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O1‐02‐01: Risk of nursing home placement in dementia with Lewy bodies and Alzheimer's dementia
Author(s) -
Rongve Arvid,
Skogseth Ragnhild,
Aarsland Dag
Publication year - 2009
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.2009.05.196
Subject(s) - dementia with lewy bodies , dementia , medicine , parkinsonism , neurology , cohort , nursing homes , neuropsychology , lewy body , severe dementia , disease , pediatrics , psychiatry , cognition , nursing
AD pathology in healthy elderly(CN) and mild cognitive impairment(MCI).We tested the hypothesis that there would be an association between rates of regional brain atrophy with baseline AD biomarkers p-tau and Ab1-42 concentrations. Methods: We examined the rate of change in tissue volume across brain in age-matched 70 CN(mean ADAS-cog 6.09), 119 MCI(mean ADAS-cog 12.11),and 46 AD patients(mean ADAS-cog 19.30).Structural brain MRI scans at three time points(baseline,6 and 12 months) were acquired at multiple ADNI sites using 1.5TMRI scanners.Using FreeSurfer4.1,a total of 94 cortical and sub-cortical volumes were automatically measured at baseline scans and longitudinal processing was utilized to estimated the corresponding volumes at 6 and 12 months scans.In each diagnostic group,linear mixed effect models followed by pair-wise maximum likelihood test were performed to determine if baseline biomarker levels predict regional absolute volumes as well as volume change over time after accounting for variations in ADAS-cog scores at scan times. Results: Lower Ab1-42 levels were associated with(i)higher annual atrophy rates of hippocampus in AD(p < 0.01),(ii)increased rates of ventricular enlargement and medial temporal lobe atrophy in CN,and(iii)increase rates of atrophy prominently in cortical regions,stretching from the medial to inferior temporal and frontal cortices in MCI.In contrast to Ab1-42,p-tau levels were not significantly associated with any brain volume changes in AD.In CN and MCI,however,the association between higher levels of p-tau and increased rates of brain atrophy largely mirrored the pattern seen for Ab1-42,though associations with p-tau involved fewer regions in MCI.Neither absolute volume measure nor decline rate in ADAS-cog correlated with baseline biomarker concentrations significantly,in any of the diagnostic group. Conclusions: The finding of faster progression of brain atrophy in presence of lower baseline Ab1-42 and higher p-tau levels supports the hypothesis that Ab1-42 and tau are measures of early AD pathology.Therefore,we propose that Ab1-42 and p-tau could serve as ‘‘predictors’’ and rates of brain atrophy(and ventricular expansion) could serve as ‘‘outcome measures’’ in AD prevention trials of healthy elderly and MCI, greatly improving the power of such trials,compared to clinical/cognitive measures.