Prospective Evaluation of Cognitive Health and Related Factors in Elderly at Risk for Developing Alzheimer’s Dementia: A Longitudinal Cohort Study

IF 8.5 3区医学 Q1 CLINICAL NEUROLOGY

Jpad-Journal of Prevention of Alzheimers Disease Pub Date : 2019-01-01 DOI:10.14283/jpad.2019.31

C. Udeh-Momoh, G. Price, M. Ropacki, N. Ketter, T. Andrews, H. Arrighi, H. Brashear, Catherine E. Robb, Darina T Bassil, M. Cohn, L. Curry, B. Su, D. Perera, P. Giannakopoulou, J. Car, Heather A. Ward, R. Perneczky, R. Perneczky, R. Perneczky, G. Novak, L. Middleton

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引用次数: 8

Abstract

BackgroundThe CHARIOT PRO Main study is a prospective, non-interventional study evaluating cognitive trajectories in participants at the preclinical stage of Alzheimer’s disease (AD) classified by risk levels for developing mild cognitive impairment due to AD (MCI-AD).ObjectivesThe study aimed to characterize factors and markers influencing cognitive and functional progression among individuals at-risk for developing MCI-AD, and examine data for more precise predictors of cognitive change, particularly in relation to APOE ε4 subgroup.DesignThis single-site study was conducted at the Imperial College London (ICL) in the United Kingdom. Participants 60 to 85 years of age were classified as high, medium (amnestic or non-amnestic) or low risk for developing MCI-AD based on RBANS z-scores. A series of clinical outcome assessments (COAs) on factors influencing baseline cognitive changes were collected in each of the instrument categories of cognition, lifestyle exposure, mood, and sleep. Data collection was planned to occur every 6 months for 48 months, however the median follow-up time was 18.1 months due to early termination of study by the sponsor.Results987 participants were screened, among them 690 participants were actively followed-up post baseline, of whom 165 (23.9%) were APOE ε4 carriers; with at least one copy of the allele. The mean age was 68.73 years, 94.6% were white, 57.4% were female, and 34.8% had a Family History of Dementia with a somewhat larger percentage in the APOE ε4 carrier group (42.4%) compared to the non-carrier group (32.4%). Over half of the participants were married and 53% had a Bachelor’s or higher degree. Most frequently, safety events typical for this population consisted of upper respiratory tract infection (10.4%), falls (5.2%), hypertension (3.5%) and back pain (3.0%).Conclusion (clinical relevance)AD-related measures collected during the CHARIOT PRO Main study will allow identification and evaluation of AD risk factors and markers associated with cognitive performance from the pre-clinical stage. Evaluating the psycho-biological characteristics of these pre-symptomatic individuals in relation to their natural neurocognitive trajectories will enhance current understanding on determinants of the initial signs of cognitive changes linked to AD.

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认知健康及相关因素对老年痴呆风险的前瞻性评价:一项纵向队列研究

CHARIOT PRO主要研究是一项前瞻性、非干预性研究，评估阿尔茨海默病(AD)临床前阶段参与者的认知轨迹，根据AD导致轻度认知障碍(MCI-AD)的风险水平进行分类。目的:研究影响MCI-AD风险个体认知和功能进展的因素和标记，并研究更精确的认知变化预测数据，特别是与APOE ε4亚群相关的数据。这项单点研究是在英国伦敦帝国理工学院(ICL)进行的。根据RBANS z-score，将60至85岁的参与者分为MCI-AD的高、中(遗忘或非遗忘)或低风险。在认知、生活方式暴露、情绪和睡眠的每个工具类别中收集了一系列影响基线认知变化因素的临床结果评估(COAs)。原计划每6个月收集一次数据，共48个月，但由于主办方提前终止研究，中位随访时间为18.1个月。结果共筛查987例，基线后积极随访690例，其中APOE ε4携带者165例(23.9%);至少有一个等位基因的拷贝。平均年龄68.73岁，白人占94.6%，女性占57.4%，有痴呆家族史的占34.8%，其中APOE ε4携带者组的比例(42.4%)略高于非携带者组(32.4%)。超过一半的参与者已婚，53%的人拥有学士或更高的学位。最常见的安全事件包括上呼吸道感染(10.4%)、跌倒(5.2%)、高血压(3.5%)和背痛(3.0%)。结论(临床相关性)在CHARIOT PRO主要研究期间收集的AD相关措施将允许从临床前阶段识别和评估AD风险因素和与认知表现相关的标志物。评估这些症状前个体的心理生物学特征与他们的自然神经认知轨迹的关系，将增强目前对与AD相关的认知变化初始迹象决定因素的理解。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Jpad-Journal of Prevention of Alzheimers Disease CLINICAL NEUROLOGY-

自引率

7.80%

发文量

期刊介绍： The JPAD « Journal of Prevention of Alzheimer’Disease » will publish reviews, original research articles and short reports to improve our knowledge in the field of Alzheimer prevention including : neurosciences, biomarkers, imaging, epidemiology, public health, physical cognitive exercise, nutrition, risk and protective factors, drug development, trials design, and heath economic outcomes. JPAD will publish also the meeting abstracts from Clinical Trial on Alzheimer Disease (CTAD) and will be distributed both in paper and online version worldwide.