Clinical and Biomarker Characteristics According to Clinical Spectrum of Alzheimer's Disease (AD) in the Validation Cohort of Korean Brain Aging Study for the Early Diagnosis and Prediction of AD.

Ju‐Hee Kang ,Dong Hoon Lee ,Jae‐Keun Hong ,Yang Ho Choi ,Bora Yoon,Jae‐Won Jang ,Yu Kyeong Kim ,Gilsoon Park,Soo Jin Yoon ,Hyuntae Park,Min Soo Byun ,Kyung Won Park ,Jin Yong Hong ,Dahyun Yi,Jongmin Lee ,Seong Hye Choi ,Eun-Joo Kim,Jee Hyang Jeong ,Jihye Hwang,Hee Jin Kim

doi:10.3390/jcm8030341

Abstract

We aimed to present the study design of an independent validation cohort from the Korean Brain Aging Study for the Early Diagnosis and Prediction of Alzheimer’s disease (AD) (KBASE-V) and to investigate the baseline characteristics of the participants according to the AD clinical spectrum. We recruited 71 cognitively normal (CN) participants, 96 with subjective cognitive decline (SCD), 72 with mild cognitive impairment (MCI), and 56 with AD dementia (ADD). The participants are followed for three years. The Consortium to Establish a Registry for AD scores was significantly different between all of the groups. The logical memory delayed recall scores were significantly different between all groups, except between the MCI and ADD groups. The Mini-Mental State Examination score, hippocampal volume, and cerebrospinal fluid (CSF) amyloid-β42 level were significant difference among the SCD, MCI, and ADD groups. The frequencies of participants with amyloid pathology according to PET or CSF studies were 8.9%, 25.6%, 48.3%, and 90.0% in the CN, SCD, MCI, and ADD groups, respectively. According to ATN classification, A+/T+/N+ or A+/T+/N− was observed in 0%, 15.5%, 31.0%, and 78.3% in the CN, SCD, MCI, and ADD groups, respectively. The KBASE-V showed a clear difference according to the AD clinical spectrum in neuropsychological tests and AD biomarkers.

Highlights

Alzheimer’s disease (AD) is the most common cause of dementia and it is characterized by an accumulation of amyloid β (Aβ) and neurofibrillary tangles, which are associated with synaptic dysfunction and neurodegeneration that lead to memory impairment and other types of cognitive decline [1]
We aim to present the study design of KBASE-V and investigate the baseline characteristics of participants according to the AD clinical spectrum
All of the cognitively normal (CN) and subjective cognitive decline (SCD) participants had normal age, gender, and education-adjusted performance on the memory tests of the Korean version of Consortium to Establish a Registry for AD (CERAD) [18] and global Clinical Dementia Rating (CDR) scale scores of 0 [19]

Summary

Introduction

Alzheimer’s disease (AD) is the most common cause of dementia and it is characterized by an accumulation of amyloid β (Aβ) and neurofibrillary tangles, which are associated with synaptic dysfunction and neurodegeneration that lead to memory impairment and other types of cognitive decline [1]. Recent studies suggest a 20- to 30-year interval between the first development of amyloid positivity and the onset of dementia [2,3]. The clinical spectrum of AD includes subjective cognitive decline (SCD), mild cognitive impairment (MCI), and AD dementia (ADD) [3]. Meta-analysis suggests that older people with SCD are twice as likely to develop dementia as individuals without SCD, and each year approximately 2.3% and 6.6% of elderly individuals with SCD may progress to dementia and MCI [5]. Due to AD, amnestic MCI with gradual and progressive episodic memory impairment is likely to be prodromal AD or MCI [6,7]

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Results