Edith Cowan University, Research Online, Perth, Western Australia
Abstract
Objective To determine the effect of β-amyloid (Aβ) level on progression risk to mild cognitive impairment (MCI) or dementia and longitudinal cognitive change in cognitively normal (CN) older individuals. Methods All CN from the Australian Imaging Biomarkers and Lifestyle study with Aβ PET and ≥ 3 years follow-up were included (n = 534; age 72 ± 6 years; 27% Aβ positive; follow-up 5.3 ± 1.7 years). Aβ level was divided using the standardized 0–100 Centiloid scale: \u3c 15 CL negative, 15–25 CL uncertain, 26–50 CL moderate, 51–100 CL high, \u3e 100 CL very high, noting \u3e 25 CL approximates a positive scan. Cox proportional hazards analysis and linear mixed effect models were used to assess risk of progression and cognitive decline. Results Aβ levels in 63% were negative, 10% uncertain, 10% moderate, 14% high, and 3% very high. Fifty-seven (11%) progressed to MCI or dementia. Compared to negative Aβ, the hazard ratio for progression for moderate Aβ was 3.2 (95% confidence interval [CI] 1.3–7.6; p \u3c 0.05), for high was 7.0 (95% CI 3.7–13.3; p \u3c 0.001), and for very high was 11.4 (95% CI 5.1–25.8; p \u3c 0.001). Decline in cognitive composite score was minimal in the moderate group (−0.02 SD/year, p = 0.05), while the high and very high declined substantially (high −0.08 SD/year, p \u3c 0.001; very high −0.35 SD/year, p \u3c 0.001). Conclusion The risk of MCI or dementia over 5 years in older CN is related to Aβ level on PET, 5% if negative vs 25% if positive but ranging from 12% if 26–50 CL to 28% if 51–100 CL and 50% if \u3e 100 CL. This information may be useful for dementia risk counseling and aid design of preclinical AD trials
