Open AccessTrajectory of clinical symptoms in relation to amyloid chronicity
Author(s) -
Birdsill Alex C.,
Koscik Rebecca L.,
Cody Karly A.,
Jonaitis Erin M.,
Cadman Robert V.,
Erickson Claire M.,
Chin Nathaniel A.,
Przybelski Robert J.,
Carlsson Cynthia M.,
Asthana Sanjay,
Christian Bradley T.,
Eisenmenger Laura B.,
Betthauser Tobey J.,
Johnson Sterling C.
Publication year - 2022
Publication title -
alzheimer's and dementia: diagnosis, assessment and disease monitoring
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.497
H-Index - 37
ISSN - 2352-8729
DOI - 10.1002/dad2.12360
Subject(s) - dementia , clinical dementia rating , amyloid (mycology) , medicine , pittsburgh compound b , psychology , positron emission tomography , disease , cognition , gerontology , pathology , psychiatry , nuclear medicine
While it is generally appreciated that amyloid precedes symptomatic Alzheimer's disease (AD) by decades, a greater understanding of this timeline may increase prognostic accuracy, planning, and care of persons who are on the AD continuum. Methods We examined trajectories of Clinical Dementia Rating–Sum of Boxes (CDR‐SB) relative to estimated years of amyloid positivity (A+) in n = 123 participants who were all A+ based on [C‐11]Pittsburgh compound B positron emission tomography. Results The average amyloid chronicity at CDR‐SB of 2.5 was 20.1 years. The average trajectory of CDR‐SB accelerated after 10 years of elevated amyloid and varied greatly between 10 and 30 years. Exploratory analyses suggested that older age and higher volume of white matter hyperintensities shortened the interval between amyloid onset and cognitive impairment. Discussion The recontextualization of amyloid burden into the time domain will facilitate studies of disease progression, the influence of co‐pathology, and factors that hasten or slow cognitive impairment.