title: Braak stage and trajectory of cognitive decline in noncognitively impaired elders.
abstract: In a previous cross-sectional study, we found that nondemented elderly participants from the Rush Religious Orders Study (RROS) displayed a wide range of Braak neurofibrillary tangle and amyloid plaque pathology similar to that seen in prodromal and frank Alzheimer's disease. Here, we examined longitudinal changes in cognitive domains in subjects from this cohort grouped by Braak stage using linear mixed effects models. We found that the trajectory of episodic memory composite (EMC), executive function composite (EFC), and global cognitive composite scores (GCS: average of EMC and EFC scores) was significantly associated with age at visit over time, but not with Braak stage, apolipoprotein E (APOE) ε4 status or plaque pathology alone. By contrast, the combined effects of Braak stage, APOE status, and age at visit were strongly correlated with the trajectory of EMC, EFC and GCS performance over time. These data suggest that age and APOE ε4 status, rather than Alzheimer's disease-related pathology, play a more prominent role in the trajectory of cognitive decline over time in this elderly nondemented population. However, the findings reported require confirmation in a larger cohort of cases.
authors.affiliation: Department of Neurobiology, Barrow Neurological Institute, Phoenix, AZ, USA. Electronic address: elliott.mufson@dignityhealth.org.
authors.forename: Elliott J
authors.initials: EJ
authors.lastname: Mufson
authors.affiliation: Banner Alzheimer's Institute, Phoenix, AZ, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Malek-Ahmadi
authors.affiliation: Banner Alzheimer's Institute, Phoenix, AZ, USA.
authors.forename: Noelle
authors.initials: N
authors.lastname: Snyder
authors.affiliation: Banner Alzheimer's Institute, Phoenix, AZ, USA.
authors.forename: Jake
authors.initials: J
authors.lastname: Ausdemore
authors.affiliation: Banner Alzheimer's Institute, Phoenix, AZ, USA.
authors.forename: Kewei
authors.initials: K
authors.lastname: Chen
authors.affiliation: Department of Neurobiology, Barrow Neurological Institute, Phoenix, AZ, USA.
authors.forename: Sylvia E
authors.initials: SE
authors.lastname: Perez
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000378:metabolism* / Q000473:pathology / Q000523:psychology*; D001057:Apolipoproteins E / Q000378:metabolism; D001921:Brain / Q000378:metabolism / Q000473:pathology / Q000502:physiology*; D003071:Cognition; D003072:Cognition Disorders / Q000209:etiology*; D015331:Cohort Studies; D056344:Executive Function; D005260:Female; D006801:Humans; D008297:Male; D061212:Memory, Episodic; D016874:Neurofibrillary Tangles / Q000473:pathology*; D058225:Plaque, Amyloid / Q000378:metabolism
chemical_list: D001057:Apolipoproteins E
keywords: Aging; Alzheimer's; Cognition; Dementia; Longitudinal; Neurofibrillary tangles