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Am J Geriatr Psychiatry. 2016 Feb;24(2):144-53. doi: 10.1016/j.jagp.2015.06.004. Epub 2015 Jun 26.

Amyloid-Independent Amnestic Mild Cognitive Impairment and Serum Apolipoprotein A1 Levels.

Author information

1
Department of Neuropsychiatry, Seoul National University Hospital & Seoul National University College of Medicine, Seoul, Korea.
2
Division of Natural Medical Sciences, College of Health Science, Chosun University, Gwangju, Korea.
3
Department of Neuropsychiatry, Seoul Metropolitan BORAMAE Medical Center, Dongjak-Gu, Seoul, Korea.
4
Department of Biomedical Engineering, Hanyang University, Seoul, Korea.
5
Department of Neuropsychiatry, Seoul National University Hospital & Seoul National University College of Medicine, Seoul, Korea. Electronic address: selfpsy@snu.ac.kr.

Abstract

OBJECTIVES:

The present study investigated the characteristics of amnestic mild cognitive impairment (aMCI) in subjects with low brain amyloid-beta (Aβ) burden. Furthermore, the relationships between amyloid-independent cognitive decline and serum lipid profiles, particularly apolipoprotein A1 (APOA1), were evaluated.

DESIGN:

Cross-sectional and longitudinal follow-up study.

SETTING:

University hospital dementia clinic.

PARTICIPANTS:

28 aMCI and 35 cognitive normal (CN) elderly.

MEASUREMENTS:

The study measures included baseline assessments of the subjects' clinical characteristics, lipid profiles, and magnetic resonance imaging and (11)C-labelled Pittsburgh Compound B (PiB) positron emission tomography scans. Based on PiB retention at baseline, the aMCI subjects were divided into low Aβ (aMCI-) and high Aβ (aMCI+) subgroups. All aMCI subjects were followed up over a 1-year period.

RESULTS:

The aMCI- group had a longer duration of illness than did the aMCI+ group. None of the aMCI- subjects were diagnosed with Alzheimer disease (AD) dementia during the 1-year follow-up period, whereas 26.7% of aMCI+ subjects developed AD dementia. The aMCI- group also exhibited lower serum APOA1 levels compared with both the aMCI+ and CN groups. Additionally, lower serum APOA1 levels were associated with cognitive decline and brain atrophy independent of Aβ deposition and vascular burden.

CONCLUSIONS:

Patients with aMCI- likely exhibit different clinical and pathophysiological characteristics than patients with aMCI+. Additionally, APOA1 may be an important contributor underlying amyloid-independent neurodegeneration.

KEYWORDS:

Alzheimer disease; Amyloid PET; MRI; apolipoprotein; mild cognitive impairment

PMID:
26238231
DOI:
10.1016/j.jagp.2015.06.004
[Indexed for MEDLINE]

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