Characterization of the NIA‐AA Research Framework stage 2 in the longitudinal multicenter DELCODE study

Media type: E-Article
Title: Characterization of the NIA‐AA Research Framework stage 2 in the longitudinal multicenter DELCODE study
Contributor: Sannemann, Lena; Meiberth, Dix U.; Schild, Ann‐Katrin; Bürger, Katharina; Heneka, Michael T.; Laske, Christoph; Perneczky, Robert; Peters, Oliver; Priller, Josef; Schneider, Anja; Spottke, Annika; Teipel, Stefan J.; Wagner, Michael; Wiltfang, Jens; Wolfsgruber, Steffen; Düzel, Emrah; Jessen, Frank
imprint: Wiley, 2021
Published in: Alzheimer's & Dementia
Language: English
DOI: 10.1002/alz.055431
ISSN: 1552-5260; 1552-5279
Keywords: Psychiatry and Mental health ; Cellular and Molecular Neuroscience ; Geriatrics and Gerontology ; Neurology (clinical) ; Developmental Neuroscience ; Health Policy ; Epidemiology
Origination:
Footnote:
Description: <jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>The latest NIA‐AA Research Framework for Alzheimer’s disease (AD) includes a numerical staging system for individuals in the Alzheimer’s continuum. The authors introduce “stage 2” as a transitional stage, characterized by the earliest detectable cognitive or neurobehavioral changes. We aimed to characterize stage 2 in a large German multicentre cohort study.</jats:p></jats:sec><jats:sec><jats:title>Method</jats:title><jats:p>Our analysis included baseline data of <jats:italic>N</jats:italic> = 349 cognitively healthy participants with available CSF biomarker information from the DZNE Longitudinal Cognitive Impairment and Dementia (DELCODE) study. A subsample of <jats:italic>n</jats:italic> = 110 participants presented with abnormal Aß42/40 biomarkers and was therefore classified as part of the Alzheimer’s continuum. Stage 2 characteristics at baseline were defined by subjective decline with concern in any domain on the SCD interview that persisted for at least 6 months. In addition, subtle impairment of objective cognitive performance (<0,5SD) was derived from factor scores of the DELCODE neuropsychological test battery. Subtle neurobehavioral changes were defined by the presence of at least one neuropsychiatric symptom (NPS) on the Neuropsychiatric Inventory Questionnaire (NPI‐Q).</jats:p></jats:sec><jats:sec><jats:title>Result</jats:title><jats:p>The majority of participants in the Alzheimer’s continuum presented with only SCD (22.7%) or both SCD and NPS (20.9%), whereas 12.7% presented with only NPS and 5.5% with only subtle objective cognitive decline. While 10.9% showed all three stage 2 characteristics, 14.5% showed none. The distribution of stage 2 characteristics differed between participants in the Alzheimer’s continuum and those with normal Aß42/40 (<jats:italic>X<jats:sup>2</jats:sup> </jats:italic>(7)=21.21, <jats:italic>p</jats:italic><.01). In addition, the number of fulfilled stage 2 criteria was higher in participants with abnormal Aß42/40 (<jats:italic>M</jats:italic>=1.41, <jats:italic>SD</jats:italic>=0.87) compared to those with normal amyloid biomarkers (<jats:italic>M</jats:italic>=1.10, <jats:italic>SD</jats:italic>=0.84, <jats:italic>t</jats:italic>(347)=1.45, <jats:italic>p</jats:italic>=.001).</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Our findings provide a systematic overview on stage 2 characteristics in a large cohort of cognitively healthy participants with abnormal AD biomarkers and indicate that both the number of fulfilled stage 2 criteria and their distribution differs from participants outside the Alzheimer’s continuum.</jats:p></jats:sec>

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