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P4‐103: Preliminary findings from the Wisconsin Registry for Alzheimer's Prevention (WRAP)
Author(s) -
Sager Mark A.,
Hermann Bruce P.,
Dowling Maritza,
Rowley Janet,
La Rue Asenath
Publication year - 2008
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2008.05.2169
Subject(s) - cohort , family history , medicine , asymptomatic , neuropsychology , neuropsychological test , memory clinic , cognitive decline , alzheimer's disease , dementia , gerontology , pediatrics , psychology , psychiatry , cognition , disease
Background: The Wisconsin Registry for Alzheimer’s Prevention (WRAP) is a longitudinal cohort study of asymptomatic middle-aged adult children of persons with Alzheimer’s disease (AD). To be eligible for WRAP, a person must have a parent with either autopsyor medical record-confirmed AD, be between the ages of 40-65 and agree to longitudinal follow-up studies over a 20-year period of time. Methods: The primary objective of WRAP is to conduct a longitudinal cohort study to define the biological and neuro-cognitive course of pre-clinical AD in a high-risk cohort. Results: A total of 841 asymptomatic persons (mean age 53) with a family history and 308 controls without a family history have undergone baseline neuropsychological and laboratory testing including APOE genotyping. Baseline data indicate that the family history cohort has a high prevalence of APOE 4 (44% vs. 16%) and higher self-reported memory problems (29% vs. 13%) when compared to controls. There are no significant baseline differences between groups in demographic, health, laboratory or neuropsychological variables at baseline. To date, a total of 250 family history subjects have undergone repeat neuropsychological and laboratory testing 4 years after baseline. Although there are no differences in mean test/re-test neuropsychological performance, 11% of the family history cohort (mean age 57) declined by more than 1 standard deviation in auditory verbal memory test (AVLT). In addition, 8% of the family history cohort now meets the criteria for mild cognitive impairment (MCI) defined as 1.5 standard deviations below age, gender and IQ adjusted norms on the AVLT. Conclusions: A substantial proportion of the family history cohort show declines in verbal learning over a 4-year interval. These findings may be consistent with published data suggesting that there are neuro-cognitive, fMRI and cerebrospinal fluid changes suggestive of pre-clinical AD in this cohort. Our failure to find differences in mean test scores over the 4-year interval suggest that a substantial number of research subjects also improved in their test performance. The significance of these findings will be better defined once we complete T2 testing of the control group.