Abnormal CSF amyloid-β42 and tau levels in hip fracture patients without dementia.

Esther S Oh,Juan C Troncoso,Paul B Rosenberg,Kaj Blennow,Henrik Zetterberg,George E Bigelow,Edward R Marcantonio,Sharon K Inouye,Frederick E Sieber,Nae-Yuh Wang,Constantine G Lyketsos,Karin J Neufeld,Hemachandra Reddy

doi:10.1371/journal.pone.0204695

Abstract

BackgroundThere is strong association of Alzheimer’s disease (AD) pathology with gait disorder and falls in older adults without dementia. The goal of the study was to examine the prevalence and severity of AD pathology in older adults without dementia who fall and sustain hip fracture.MethodsCerebrospinal fluid (CSF) was obtained from 168 hip fracture patients. CSF Aβ42/40 ratio, p-tau, and t-tau measures were dichotomized into normal vs. abnormal, and categorized according to the A/T/N classification.ResultsAmong the hip fracture patients, 88.6% of the cognitively normal (Clinical Dementia Rating-CDR 0; n = 70) and 98.8% with mild cognitive impairment (CDR 0.5; n = 81) fell in the abnormal biomarker categories by the A/T/N classification.ConclusionsA large proportion of older hip fracture patients have CSF evidence of AD pathology. Preoperative determination of AD biomarkers may play a crucial role in identifying persons without dementia who have underlying AD pathology in perioperative settings.

Highlights

Alzheimer’s disease (AD) is the most common cause of dementia in the United States (U.S.), with an estimated 5.5 million affected individuals in 2017
Preoperative determination of AD biomarkers may play a crucial role in identifying persons without dementia who have underlying AD pathology in perioperative settings
The goal of this study was to examine a cohort of hip fracture patients for underlying AD pathology as evidenced by Cerebrospinal fluid (CSF) biomarkers, and to determine how often such pathology is seen in hip fracture patients without dementia

Summary

Introduction

Alzheimer’s disease (AD) is the most common cause of dementia in the United States (U.S.), with an estimated 5.5 million affected individuals in 2017. A further indicator of the significant public health impact of AD and related dementias is the annual economic cost estimated at upwards of 215 billion dollars in the U.S [2]. As with AD the number of hip fractures in adults 65 years and older is increasing in the U.S, and is expected to approach 300,000/year by 2030 in the U. The economic cost associated with hip fracture is high, with annual Medicare expenditures of 2.9 billion dollars [6]. There is strong association of Alzheimer’s disease (AD) pathology with gait disorder and falls in older adults without dementia. The goal of the study was to examine the prevalence and severity of AD pathology in older adults without dementia who fall and sustain hip fracture

Objectives

Methods

Discussion

Conclusion