Cited by 1,610Dementia and Cognitive Impairment ResearchAlzheimer's disease research and treatmentsCancer-related cognitive impairment studies

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Prevalence of Cerebral Amyloid Pathology in Persons Without Dementia: A Meta-analysis

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Jansen, Willemijn J., Ossenkoppele, Rik, Knol, Dirk L., Tijms, Betty M., Scheltens, Philip, Verhey, Frans R. J., Visser, Pieter Jelle, Aalten, Pauline, Aarsland, Dag, Alcolea, Daniel, Alexander, Myriam, Almdahl, Ina S., Arnold, Steven E., Baldeiras, Inês, Barthel, Henryk, van Berckel, Bart N. M., Bibeau, Kristen, Blennow, Kaj, Brooks, David J., van Buchem, Mark A., Camus, Vincent, Cavedo, Enrica, Chen, Kewei, Chetelat, Gael, Cohen, Ann D., Drzezga, Alexander, Engelborghs, Sebastiaan, Fagan, Anne M., Fladby, Tormod, Fleisher, Adam S., van der Flier, Wiesje M., Ford, Lisa, Förster, Stefan, Fortea, Juan, Foskett, Nadia, Frederiksen, Kristian S., Freund-Levi, Yvonne, Frisoni, Giovanni B., Froelich, Lutz, Gabryelewicz, Tomasz, Gill, Kiran Dip, Gkatzima, Olymbia, Gómez-Tortosa, Estrella, Gordon, Mark Forrest, Grimmer, Timo, Hampel, Harald, Hausner, Lucrezia, Hellwig, Sabine, Herukka, Sanna-Kaisa, Hildebrandt, Helmut, Ishihara, Lianna, Ivanoiu, Adrian, Jagust, William J., Johannsen, Peter, Kandimalla, Ramesh, Kapaki, Elisabeth, Klimkowicz-Mrowiec, Aleksandra, Klunk, William E., Köhler, Sebastian, Koglin, Norman, Kornhuber, Johannes, Kramberger, Milica G., Van Laere, Koen, Landau, Susan M., Lee, Dong Young, de Leon, Mony, Lisetti, Viviana, Lleó, Alberto, Madsen, Karine, Maier, Wolfgang, Marcusson, Jan, Mattsson, Niklas, de Mendonça, Alexandre, Meulenbroek, Olga, Meyer, Philipp T., Mintun, Mark A., Mok, Vincent, Molinuevo, José Luis, Møllergård, Hanne M., Morris, John C., Mroczko, Barbara, Van der Mussele, Stefan, Na, Duk L., Newberg, Andrew, Nordberg, Agneta, Nordlund, Arto, Novak, Gerald P., Paraskevas, George P., Parnetti, Lucilla, Perera, Gayan, Peters, Oliver, Popp, Julius, Prabhakar, Sudesh, Rabinovici, Gil D., Ramakers, Inez H. G. B., Rami, Lorena, Resende de Oliveira, Catarina, Rinne, Juha O., Rodrigue, Karen M., Rodríguez-Rodríguez, Eloy, Roe, Catherine M., Rot, Uros, Rowe, Christopher C., Rüther, Eckart, Sabri, Osama, Sanchez-Juan, Páscual, Santana, Isabel, Sarazin, Marie, Schröder, Johannes, Schütte, Christin, Seo, Sang W., Soetewey, Femke, Soininen, Hilkka, Spiru, Luiza, Struyfs, Hanne, Teunissen, Charlotte E., Tsolaki, Magda, Vandenberghe, Rik, Verbeek, Marcel M., Villemagne, Victor L., Vos, Stephanie J. B., van Waalwijk van Doorn, Linda J. C., Waldemar, Gunhild, Wallin, Anders, Wallin, Åsa K., Wiltfang, Jens, Wolk, David A., Zboch, Marzena, Zetterberg, Henrik·2015·JAMA

Abstract

IMPORTANCE: Cerebral amyloid-β aggregation is an early pathological event in Alzheimer disease (AD), starting decades before dementia onset. Estimates of the prevalence of amyloid pathology in persons without dementia are needed to understand the development of AD and to design prevention studies. OBJECTIVE: To use individual participant data meta-analysis to estimate the prevalence of amyloid pathology as measured with biomarkers in participants with normal cognition, subjective cognitive impairment (SCI), or