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Alzheimers Dement (Amst). 2019 Sep 25;11:670-678. doi: 10.1016/j.dadm.2019.08.004. eCollection 2019 Dec.

Using subjective cognitive decline to identify high global amyloid in community-based samples: A cross-cohort study.

Author information

1
The Florey Institute, The University of Melbourne, Melbourne, Victoria, Australia.
2
Melbourne School of Psychological Science, University of Melbourne, Melbourne, Victoria, Australia.
3
Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
4
Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA.
5
Alzheimer Center and Department of Neurology, Amsterdam Neuroscience, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, the Netherlands.
6
Department of Epidemiology and Biostatistics, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, the Netherlands.
7
Department of Nuclear Medicine and Centre for PET, Austin Health, Victoria, Australia.
8
The Department of Medicine, Austin Health, The University of Melbourne, Victoria, Australia.
9
Department of Neurology, Stanford University, Palo Alto, CA, USA.
10
Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
11
The Australian eHealth Research Centre, CSIRO Health & Biosecurity, Melbourne, Victoria, Australia.
12
The Australian eHealth Research Centre, CSIRO Health & Biosecurity, Brisbane, Queensland, Australia.
13
Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA.

Abstract

Introduction:

We aimed to examine the contribution of subjective cognitive decline (SCD) to reduce the number of β-amyloid (Aβ) positron emission tomography scans required for recruiting Aβ+ clinically normal individuals in clinical trials.

Methods:

Three independent cohorts (890 clinically normal: 72 yrs ± 6.7; Female: 43.4%; SCD+: 24%; apolipoprotein E [APOE] ε4+: 28.5%; Aβ+: 32%) were used. SCD was dichotomized from one question. Using logistic regression, we classified Aβ+ using the SCD dichotomy, APOEε4, sex, and age.

Results:

SCD increased odds of Aβ+ by 1.58 relative to non-SCD. Female APOEε4 carriers with SCD exhibited higher odds of Aβ+ (OR = 3.34), whereas male carriers with SCD showed a weaker, opposing effect (OR = 0.37). SCD endorsement reduces the number of Aβ positron emission tomography scans to recruit Aβ+ individuals by 13% and by 9% if APOEε4 status is known.

Conclusion:

SCD helps to classify those with high Aβ, even beyond the substantial effect of APOE genotype. Collecting SCD is a feasible method for targeting recruitment for those likely on the AD trajectory.

KEYWORDS:

APOEε4; Alzheimer's disease; Amyloid; Subjective cognitive decline

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