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Mol Psychiatry. 2018 Feb 27. doi: 10.1038/s41380-018-0030-8. [Epub ahead of print]

Use of an Alzheimer's disease polygenic risk score to identify mild cognitive impairment in adults in their 50s.

Author information

1
Research Service, VA Boston Healthcare System, Boston, MA, USA.
2
Biomedical Genetics, Boston University School of Medicine, Boston, MA, USA.
3
Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA.
4
Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA.
5
Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA.
6
Virginia Institute for Psychiatric and Behavior Genetics, Virginia Commonwealth University, Richmond, VA, USA.
7
NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
8
Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.
9
Department of Radiology, University of California, San Diego, La Jolla, CA, USA.
10
Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA.
11
Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA.
12
Department of Psychology, University of California, Riverside, Riverside, CA, USA.
13
Department of Family Medicine and Public Health, VA San Diego Healthcare System, La Jolla, CA, USA.
14
Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA. wkremen@ucsd.edu.
15
Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA. wkremen@ucsd.edu.
16
Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, La Jolla, CA, USA. wkremen@ucsd.edu.

Abstract

Early identification of younger, non-demented adults at elevated risk for Alzheimer's disease (AD) is crucial because the pathological process begins decades before dementia onset. Toward that end, we showed that an AD polygenic risk score (PRS) could identify mild cognitive impairment (MCI) in adults who were only in their 50s. Participants were 1176 white, non-Hispanic community-dwelling men of European ancestry in the Vietnam Era Twin Study of Aging (VETSA): 7% with amnestic MCI (aMCI); 4% with non-amnestic MCI (naMCI). Mean age was 56 years, with 89% <60 years old. Diagnosis was based on the Jak-Bondi actuarial/neuropsychological approach. We tested six P-value thresholds (0.05-0.50) for single nucleotide polymorphisms included in the ADPRS. After controlling for non-independence of twins and non-MCI factors that can affect cognition, higher PRSs were associated with significantly greater odds of having aMCI than being cognitively normal (odds ratios (ORs) = 1.36-1.43 for thresholds P < 0.20-0.50). The highest OR for the upper vs. lower quartile of the ADPRS distribution was 3.22. ORs remained significant after accounting for APOE-related SNPs from the ADPRS or directly genotyped APOE. Diabetes was associated with significantly increased odds of having naMCI (ORs = 3.10-3.41 for thresholds P < 0.05-0.50), consistent with naMCI having more vascular/inflammation components than aMCI. Analysis of sensitivity, specificity, and negative and positive predictive values supported some potential of ADPRSs for selecting participants in clinical trials aimed at early intervention. With participants 15+ years younger than most MCI samples, these findings are promising with regard to efforts to more effectively treat or slow AD progression.

PMID:
29487403
PMCID:
PMC6110977
[Available on 2019-08-27]
DOI:
10.1038/s41380-018-0030-8

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