Alzheimer’s & Dementia: Diagnosis, Assessment & Disease Monitoring (Dec 2019)

Using subjective cognitive decline to identify high global amyloid in community‐based samples: A cross‐cohort study

  • Rachel F. Buckley,
  • Sietske Sikkes,
  • Victor L. Villemagne,
  • Elizabeth C. Mormino,
  • Jennifer S. Rabin,
  • Samantha Burnham,
  • Kathryn V. Papp,
  • Vincent Doré,
  • Colin L. Masters,
  • Michael J. Properzi,
  • Aaron P. Schultz,
  • Keith A. Johnson,
  • Dorene M. Rentz,
  • Reisa A. Sperling,
  • Rebecca E. Amariglio

DOI
https://doi.org/10.1016/j.dadm.2019.08.004
Journal volume & issue
Vol. 11, no. 1
pp. 670 – 678

Abstract

Read online

Abstract Introduction We aimed to examine the contribution of subjective cognitive decline (SCD) to reduce the number of β‐amyloid (Aβ) positron emission tomography scans required for recruiting Aβ+ clinically normal individuals in clinical trials. Methods Three independent cohorts (890 clinically normal: 72 yrs ± 6.7; Female: 43.4%; SCD+: 24%; apolipoprotein E [APOE] ε4+: 28.5%; Aβ+: 32%) were used. SCD was dichotomized from one question. Using logistic regression, we classified Aβ+ using the SCD dichotomy, APOEε4, sex, and age. Results SCD increased odds of Aβ+ by 1.58 relative to non‐SCD. Female APOEε4 carriers with SCD exhibited higher odds of Aβ+ (OR = 3.34), whereas male carriers with SCD showed a weaker, opposing effect (OR = 0.37). SCD endorsement reduces the number of Aβ positron emission tomography scans to recruit Aβ+ individuals by 13% and by 9% if APOEε4 status is known. Conclusion SCD helps to classify those with high Aβ, even beyond the substantial effect of APOE genotype. Collecting SCD is a feasible method for targeting recruitment for those likely on the AD trajectory.

Keywords