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Abstract
Objective To investigate brain amyloid pathology in a dementia-risk population defined as cardiovascular risk factors, aging, and dementia risk (CAIDE) score of at least 6 but with normal cognition and to examine associations between brain amyloid load and cognitive performance and vascular risk factors.
Methods A subgroup of 48 individuals from the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) main study participated in brain 11C-Pittsburgh compound B (PiB)-PET imaging, brain MRI, and neuropsychological assessment at the beginning of the study. Lifestyle/vascular risk factors were determined as body mass index, blood pressure, total and low-density lipoprotein cholesterol, and glucose homeostasis model assessment. White matter lesions were visually rated from MRIs by a semiquantitative Fazekas score.
Results Twenty participants (42%) had a positive PiB-PET on visual analysis. The PiB-positive group performed worse in executive functioning tests, included more participants with APOE ε4 allele (50%), and showed slightly better glucose homeostasis compared to PiB-negative participants. PiB-positive and -negative participants did not differ significantly in other cognitive domain scores or other vascular risk factors. There was no significant difference in Fazekas score between the PiB groups.
Conclusions The high percentage of PiB-positive participants provides evidence of a successful recruitment process of the at-risk population in the main FINGER intervention trial. The results suggest a possible association between early brain amyloid accumulation and decline in executive functions. APOE ε4 was clearly associated with amyloid positivity, but no other risk factor was found to be associated with positive PiB-PET.
GLOSSARY
- AD=
- Alzheimer disease;
- BMI=
- body mass index;
- CAIDE=
- cardiovascular risk factors, aging, and dementia risk score;
- CERAD=
- Consortium to Establish a Registry for Alzheimer's Disease;
- FINGER=
- Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability;
- HOMA-IR=
- glucose homeostasis model assessment index;
- LDL=
- low-density lipoprotein;
- MMSE=
- Mini-Mental State Examination;
- NTB=
- neuropsychological test battery;
- PiB=
- Pittsburgh compound B;
- ROI=
- region of interest
Footnotes
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
- Received March 8, 2017.
- Accepted in final form October 6, 2017.
- Copyright © 2017 American Academy of Neurology
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