Premium
P4‐137: N‐terminal pro‐b type natriuretic peptide and mild cognitive impairment in the general population: Results of the heinz nixdorf recall study
Author(s) -
Dlugaj Martha,
Kara Kaffer,
Mahabadi Amir-Abbas,
Winkler Angela,
Kälsch Hagen,
Neumann Till,
Dragano Nico,
Moebus Susanne,
Jöckel Karl-Heinz,
Erbel Raimund,
Weimar Christian
Publication year - 2015
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.2015.06.1843
Subject(s) - medicine , natriuretic peptide , poisson regression , cognitive impairment , population , cardiology , confidence interval , heart failure , disease , environmental health
Background: Our goal was to find the combination of candidate biomarkers and cognitive endpoints to maximize statistical power and minimize cost of clinical trials of healthy elders at risk for cognitive decline due to Alzheimer’s disease. Methods:412 cognitively-normal participants were followed over 7 years. Nonlinear methods were used to estimate the longitudinal trajectories of several cognitive outcomes including delayed memory recall, executive function, processing speed, and several cognitive composites by subgroups selected on the basis of biomarkers, including APOE-ε4 allele carriers, CSF biomarkers (Ab42, total tau and phosphorylated tau), and those with small hippocampi. Results:Derived cognitive composites combining ADAS-cog scores with additional delayed memory recall and executive function components captured decline more robustly across biomarker groups than any measure of a single cognitive domain or ADAS-cog alone. Substantial increases in power resulted when including only participants positive for three or more biomarkers in simulations of clinical trials. Conclusions: Clinical trial power may be improved by selecting participants on the basis of amyloid and neurodegeneration biomarkers and carefully tailoring primary cognitive endpoints to reflect the expected decline specific to these individuals.