James J. Lah MD, PhD, Ganzhong Tian PhD, Benjamin B. Risk PhD, John J. Hanfelt PhD, Liangkang Wang BS, Liping Zhao MS, Chadwick M. Hales MD, PhD, Erik C.B. Johnson MD, PhD, Morgan B. Elmor BS, Sarah J. Malakauskas MS, Craig Heilman BS, Thomas S. Wingo MD, Cornelya D. Dorbin MPA, Crystal P. Davis MPH, Tiffany I. Thomas MPH, Ihab M. Hajjar MD, Allan I. Levey MD, PhD, Monica W. Parker MD
{"title":"Lower Prevalence of Asymptomatic Alzheimer's Disease Among Healthy African Americans","authors":"James J. Lah MD, PhD, Ganzhong Tian PhD, Benjamin B. Risk PhD, John J. Hanfelt PhD, Liangkang Wang BS, Liping Zhao MS, Chadwick M. Hales MD, PhD, Erik C.B. Johnson MD, PhD, Morgan B. Elmor BS, Sarah J. Malakauskas MS, Craig Heilman BS, Thomas S. Wingo MD, Cornelya D. Dorbin MPA, Crystal P. Davis MPH, Tiffany I. Thomas MPH, Ihab M. Hajjar MD, Allan I. Levey MD, PhD, Monica W. Parker MD","doi":"10.1002/ana.26960","DOIUrl":null,"url":null,"abstract":"<div>\n \n <section>\n \n <h3> Objective</h3>\n \n <p>Alzheimer's disease (AD) is believed to be more common in African Americans (AA), but biomarker studies in AA populations are limited. This report represents the largest study to date examining cerebrospinal fluid AD biomarkers in AA individuals.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>We analyzed 3,006 cerebrospinal fluid samples from controls, AD cases, and non-AD cases, including 495 (16.5%) self-identified black/AA and 2,456 (81.7%) white/European individuals using cutoffs derived from the Alzheimer's Disease Neuroimaging Initiative, and using a data-driven multivariate Gaussian mixture of regressions.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Distinct effects of race were found in different groups. Total Tauand phospho181-Tau were lower among AA individuals in all groups (<i>p</i> < 0.0001), and Aβ<sub>42</sub> was markedly lower in AA controls compared with white controls (<i>p</i> < 0.0001). Gaussian mixture of regressions modeling of cerebrospinal fluid distributions incorporating adjustments for covariates revealed coefficient estimates for AA race comparable with 2-decade change in age. Using Alzheimer's Disease Neuroimaging Initiative cutoffs, fewer AA controls were classified as biomarker-positive asymptomatic AD (8.0% vs 13.4%). After adjusting for covariates, our Gaussian mixture of regressions model reduced this difference, but continued to predict lower prevalence of asymptomatic AD among AA controls (9.3% vs 13.5%).</p>\n </section>\n \n <section>\n \n <h3> Interpretation</h3>\n \n <p>Although the risk of dementia is higher, data-driven modeling indicates lower frequency of asymptomatic AD in AA controls, suggesting that dementia among AA populations may not be driven by higher rates of AD. ANN NEUROL 2024;96:463–475</p>\n </section>\n </div>","PeriodicalId":127,"journal":{"name":"Annals of Neurology","volume":null,"pages":null},"PeriodicalIF":8.1000,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ana.26960","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Neurology","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/ana.26960","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Objective
Alzheimer's disease (AD) is believed to be more common in African Americans (AA), but biomarker studies in AA populations are limited. This report represents the largest study to date examining cerebrospinal fluid AD biomarkers in AA individuals.
Methods
We analyzed 3,006 cerebrospinal fluid samples from controls, AD cases, and non-AD cases, including 495 (16.5%) self-identified black/AA and 2,456 (81.7%) white/European individuals using cutoffs derived from the Alzheimer's Disease Neuroimaging Initiative, and using a data-driven multivariate Gaussian mixture of regressions.
Results
Distinct effects of race were found in different groups. Total Tauand phospho181-Tau were lower among AA individuals in all groups (p < 0.0001), and Aβ42 was markedly lower in AA controls compared with white controls (p < 0.0001). Gaussian mixture of regressions modeling of cerebrospinal fluid distributions incorporating adjustments for covariates revealed coefficient estimates for AA race comparable with 2-decade change in age. Using Alzheimer's Disease Neuroimaging Initiative cutoffs, fewer AA controls were classified as biomarker-positive asymptomatic AD (8.0% vs 13.4%). After adjusting for covariates, our Gaussian mixture of regressions model reduced this difference, but continued to predict lower prevalence of asymptomatic AD among AA controls (9.3% vs 13.5%).
Interpretation
Although the risk of dementia is higher, data-driven modeling indicates lower frequency of asymptomatic AD in AA controls, suggesting that dementia among AA populations may not be driven by higher rates of AD. ANN NEUROL 2024;96:463–475
期刊介绍：
Annals of Neurology publishes original articles with potential for high impact in understanding the pathogenesis, clinical and laboratory features, diagnosis, treatment, outcomes and science underlying diseases of the human nervous system. Articles should ideally be of broad interest to the academic neurological community rather than solely to subspecialists in a particular field. Studies involving experimental model system, including those in cell and organ cultures and animals, of direct translational relevance to the understanding of neurological disease are also encouraged.
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