mild cognitive impairment (MCI). DATA SOURCES: Relevant biomarker studies identified by searching studies published before April 2015 using the MEDLINE and Web of Science databases and through personal communication with investigators. STUDY SELECTION: Studies were included if they provided individual participant data for participants without dementia and used an a priori defined cutoff for amyloid positivity. DATA EXTRACTION AND SYNTHESIS: Individual records were provided for 2914 participants with normal cognition, 697 with SCI, and 3972 with MCI aged 18 to 100 years from 55 studies. MAIN OUTCOMES AND MEASURES: Prevalence of amyloid pathology on positron emission tomography or in cerebrospinal fluid according to AD risk factors (age, apolipoprotein E [APOE] genotype, sex, and education) estimated by generalized estimating equations. RESULTS: The prevalence of amyloid pathology increased from age 50 to 90 years from 10% (95% CI, 8%-13%) to 44% (95% CI, 37%-51%) among participants with normal cognition; from 12% (95% CI, 8%-18%) to 43% (95% CI, 32%-55%) among patients with SCI; and from 27% (95% CI, 23%-32%) to 71% (95% CI, 66%-76%) among patients with MCI. APOE-ε4 carriers had 2 to 3 times higher prevalence estimates than noncarriers. The age at which 15% of the participants with normal cognition were amyloid positive was approximately 40 years for APOE ε4ε4 carriers, 50 years for ε2ε4 carriers, 55 years for ε3ε4 carriers, 65 years for ε3ε3 carriers, and 95 years for ε2ε3 carriers. Amyloid positivity was more common in highly educated participants but not associated with sex or biomarker modality. CONCLUSIONS AND RELEVANCE: Among persons without dementia, the prevalence of cerebral amyloid pathology as determined by positron emission tomography or cerebrospinal fluid findings was associated with age, APOE genotype, and presence of cognitive impairment. These findings suggest a 20- to 30-year interval between first development of amyloid positivity and onset of dementia.

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Authors
Jansen, W. J., Ossenkoppele, R., Knol, D. L., Tijms, B. M., Scheltens, P., Verhey, F. R. J., Visser, P. J., Aalten, P., Aarsland, D., Alcolea, D., Alexander, M., Almdahl, I. S., Arnold, S. E., Baldeiras, I., Barthel, H., van Berckel, B. N. M., Bibeau, K., Blennow, K., Brooks, D. J., van Buchem, M. A., Camus, V., Cavedo, E., Chen, K., Chetelat, G., Cohen, A. D., Drzezga, A., Engelborghs, S., Fagan, A. M., Fladby, T., Fleisher, A. S., van der Flier, W. M., Ford, L., Förster, S., Fortea, J., Foskett, N., Frederiksen, K. S., Freund-Levi, Y., Frisoni, G. B., Froelich, L., Gabryelewicz, T., Gill, K. D., Gkatzima, O., Gómez-Tortosa, E., Gordon, M. F., Grimmer, T., Hampel, H., Hausner, L., Hellwig, S., Herukka, S.