Abstract

AbstractBackgroundGlobal amyloid‐PET is associated with cognition and cognitive decline, but most research on this association does not account for past cognitive information. We assessed the prognostic benefit of amyloid‐PET measures for future cognition when prior cognitive assessments are available, evaluating the added value of amyloid measures beyond information on multiple past cognitive assessments.MethodThe French MEMENTO cohort (a cohort of outpatients from French research memory centers in order to improve knowledge on Alzheimer’s disease and related disorders, via DPUK) includes older outpatients with incipient cognitive changes, but no dementia diagnosis at inclusion. Global amyloid burden was assessed using positron emission tomography (amyloid‐PET) for a subset of participants at baseline or during follow up; semiannual cognitive testing was subsequently performed. Our analytic sample included 488 individuals who underwent amyloid‐PET scans and with at least 4 subsequent mini‐mental state examination (MMSE) scores available. We predicted MMSE scores using demographic characteristics (age, sex, marital status, and education) alone or in combination with information on prior cognitive measures. The added value of including amyloid burden as a predictor in these models was evaluated by the percent reduction of the mean‐squared error (MSE). All models were conducted separately for evaluating the added value of dichotomous amyloid positivity status compared to continuous amyloid standardized uptake‐value ratio.ResultAdding amyloid burden to a model adjusting for only demographic characteristics reduced the MSE of predictions by 6.35% (95% CI: [1.50%, 12.63%]) and 12.04% (95% CI: [3.37%, 22.48%]) for binary and continuous amyloid, respectively. If the model included one past MMSE measure, the MSE improvement was only 4.08% (95% CI: [1.12%, 7.93%]) when adding binary amyloid and 7.87% (95% CI: [2.46%, 13.92%]) when adding continuous amyloid.Improvements in model fit were even smaller with the addition of amyloid burden when more than one past cognitive assessment was included. For models incorporating one or more past cognitive assessments, differences in predictions associated with adding information about amyloid amounted to a fraction of one MMSE point on average.ConclusionGlobal amyloid burden did not appreciably improve cognitive predictions when past cognitive assessments were available.

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