Abstract
Backgroundβ-amyloid (Aβ) and tau positron emission tomography (PET) detect the pathological changes that define Alzheimer’s disease (AD) in living people. Cognitive measures sensitive to Aβ and tau burden may help streamline identification of cases for confirmatory AD biomarker testing.MethodsWe examined the association of Brain Health Assessment (BHA) tablet-based cognitive measures with dichotomized Aβ -PET status using logistic regression models in individuals with mild cognitive impairment (MCI) or dementia (N = 140; 43 Aβ-, 97 Aβ+). We also investigated the relationship between the BHA tests and regional patterns of tau-PET signal using voxel-wise regression analyses in a subsample of 60 Aβ+ individuals with MCI or dementia.ResultsFavorites (associative memory), Match (executive functions and speed), and Everyday Cognition Scale scores were significantly associated with Aβ positivity (area under the curve [AUC] = 0.75 [95% CI 0.66–0.85]). We found significant associations with tau-PET signal in mesial temporal regions for Favorites, frontoparietal regions for Match, and occipitoparietal regions for Line Orientation (visuospatial skills) in a subsample of individuals with MCI and dementia.ConclusionThe BHA measures are significantly associated with both Aβ and regional tau in vivo imaging markers and could be used for the identification of patients with suspected AD pathology in clinical practice.
Highlights
Alzheimer’s disease (AD) is a major cause of dementia in older adults
We explored the associations between cognitive performance on the University of California San Francisco (UCSF) Brain Health Assessment (BHA), a brief tablet-based battery developed and validated for the detection of neurocognitive disorders in older adults
Our findings suggest that individual BHA cognitive measures are significantly associated with both in vivo AD pathological markers and support use of highly sensitive and reliable brief cognitive measures to help identify and monitor patients with suspected AD pathology in clinical practice
Summary
Alzheimer’s disease (AD) is a major cause of dementia in older adults. The disease is defined by abnormal accumulation of two proteins: fibrillar β-amyloid (Aβ)Tsoy et al Alzheimer's Research & Therapy (2021) 13:36 development of effective diagnostic markers and approaches is critical for diagnostic accuracy and identification of candidates for clinical trials and diseasemodifying therapies on the horizon [6].Several studies have investigated the association between cognitive measures and AD PET pathology markers [7,8,9,10,11]. Tau-PET has been associated with cognitive performance and decline in cognitively normal older adults [9, 15, 16] as well as with the severity of functional impairment in mixed clinical samples [17, 18]. Associations between Aβ -PET burden and cognition have been reported in both clinically mixed [10, 11, 19,20,21,22,23] and cognitively unimpaired [24, 25] samples, including greater rates of decline in cognitively normal Aβ-positive (Aβ+) older individuals [24, 25]. The effects of greater Aβ burden on cognitive performance tend to be weaker and less specific compared to tau [11, 25] likely due to the fact that tau pathology is more strongly related to neuronal loss in affected brain areas [26]
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