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P1‐186: Chronic Kidney Disease is Associated With Mild Cognitive Impairment and Alzheimer's Disease in Older Mexican People
Author(s) -
Mimenza Alberto Jose,
Anaya Escamilla Antonio,
Aguilar Sara Gloria,
Avila Jose Alberto
Publication year - 2016
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.2016.06.934
Subject(s) - medicine , cognition , logistic regression , renal function , disease , neuropsychology , cognitive decline , kidney disease , depression (economics) , cross sectional study , creatinine , structural equation modeling , dementia , clinical psychology , gerontology , psychiatry , pathology , economics , macroeconomics , statistics , mathematics
Background: The earliest stage of preclinical Alzheimer’s disease (AD) is defined by low levels of cerebrospinal fluid (CSF) amyloid-B (AB42). However, covariance in longitudinal dynamic changes of AB42 and tau in incipient preclinical AD is poorly understood. Here we aimed to examine dynamic interrelationships between AB42 and tau in preclinical AD. Methods:We followed 47 cognitively intact participants (HC) with available CSF data over four years in ADNI. Based on longitudinal AB42 levels in CSF, HCs were classified into three groups: 1) AB42 stable with normal levels of AB42 over time (N1⁄4 15); 2) AB42 declining with normal AB42 levels at baseline but showing decline over time (N1⁄4 14; and 3) AB42 levels consistently abnormal (N1⁄4 18). Results: In the AB42 declining group, suggestive of incipient preclinical AD, using mixed model analysis, CSF phosphorylated tau (p-tau) showed a longitudinal pattern similar of increasing abnormality over time (p1⁄4 0.0001). Correlation between longitudinal slopes of AB42 and p-tau confirmed that the trajectories were anti-correlated (rho 1⁄4 -0.60; p 1⁄4 0.02). Regression analysis showed that AB42 slope (decreasing AB42) predicted p-tau slope (increasing p-tau) (R21⁄4 0.47, p1⁄4 0.03). Atrophy in the hippocampus was predicted by the interaction of AB42 and p-tau slopes (p < 0.0001) only in this incipient preclinical AD group. In all groups combined, memory decline was predicted by p-tau. Conclusions: The evolution of AB42 and p-tau CSF biomarkers in CI subjects follows an anticorrelated trajectory, i.e. as AB42 declined p-tau increased, and thus was suggestive of strong temporal coincidence. Rapid and pathogenic cross-talk between AB42 and p-tau thus may be evident in very early stages of preclinical AD.