-K., Hildebrandt, H., Ishihara, L., Ivanoiu, A., Jagust, W. J., Johannsen, P., Kandimalla, R., Kapaki, E., Klimkowicz-Mrowiec, A., Klunk, W. E., Köhler, S., Koglin, N., Kornhuber, J., Kramberger, M. G., Van Laere, K., Landau, S. M., Lee, D. Y., de Leon, M., Lisetti, V., Lleó, A., Madsen, K., Maier, W., Marcusson, J., Mattsson, N., de Mendonça, A., Meulenbroek, O., Meyer, P. T., Mintun, M. A., Mok, V., Molinuevo, J. L., Møllergård, H. M., Morris, J. C., Mroczko, B., Van der Mussele, S., Na, D. L., Newberg, A., Nordberg, A., Nordlund, A., Novak, G. P., Paraskevas, G. P., Parnetti, L., Perera, G., Peters, O., Popp, J., Prabhakar, S., Rabinovici, G. D., Ramakers, I. H. G. B., Rami, L., Resende de Oliveira, C., Rinne, J. O., Rodrigue, K. M., Rodríguez-Rodríguez, E., Roe, C. M., Rot, U., Rowe, C. C., Rüther, E., Sabri, O., Sanchez-Juan, P., Santana, I., Sarazin, M., Schröder, J., Schütte, C., Seo, S. W., Soetewey, F., Soininen, H., Spiru, L., Struyfs, H., Teunissen, C. E., Tsolaki, M., Vandenberghe, R., Verbeek, M. M., Villemagne, V. L., Vos, S. J. B., van Waalwijk van Doorn, L. J. C., Waldemar, G., Wallin, A., Wallin, Å. K., Wiltfang, J., Wolk, D. A., Zboch, M., & Zetterberg, H.
Affiliations
  • Maastricht University (NL)
  • Amsterdam Neuroscience (NL)
  • Amsterdam UMC Location Vrije Universiteit Amsterdam (NL)
  • Stavanger University Hospital (NO)
  • Hospital de Sant Pau (ES)
  • Roche (United Kingdom) (GB)
  • Akershus University Hospital (NO)
  • University of Pennsylvania (US)
  • Unidade Local de Saúde de Coimbra (PT)
  • Leipzig University (DE)
  • Department of Radiology and Nuclear Medicine, VU University Medical Center, Neuroscience Campus Amsterdam, Amsterdam, the Netherlands
  • GlaxoSmithKline (United States) (US)
  • University of Gothenburg (SE)
  • Imperial College London (GB)
  • Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
  • Université de Tours (FR)
  • Sorbonne Université (FR)
  • Banner Alzheimer’s Institute (US)
  • Institut National de la Santé et de la Recherche Médicale (Inserm), U1077, Caen, France
  • University of Pittsburgh (US)
  • University of Cologne (DE)
  • University of Antwerp (BE)
  • Washington University in St. Louis (US)
  • University of California San Diego (US)
  • Department of Neurology and Alzheimer Center, VU University Medical Center, Neuroscience Campus Amsterdam, Amsterdam, the Netherlands6Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, the Netherlands
  • Janssen Research and Development, Titusville, New Jersey
  • Technical University of Munich (DE)
  • University of Copenhagen (DK)
  • Department of Geriatrics, Institution of NVS, Section of Clinical Geriatrics, Karolinska Institutet, Stockholm, Sweden
  • University of Geneva (CH)
  • Heidelberg University (DE)
  • Mossakowski Medical Research Institute, Polish Academy of Sciences (PL)
  • Post Graduate Institute of Medical Education and Research (IN)
  • Aristotle University of Thessaloniki (GR)
  • Department of Neurology, Fundación Jiménez Díaz, Madrid, Spain
  • Boehringer Ingelheim (United States) (US)
  • TUM Klinikum (DE)
  • Inserm (FR)
  • University Medical Center Freiburg (DE)
  • University of Eastern Finland (FI)
  • Center for Neurology, Hospital of Bremen-Ost, Bremen, Germany
  • GlaxoSmithKline (United Kingdom) (GB)
  • Cliniques Universitaires Saint-Luc (BE)
  • University of California, Berkeley (US)
  • Rigshospitalet (DK)
  • Emory University (US)
  • National and Kapodistrian University of Athens (GR)
  • Jagiellonian University College of Medicine, Krakow, Poland
  • Piramal (Germany) (DE)
  • Friedrich-Alexander-Universität Erlangen-Nürnberg (DE)
  • Ljubljana University Medical Centre (SI)
  • Department of Imaging and Pathology, Catholic University Leuven, Leuven, Belgium
