Abstract Details

Title Functional Performance and Alzheimer’s Disease Neuroimaging Biomarkers

Topic Aging, Dementia, and Behavioral Neurology

Presentation(s) S13 - Behavioral and Cognitive Neurology: Behavioral Neurology, Aging, and Dementia (1:22 PM-1:33 PM)

Poster/Presentation
Number 003

Background

Impairment in instrumental activities of daily living (IADL) is an important element of AD but the longitudinal association between AD neuroimaging biomarkers and functional performance in initially nondemented individuals has not been thoroughly studied.

Objective To study the longitudinal association of Alzheimer’s disease (AD) neuroimaging biomarkers with functional performance in the population-based Mayo Clinic Study of Aging (MCSA).

Design/Methods 1805 non-demented (ND) participants (≥50 years old) enrolled in the MCSA, who had undergone ¹¹C-PiB PET imaging. 1762 of the 1805 had available MR imaging. Abnormal (elevated amyloid; A+) ¹¹C-PiB-PET retention ratio was defined as standardized uptake value ratio >1.42, abnormal (reduced) AD signature cortical thickness as <2.67mm (neurodegeneration; N+), and biomarker groups by the combination of abnormality status for amyloid accumulation (A+/A-) and neurodegeneration (N+/N-). Functional performance was assessed by the Functional Activities Questionnaire (FAQ) at baseline imaging visit and at follow-ups (approximately every 15 months). The longitudinal association was examined using mixed effects models allowing for random intercepts and slopes adjusted for age, sex, education, apolipoprotein E ?4 allele carrier status, global cognitive z-score, depression and the Charlson comorbidity index.

Results Among 1805 ND participants (mean age 79.4 years; 53.5% men; 3.7 (2.4) mean (SD) years follow-up), 505 (28.5%) were APOE ?4 allele carriers, and 1591 (88.1%) were cognitively unimpaired (CU). There were statistically significant differences between the slopes for FAQ-scores of A+ vs. A- participants (difference in slopes (DIS)=0.14, 95%CI 0.07, 0.22) per year; p<0.001), as well as, between N+ and N- (DIS =0.12, 95%CI 0.04, 0.19) per year; p=0.002). Individuals with A+N+ biomarkers had the steepest decline in IADL performance (as measured by FAQ; vs. A-N+ or A+N- or A-N-) over time.

Conclusions Findings agree with limited available studies that support different functional performance trajectories for individuals with abnormal neuroimaging biomarkers early in the dementia pathophysiology.

Authors/Disclosures
Maria Vassilaki, MD, PhD (Mayo Clinic, Department of Quantitative Health Sciences) PRESENTER	Dr. Vassilaki has stock in Abbott Laboratories. Dr. Vassilaki has stock in Johnson and Johnson. Dr. Vassilaki has stock in Medtronic. Dr. Vassilaki has stock in Amgen. Dr. Vassilaki has stock in AbbVie. Dr. Vassilaki has stock in Merck. The institution of Dr. Vassilaki has received research support from NIH. The institution of Dr. Vassilaki has received research support from European Union/ St. Anne's University Hospital Brno, Czech Republic. The institution of an immediate family member of Dr. Vassilaki has received research support from Avobis Bio, LLC.
Jeremiah Aakre, MPH	Mr. Aakre has nothing to disclose.
Walter Kremers	The institution of Walter Kremers has received research support from NIH. The institution of an immediate family member of Walter Kremers has received research support from NIH.
Michelle M. Mielke, PhD (Wake Forest University School of Medicine)	Dr. Mielke has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. Dr. Mielke has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eisai. Dr. Mielke has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eli Lilly. Dr. Mielke has received personal compensation in the range of $500-$4,999 for serving as a Consultant for LabCorp. Dr. Mielke has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Roche. Dr. Mielke has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Siemens Healthineers. Dr. Mielke has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sunbird Bio. Dr. Mielke has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Eisai. Dr. Mielke has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Roche. Dr. Mielke has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novo Nordisk.
Yonas E. Geda, MD (Barrow Neurological Institute)	The institution of Dr. Geda has received research support from NIH.
Mary M. Machulda, PhD (Mayo Clinic)	The institution of Dr. Machulda has received research support from NIH.
David S. Knopman, MD, FAAN (Mayo Clinic)	Dr. Knopman has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for DIAN TU study. The institution of Dr. Knopman has received research support from NIH.
	No disclosure on file
Martin Traber	Martin Traber has received personal compensation for serving as an employee of F. Hoffmann-LaRoche Inc.. Martin Traber has received stock or an ownership interest from F. Hoffmann-LaRoche Inc..
Prashanthi Vemuri, PhD (Mayo Clinic)	The institution of Dr. Vemuri has received research support from NIH.
Val J. Lowe, MD (Mayo Clinic)	Dr. Lowe has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for AVID Radiopharmaceutical. Dr. Lowe has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eisai Inc. The institution of Dr. Lowe has received research support from AVID Radiopharmaceuticals.
Clifford R. Jack, Jr., MD (Mayo Clinic)	The institution of Dr. Jack has received research support from NIH. The institution of Dr. Jack has received research support from Alexander Family Alzheimer's Disease Research Professorship of the Mayo Clinic.
Rosebud O. Roberts, MD (Mayo Clinic)	No disclosure on file
Ronald C. Petersen, MD, PhD, FAAN (Mayo Clinic)	Dr. Petersen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Petersen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech. Dr. Petersen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eli Lilly and Co.. Dr. Petersen has received personal compensation in the range of $0-$499 for serving as a Consultant for Eisai, Inc.. Dr. Petersen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novo Nordisk. Dr. Petersen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Petersen has received publishing royalties from a publication relating to health care. Dr. Petersen has received publishing royalties from a publication relating to health care. Dr. Petersen has received publishing royalties from a publication relating to health care. Dr. Petersen has a non-compensated relationship as a Board of Directors with American Brain Foundation that is relevant to AAN interests or activities.

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