Using subjective cognitive decline to identify high global amyloid in community-based samples: A cross-cohort study

Rachel F Buckley; Sietske Sikkes; Victor L Villemagne; Elizabeth C Mormino; Jennifer S Rabin; Samantha Burnham; Kathryn V Papp; Vincent Doré; Colin L Masters; Michael J Properzi; Aaron P Schultz; Keith A Johnson; Dorene M Rentz; Reisa A Sperling; Rebecca E Amariglio

doi:10.1016/j.dadm.2019.08.004

Using subjective cognitive decline to identify high global amyloid in community-based samples: A cross-cohort study

Alzheimers Dement (Amst). 2019 Sep 25:11:670-678. doi: 10.1016/j.dadm.2019.08.004. eCollection 2019 Dec.

Authors

Rachel F Buckley^{1

2

3

4}, Sietske Sikkes^{5

6}, Victor L Villemagne^{7

8}, Elizabeth C Mormino⁹, Jennifer S Rabin¹⁰, Samantha Burnham^{7

11}, Kathryn V Papp^{3

4}, Vincent Doré^{7

12}, Colin L Masters¹, Michael J Properzi³, Aaron P Schultz^{3

4}, Keith A Johnson^{4

13}, Dorene M Rentz^{3

4}, Reisa A Sperling^{3

4}, Rebecca E Amariglio^{3

4}

Affiliations

¹ The Florey Institute, The University of Melbourne, Melbourne, Victoria, Australia.
² Melbourne School of Psychological Science, University of Melbourne, Melbourne, Victoria, Australia.
³ Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
⁴ Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA.
⁵ Alzheimer Center and Department of Neurology, Amsterdam Neuroscience, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, the Netherlands.
⁶ Department of Epidemiology and Biostatistics, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, the Netherlands.
⁷ Department of Nuclear Medicine and Centre for PET, Austin Health, Victoria, Australia.
⁸ The Department of Medicine, Austin Health, The University of Melbourne, Victoria, Australia.
⁹ Department of Neurology, Stanford University, Palo Alto, CA, USA.
¹⁰ Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
¹¹ The Australian eHealth Research Centre, CSIRO Health & Biosecurity, Melbourne, Victoria, Australia.
¹² The Australian eHealth Research Centre, CSIRO Health & Biosecurity, Brisbane, Queensland, Australia.
¹³ Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA.

Abstract

Introduction: We aimed to examine the contribution of subjective cognitive decline (SCD) to reduce the number of β-amyloid (Aβ) positron emission tomography scans required for recruiting Aβ+ clinically normal individuals in clinical trials.

Methods: Three independent cohorts (890 clinically normal: 72 yrs ± 6.7; Female: 43.4%; SCD+: 24%; apolipoprotein E [APOE] ε4+: 28.5%; Aβ+: 32%) were used. SCD was dichotomized from one question. Using logistic regression, we classified Aβ+ using the SCD dichotomy, APOEε4, sex, and age.

Results: SCD increased odds of Aβ+ by 1.58 relative to non-SCD. Female APOEε4 carriers with SCD exhibited higher odds of Aβ+ (OR = 3.34), whereas male carriers with SCD showed a weaker, opposing effect (OR = 0.37). SCD endorsement reduces the number of Aβ positron emission tomography scans to recruit Aβ+ individuals by 13% and by 9% if APOEε4 status is known.

Conclusion: SCD helps to classify those with high Aβ, even beyond the substantial effect of APOE genotype. Collecting SCD is a feasible method for targeting recruitment for those likely on the AD trajectory.

Keywords: APOEε4; Alzheimer's disease; Amyloid; Subjective cognitive decline.

Abstract

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