  • Seoul National University (KR)
  • School of Medicine, Center for Brain Health, New York University, New York
  • University of Perugia (IT)
  • Copenhagen University Hospital (DK)
  • University of Bonn (DE)
  • Linköping University (SE)
  • Lund University (SE)
  • Institute of Molecular Medicine and Faculty of Medicine, University of Lisbon, Portugal
  • Radboud University Medical Center (NL)
  • Avid Radiopharmaceuticals (United States) (US)
  • Chinese University of Hong Kong (HK)
  • Alzheimer’s Disease and Other Cognitive Disorders Unit, IDIBAPS, Clinic University Hospital, Barcelona, Spain
  • Medical University of Białystok (PL)
  • Reference Center for Biological Markers of Dementia (BIODEM), University of Antwerp, Antwerp, Belgium
  • Samsung Medical Center (KR)
  • Thomas Jefferson University (US)
  • Karolinska University Hospital (SE)
  • King's College London (GB)
  • German Center for Neurodegenerative Diseases (DE)
  • Centre Hospitalier Universitaire Vaudois (CH)
  • University of California, San Francisco (US)
  • Consorci Institut D'Investigacions Biomediques August Pi I Sunyer (ES)
  • Center for Neuroscience and Cell Biology, Faculty of Medicine, Hospital Center University of Coimbra, Portugal
  • University of Turku (FI)
  • The University of Texas at Dallas (US)
  • Neurology Service, Universitary Hospital Marqués de Valdecilla, IDIVAL, Santander, Spain
  • Center for Cognitive Impairments, University Medical Centre Ljubljana, Ljubljana, Slovenia
  • Austin Hospital (AU)
  • Universitätsmedizin Göttingen (DE)
  • Centre Hospitalier Sainte-Anne (FR)
  • Carol Davila University of Medicine and Pharmacy (RO)
  • KU Leuven (BE)
  • Departments of Neurology and Laboratory Medicine, Donders Institute for Brain, Cognition and Behaviour, Radboud Alzheimer Center, Radboud University Medical Center, Nijmegen, the Netherlands
  • Wroclaw Medical University (PL)
  • National Hospital for Neurology and Neurosurgery (GB)
Venue
JAMA
Published
2015-05-19
Volume
313
Issue
19
Pages
1924
ISSN
  • 0002-9955 (ISSN-L)
  • 0098-7484
OpenAlex
W2168357345
Cited by
1,610
References
51
Citations by year
2026: 118 · 2025: 144 · 2024: 168 · 2023: 140 · 2022: 151 · 2021: 174 · 2020: 184 · 2019: 142 · 2018: 135 · 2017: 117 · 2016: 92 · 2015: 43
FWCI
104.60
Type
journal article
Language
en
Licence
other-oa
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  • JAMA (publishedVersion)
  • PubMed (publishedVersion)
  • Research Publications (Maastricht University) (publishedVersion, other-oa)
  • Pure Amsterdam UMC (publishedVersion, other-oa)
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  • VUBIR (Vrije Universiteit Brussel) (submittedVersion)
  • Research Publications (Maastricht University) (submittedVersion, other-oa)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
Funders
  • National Science Foundation (P01AG003991,, P50AG005681, P01 AG026276, FP7/2007-2013, P50 AG005133, U01 AG024904)
  • U.S. Department of Defense (U01 AG024904, W81XWH, W81XWH-12-2-, W81XWH1220012, AG024904)
  • Foundation for the National Institutes of Health (P01AG026276, W81XWH-12-2-0012, U01AG024904, AG024904, P01AG003991)
  • Alzheimer's Association (P01 AG003991, P50 AG005681, U01 AG024904, W81XWH-12-2-0012)
