Sensitivity of composite scores to amyloid burden in preclinical Alzheimer's disease: Introducing the Z-scores of Attention, Verbal fluency, and Episodic memory for Nondemented older adults composite score.

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Lim, YY; Snyder, PJ; Pietrzak, RH; Ukiqi, A; Villemagne, VL; Ames, D; Salvado, O; Bourgeat, P; Martins, RN; Masters, CL; ...Date
2016Source Title
Alzheimer's & dementia (Amsterdam, Netherlands)Publisher
WileyUniversity of Melbourne Author/s
Ames, David; Rowe, Christopher; Masters, Colin; Maruff, Paul; Lim, Yen Ying; Villemagne, VictorAffiliation
Anatomy and NeuroscienceFlorey Department of Neuroscience and Mental Health
Psychiatry
Medicine and Radiology
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Lim, Y. Y., Snyder, P. J., Pietrzak, R. H., Ukiqi, A., Villemagne, V. L., Ames, D., Salvado, O., Bourgeat, P., Martins, R. N., Masters, C. L., Rowe, C. C. & Maruff, P. (2016). Sensitivity of composite scores to amyloid burden in preclinical Alzheimer's disease: Introducing the Z-scores of Attention, Verbal fluency, and Episodic memory for Nondemented older adults composite score.. Alzheimers Dement (Amst), 2 (1), pp.19-26. https://doi.org/10.1016/j.dadm.2015.11.003.Access Status
Open AccessOpen Access at PMC
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4879646Abstract
INTRODUCTION: Cognitive composite scores developed for preclinical Alzheimer's disease (AD) often consist of multiple cognitive domains as they may provide greater sensitivity to detect β-amyloid (Aβ)-related cognitive decline than episodic memory (EM) composite scores alone. However, this has never been empirically tested. We compared the rate of cognitive decline associated with high Aβ (Aβ+) and very high Aβ (Aβ++) in cognitively normal (CN) older adults on three multidomain cognitive composite scores and one single-domain (EM) composite score. METHODS: CN older adults (n = 423) underwent Aβ neuroimaging and completed neuropsychological assessments at baseline, and at 18-, 36-, 54-, and 72-month follow-ups. Four cognitive composite scores were computed: the ADCS-PACC (ADCS-Preclinical Alzheimer Cognitive Composite), ADCS-PACC without the inclusion of the mini-mental state examination (MMSE), an EM composite, and the Z-scores of Attention, Verbal fluency, and Episodic memory for Nondemented older adults (ZAVEN) composite. RESULTS: Compared with Aβ+ CN older adults, Aβ++ CN older adults showed faster rates of decline across all cognitive composites, with the largest decline observed for ZAVEN composite (d = 1.07). Similarly, compared with Aβ- CN older adults, Aβ+ CN older adults also showed faster rates of cognitive decline, but only for the ADCS-PACC no MMSE (d = 0.43), EM (d = 0.53), and ZAVEN (d = 0.50) composites. DISCUSSION: Aβ-related cognitive decline is best detected using validated neuropsychological instruments. Removal of the MMSE from the ADCS-PACC and replacing it with a test of executive function (verbal fluency; i.e., the ZAVEN) rendered this composite more sensitive even in detecting Aβ-related cognitive decline between Aβ+ and Aβ++ CN older adults.
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