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Predicting resistance to amyloid-beta deposition and cognitive resilience in the oldest-old

Citation

Snitz, Beth (2021), Predicting resistance to amyloid-beta deposition and cognitive resilience in the oldest-old, Dryad, Dataset, https://doi.org/10.5061/dryad.fxpnvx0nf

Abstract

Objective: To explore long-term predictors of avoiding amyloid-beta (Aβ) deposition and maintaining unimpaired cognition as outcomes in the oldest old.

MethodsIn a longitudinal observational cohort study, N=100 former participants of the Ginkgo Evaluation of Memory Study (GEMS; 2000-2008) completed biannual Pittsburgh Compound B (PiB)-PET imaging and annual clinical-cognitive evaluations beginning in 2010. Most recent Aβ status and cognitive status were selected for each participant. Longitudinal outcomes included change in serial Aβ and cognitive tests. Baseline predictors from GEMS included neuropsychological tests, daily functioning, APOE genotype, lifestyle variables, occupational measures, health history, sleep, subjective memory, physical and cognitive activities, depressive symptoms, physical performance and health indices, among others.

Results:  Mean age at last cognitive evaluation was 92.0 years (range 86-100). Mean follow-up time from baseline to last measured Aβ status was 12.3 (SD 1.9) years and to last cognitive evaluation was 14.1 (SD 1.9) years. The APOE*2 allele predicted last Aβ status (n=34 Aβ-negative vs. n=66 Aβ-positive). Baseline cognition predicted cognitive status (n=30 unimpaired vs. n=70 impaired). Predictors of cognitive status among Aβ-positive participants only (n=14 normal cognition vs. n=52 impaired) were baseline cognitive test scores and smoking history. Baseline pulse pressure predicted longitudinal Aβ increase; paid work engagement and life satisfaction predicted less cognitive decline.

Conclusions: The APOE*2 allele and lower pulse pressure predicts resistance to Aβ deposition in advanced aging. Cognitive test scores 14 years prior, likely reflecting premorbid abilities, predict cognitive status and maintenance of unimpaired cognition in the presence of Aβ. Several lifestyle factors appear protective.

Usage Notes

Dataset overview

Supplemental Tables 1a and 1b. Longitudinal models predicting continuous Aβ deposition (global PiB SUVR) over time as the outcome

Supplemental Tables 2a and 2b. Longitudinal models predicting verbal memory test performance (CVLT delayed recall) over time as the outcome

Supplemental Tables 3a and 3b. Longitudinal models predicting visual memory test performance (Rey-Osterrieth figure delayed recall) over time as the outcome

Supplemental Tables 4a and 4b. Longitudinal models predicting language test (semantic fluency) performance over time as the outcome

Supplemental Tables 5a and 5b. Longitudinal models predicting executive function test performance (Trails B) over time as the outcome

Supplemental Tables 6a and 6b. Longitudinal models predicting verbal memory test performance (CVLT delayed recall) over time as the outcome, in n=66 Aβ-positive    participants

Supplemental Tables 7a and 7b. Longitudinal models predicting visual memory test performance (Rey Osterrieth figure delayed recall) over time as the outcome, in n=66 Aβ-positive participants

Supplemental Tables 9a and 9b. Longitudinal models predicting executive function (Trails B) test performance over time as the outcome, in n=66 Aβ-positive participants