  • Bristol-Myers Squibb (U01 AG024904, AG024904, W81XWH-12-2-0012)
  • Eli Lilly and Company (U01 AG024904, AG024904, W81XWH-12-2-0012)
  • Pfizer (AG024904, W81XWH-12-2-0012, 115372, U01 AG024904)
  • AstraZeneca
  • GlaxoSmithKline (P01AG026276)
  • Biogen (W81XWH-12-2-0012, U01 AG024904, AG024904)
  • University of Southern California (P01 AG003991, W81XWH-12-2-0012, P01 AG026276, U01 AG024904)
  • University of Pennsylvania
  • Emory University
  • F. Hoffmann-La Roche (W81XWH-12-2-0012, AG024904, U01 AG024904)
  • Medpace (U01 AG024904)
  • Meso Scale Diagnostics (U01 AG024904, AG024904, W81XWH-12-2-0012)
  • Synarc (U01 AG024904)
  • Alzheimer's Disease Neuroimaging Initiative (P01AG026276, W81XWH-12-2–0012, U01AG024904, AG024904, W81XWH-12-2-)
  • BioClinica (U01 AG024904, W81XWH-12-2-0012, AG024904)
  • Itä-Suomen Yliopisto
  • National Research Centre
  • University of Pittsburgh (P50 AG005133)
  • Sundhed og Sygdom, Det Frie Forskningsråd
  • Thomas Jefferson University
  • Science and Industry Endowment Fund
  • Northern California Institute for Research and Education (U01 AG024904, W81XWH-12-2-0012)
  • EU Joint Programme – Neurodegenerative Disease Research
  • European Federation of Pharmaceutical Industries and Associations (FP7/20072013, ANR-10-IAIHU-06, 115372)
  • Postgraduate Institute of Medical Education and Research, Chandigarh
  • Lui Che Woo Institute of Innovative Medicine
  • York University
  • Imperial College London
  • European Commission (37670, U01 AG024904, 601055, 2007–2013, FP7 2007-2013, LSHB-CT-2005-512146, FP7/2007, W81XWH-12-2-0012, QLRT-2001-2455, 115372)
  • Bayer HealthCare
  • Commonwealth Scientific and Industrial Research Organisation
  • Indian Council of Medical Research
  • Deutsche Forschungsgemeinschaft (HE 4560/1-2, DR 445/3-1, 115372, FP7/2007–2013, DR 445/4-1)
  • Universität Heidelberg
  • Agence Nationale de la Recherche (ANR-10-IAIHU06, 10-IAIHU-06, ANR-10)
  • Institut National de la Santé et de la Recherche Médicale (ANR-10-IAIHU-06, INSERM U930)
  • Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung (FP7/2007-2013, 37670)
  • Universiteit Leiden
  • Edith Cowan University
  • ZonMw
  • Universiteit van Amsterdam
  • Radboud Universiteit
  • Vrije Universiteit Amsterdam (FP7/2007-2013)
  • AXA Research Fund (ANR-10-IAIHU-06)
  • Academy of Finland (W81XWH-12-2-0012, 115372, U01 AG024904)
  • Bundesministerium für Bildung und Forschung (01GI1007A, 01GI0420)
  • Seoul National University (FP7/2007-2013)
  • Sungkyunkwan University
  • Belgian Federal Science Policy Office
  • Gentofte Hospital
  • Dementia Collaborative Research Centres, Australia
  • Fonds Wetenschappelijk Onderzoek
  • Ministero della Salute
  • Lunds Universitet
  • Lundbeckfonden
  • Eisai (W81XWH-12-2-0012, U01 AG024904, AG024904)
  • KU Leuven
  • Karolinska Institutet
  • Kuopion Yliopistollinen Sairaala
  • Chinese University of Hong Kong
  • Leids Universitair Medisch Centrum
  • Rigshospitalet
  • National and Kapodistrian University of Athens
  • Deutsches Zentrum für Neurodegenerative Erkrankungen
  • Turun Yliopisto
  • Technische Universität München
  • Universidade de Coimbra
  • Université Pierre et Marie Curie (FP7/2007-2013)
  • Göteborgs Universitet
  • Universidade de Lisboa
