanding age-related trends in amyloid positivity and AD signature cortical thickness in the population, and for potentially projecting the future burden of biomarkers in elderly persons.
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