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Alzheimers Res Ther. 2018 Feb 7;10(1):15. doi: 10.1186/s13195-017-0314-2.

Design and first baseline data of the DZNE multicenter observational study on predementia Alzheimer's disease (DELCODE).

Author information

1
German Center for Neurodegenerative Diseases (DZNE), Sigmund-Freud-Straße 27, 53127, Bonn, Germany. frank.jessen@uk-koeln.de.
2
Department of Psychiatry, Medical Faculty, University of Cologne, Kerpener Straße 62, 50924, Cologne, Germany. frank.jessen@uk-koeln.de.
3
German Center for Neurodegenerative Diseases (DZNE), Sigmund-Freud-Straße 27, 53127, Bonn, Germany.
4
Department of Neurology, University of Bonn, Sigmund-Freud-Straße 25, 53127, Bonn, Germany.
5
Department of Radiology, University of Bonn, Sigmund-Freud-Straße 25, 53127, Bonn, Germany.
6
German Center for Neurodegenerative Diseases (DZNE), Feodor-Lynen-Straße 17, 81377, Munich, Germany.
7
Institute for Stroke and Dementia Research, Klinikum der Universität München, Feodor-Lynen-Straße 17, 81377, Munich, Germany.
8
Department of Neurodegenerative Diseases and Gerontopsychiatry, University of Bonn, Sigmund-Freud-Straße 25, 53127, Bonn, Germany.
9
Department of Psychiatry and Psychotherapy, University of Bonn, Sigmund-Freud-Straße 25, 53127, Bonn, Germany.
10
Department of Psychiatry and Psychotherapy, Charité, Charitéplatz 1, 10117, Berlin, Germany.
11
Department of Psychiatry and Psychotherapy, Charité, Hindenburgdamm 30, 12203, Berlin, Germany.
12
German Center for Neurodegenerative Diseases (DZNE), Gehlsheimer Straße 20, 18147, Rostock, Germany.
13
Department of Psychosomatic Medicine, University of Rostock, Gehlsheimer Straße 20, 18147, Rostock, Germany.
14
German Center for Neurodegenerative Diseases (DZNE), Otfried-Müller-Straße 23, 72076 Tübingen, Germany.
15
Section for Dementia Research, Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tübingen, Calwerstraße 14, 72076 Tübingen, Germany.
16
German Center for Neurodegenerative Diseases (DZNE), Leipziger Straße 44, 39120, Magdeburg, Germany.
17
German Center for Neurodegenerative Diseases (DZNE), Charitéplatz 1, 10117 Berlin, Germany.
18
Department of Psychiatry, Medical Faculty, University of Cologne, Kerpener Straße 62, 50924, Cologne, Germany.
19
Institute of Human Genetics, University of Bonn, Sigmund-Freud-Straße 25, 53127, Bonn, Germany.
20
Department of Biomedical Magnetic Resonance, Otto-von-Guericke University Magdeburg, Leipziger Straße 44, 39120, Magdeburg, Germany.
21
Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, University of Goettingen, Von-Siebold-Straße 5, 37075, Goettingen, Germany.
22
German Center for Neurodegenerative Diseases (DZNE), 37075 Goettingen, Von-Siebold-Str. 3a, Germany.
23
iBiMED, Medical Sciences Department, University of Aveiro, Aveiro, Portugal.

Abstract

BACKGROUND:

Deep phenotyping and longitudinal assessment of predementia at-risk states of Alzheimer's disease (AD) are required to define populations and outcomes for dementia prevention trials. Subjective cognitive decline (SCD) is a pre-mild cognitive impairment (pre-MCI) at-risk state of dementia, which emerges as a highly promising target for AD prevention.

METHODS:

The German Center for Neurodegenerative Diseases (DZNE) is conducting the multicenter DZNE-Longitudinal Cognitive Impairment and Dementia Study (DELCODE), which focuses on the characterization of SCD in patients recruited from memory clinics. In addition, individuals with amnestic MCI, mild Alzheimer's dementia patients, first-degree relatives of patients with Alzheimer's dementia, and cognitively unimpaired control subjects are studied. The total number of subjects to be enrolled is 1000. Participants receive extensive clinical and neuropsychological assessments, magnetic resonance imaging, positron emission tomography, and biomaterial collection is perfomed. In this publication, we report cognitive and clinical data as well as apolipoprotein E (APOE) genotype and cerebrospinal fluid (CSF) biomarker results of the first 394 baseline data sets.

RESULTS:

In comparison with the control group, patients with SCD showed slightly poorer performance on cognitive and functional measures (Alzheimer's Disease Assessment Scale-cognitive part, Clinical Dementia Rating, Functional Activities Questionnaire), with all mean scores in a range which would be considered unimpaired. APOE4 genotype was enriched in the SCD group in comparison to what would be expected in the population and the frequency was significantly higher in comparison to the control group. CSF Aβ42 was lower in the SCD group in comparison to the control group at a statistical trend with age as a covariate. There were no group differences in Tau or pTau concentrations between the SCD and the control groups. The differences in all measures between the MCI group and the AD group were as expected.

CONCLUSIONS:

The initial baseline data for DELCODE support the approach of using SCD in patients recruited through memory clinics as an enrichment strategy for late-stage preclinical AD. This is indicated by slightly lower performance in a range of measures in SCD in comparison to the control subjects as well as by enriched APOE4 frequency and lower CSF Aβ42 concentration.

TRIAL REGISTRATION:

German Clinical Trials Register DRKS00007966 . Registered 4 May 2015.

KEYWORDS:

Alzheimer’s disease; Apolipoprotein E; Beta-amyloid 42; Cerebrospinal fluid; Longitudinal; Magnetic resonance imaging; Mild cognitive impairment; Positron emission tomography; Subjective cognitive decline; Tau

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