  • Center for Translational Molecular Medicine (02N-101)
  • Radboud Universitair Medisch Centrum
  • Université de Genève
  • Aristotle University of Thessaloniki
  • Universiteit Antwerpen (FP7/2007-2013)
  • Universitatea de Medicină şi Farmacie "Carol Davila" Bucureşti
  • Universität zu Köln
  • Rheinische Friedrich-Wilhelms-Universität Bonn
  • Uniwersytet Medyczny im. Piastów Slaskich we Wroclawiu
  • Università degli Studi di Perugia (ANR-10-IAIHU-06)
  • Innovative Medicines Initiative (#115372, FP7/2007‐2013)
  • Servier (AG024904, W81XWH-12-2-0012, U01 AG024904)
  • Turun Yliopistollinen Keskussairaala
  • Vlaamse regering
  • Merz Pharmaceuticals
  • H. Lundbeck A/S (U01 AG024904, AG024904, W81XWH-12-2-0012)
  • Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas
  • IXICO (AG024904, W81XWH-12-2-0012, U01 AG024904)
  • Région Normandie
  • Instituto de Investigación Marqués de Valdecilla
  • Sorbonne Université
  • Fondation pour la Recherche sur Alzheimer (ANR-10-IAIHU-06)
  • National Institutes of Health (3u01ag024904-10s2, FP7/2007-2013, W81XWH, W81XWH-12-2-0012, U01-AG024904, AG005133, R01 AG12101, AG008051, AG024904, AG005681, AG12101, AG025204, AG003991, AG026276, AG025516, ANR-10-IAIHU-06)
  • Genentech (W81XWH-12-2-0012, AG024904, U01 AG024904)
  • Samsung
  • University of California, San Diego (P50 AG005133)
  • Avid Radiopharmaceuticals
  • Canadian Institutes of Health Research (U01 AG024904, W81XWH-12-2-0012)
  • Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University in St. Louis (P01AG003991)
  • Medical Research Council (U01 AG024904)
  • Menzies Centre for Australian Studies, King's College London, University of London
  • National Health and Medical Research Council
  • Instituto de Salud Carlos III (PI11/, PI13/01532)
  • Sahlgrenska Akademin
  • European Regional Development Fund (FP7/2007‐2013, 2007 – 2013, 20/21)
  • Krajowy Naukowy Osrodek Wiodacy
  • National Institute on Aging (U01-AG-024904, AG008051, R01AG13616, AG022374, W81XWH-12-2–0012, P01AG025204, AG-005133, RF1AG025516, P50AG005133, AG 024904, R01AG022374, P30AG010124, AG 12101, AG003991, R01AG012101, P30AG008051, AG026276, P50AG005681, AG025204, P01AG003991, R01-AG-12101, U19AG032438, U19AG010483, R37AG025516, R01AG013616, AG005681, P01AG026276, R01AG025516, AG 13616)
  • National Institute of Biomedical Imaging and Bioengineering (W81XWH-12-2-0012, U01 AG024904, AG024904)
  • Janssen Research and Development
  • Janssen Pharmaceuticals
  • Cilag
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Alzheimer's disease research and treatments
  • Health Sciences › Medicine › Oncology › Cancer-related cognitive impairment studies
Keywords
cerebral amyloid-beta, Alzheimer's disease, mild cognitive impairment, subjective cognitive impairment, normal cognition, APOE ε4 carriers, APOE genotype, positron emission tomography, cerebrospinal fluid biomarkers, sex differences, dementia prevention
MeSH terms
Adult, Age Factors, Aged, Aged, 80 and over, Brain, Cerebrospinal Fluid, Dementia, Female, Genotype, Humans, Male, Middle Aged, Risk Factors, Biomarkers, Prevalence, Amyloid beta-Peptides, Positron-Emission Tomography, Apolipoprotein E4, Cognitive Dysfunction

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