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Indicators of amyloid burden in a population-based study of cognitively normal elderly
Open accessAbstract
OBJECTIVES: Secondary prevention trials in subjects with preclinical Alzheimer disease may require documentation of brain amyloidosis. The identification of inexpensive and noninvasive screening variables that can identify individuals who have significant amyloid accumulation would reduce screening costs. METHODS: A total of 483 cognitively normal (CN) individuals, aged 70-92 years, from the population-based Mayo Clinic Study of Aging, underwent Pittsburgh compound B (PiB)-PET imaging. Logistic regression determined whether age, sex, APOE genotype, family history, or cognitive performance was associated with odds of a PiB retention ratio >1.4 and >1.5. Area under the receiver operating characteristic curve (AUROC) evaluated the discrimination between PiB-positive and -negative subjects. For each characteristic, we determined the number needed to screen in each age group (70-79 and 80-89) to identify 100 participants with PiB >1.4 or >1.5. RESULTS: A total of 211 (44%) individuals had PiB >1.4 and 151 (31%) >1.5. In univariate and multivariate models, discrimination was modest (AUROC ∼0.6-0.7). Multivariately, age and APOE best predicted odds of PiB >1.4 and >1.5. Subjective memory complaints were similar to cognitive test performance in predicting PiB >1.5. Indicators of PiB positivity varied with age. Screening APOE ε4 carriers alone reduced the number needed to screen to enroll 100 subjects with PIB >1.5 by 48% in persons aged 70-79 and 33% in those aged 80-89. CONCLUSIONS: Age and APOE genotype are useful predictors of the likelihood of significant amyloid accumulation, but discrimination is modest. Nonetheless, these results suggest that inexpensive and noninvasive measures could significantly reduce the number of CN individuals needed to screen to enroll a given number of amyloid-positive subjects.
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“Sex differences in Aβ burden alone have not been reported in older adults,11–13”
From Sex Differences in the Association of Global Amyloid and Regional Tau Deposition Measured by Positron Emission Tomography in Clinically Normal Older Adults (2019) · cites this paper as [12]
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“Minimal,6 if any,11,12,36 sex differences have been found cross sectionally in levels of global Aβ burden in clinically normal older adults”
From Sex Differences in the Association of Global Amyloid and Regional Tau Deposition Measured by Positron Emission Tomography in Clinically Normal Older Adults (2019) · cites this paper as [12]
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Self-citationHypothetical model of dynamic biomarkers of the Alzheimer's pathological cascade
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Self-citationImaging brain amyloid in Alzheimer's disease with Pittsburgh Compound‐B
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Self-citationDefining imaging biomarker cut points for brain aging and Alzheimer's disease
Jack, C. R., Wiste, H. J., Weigand, S. D., Therneau, T. M., Lowe, V. J., Knopman, D. S., Gunter, J. L., Senjem, M. L., Jones, D. T., Kantarci, K., et al. (2017) · Alzheimer's & Dementia · doi:10.1016/j.jalz.2016.08.005 · Cited by 931
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Metadata
- Authors
- Mielke, M. M., Wiste, H. J., Weigand, S. D., Knopman, D. S., Lowe, V. J., Roberts, R. O., Geda, Y. E., Swenson-Dravis, D. M., Boeve, B. F., Senjem, M. L., Vemuri, P., Petersen, R. C., & Jack, C. R.
- Affiliations
- Mayo Clinic (US)
- ORCID
- Venue
- Neurology
- Published
- 2012-10-09
- Volume
- 79
- Issue
- 15
- Pages
- 1570-1577
- ISSN
- 0028-3878 (ISSN-L)
- 1526-632X
- PMC
- PMC3475629
- OpenAlex
- W2004344916
- Cited by
- 163
- References
- 34
- Citations by year
- 2026: 1 · 2025: 6 · 2024: 6 · 2023: 12 · 2022: 12 · 2021: 13 · 2020: 12 · 2019: 17 · 2018: 11 · 2017: 15 · 2016: 10 · 2015: 17 · 2014: 14 · 2013: 15 · 2012: 2
- FWCI
- 10.97
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Neurology (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Robert Wood Johnson Foundation
- Alzheimer's Association
- Eli Lilly and Company
- Pfizer (R01 AG034676)
- Baxter International
- Mayo Foundation for Medical Education and Research (AG034676, AG016574, R01-AG034676)
- European Commission
- Eisai
- National Institutes of Health (AG016574, AG034676, AG006786, AG011378)
- National Institute on Aging (R01AG034676, AG-034676, U01AG037526, AG016574, AG011378, U01AG006786, AG-006786, R01AG011378, K01AG028573, RO1 AG011378, R01AG041851, R01 AG0113, P50AG016574)
- National Institute of Mental Health (K01MH068351)
- 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 amyloidosis, Pittsburgh compound B PET, preclinical Alzheimer's disease, cognitively normal elderly, APOE ε4, age as predictor, subjective memory complaints, screening biomarkers, number needed to screen, Mayo Clinic Study of Aging
- MeSH terms
- Aged, Aged, 80 and over, Alzheimer Disease, Amyloid, Apolipoproteins E, Brain, Brain Mapping, Cognition, Female, Genotype, Humans, Male, Neuropsychological Tests, Radionuclide Imaging
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