Abstract Details

Title Amyloid Deposition and Hippocampal Volume as Predictors of Incident Dementia in Non-Demented Very Elderly Subjects

Topic Aging and Dementia

Presentation(s) IN3 - (-)

Poster/Presentation
Number 004

Objective

Background PET amyloid ligands can detect A? amyloid deposition in Alzheimer's disease patients, but there is little information about their use as predictor of dementia in cognitively normal subjects.

Design/Methods Subjects had a brain MRI and positron emission tomography scan with Pittsburgh compound B (PiB) in 2009, and were re-examined clinically in 2011. 151 of these subjects were cognitively normal and 40 were classified as mild cognitive impairment (MCI) in 2009; 105 were PiB+ (55%).

Results In 2011, 23 (12%) progressed to dementia, and 17 (74%) of these were PiB+ in 2009. Incident dementia was associated with average cortical PiB retention in five brain regions, and with hippocampal volumes. Of the 191 subjects 114 remained normal in 2011, 24 progressed to MCI, 10 progressed from normal to dementia, 27 remained as MCI, 13 progressed from MCI to dementia, and 3 MCI subjects converted to normal. There was higher cortical PiB retention in subjects who progressed from MCI to dementia, but not among those who progressed from normal to dementia over the two year interval. Hippocampal volumes were smaller in subjects who progressed from normal to dementia and from MCI to dementia compared to the other groups.

Conclusions While the amount of amyloid deposited in specific brain regions was a strong predictor of dementia, a binary measure of PiB "positivity" was not. In some individuals, atrophy and amyloid deposition must be present before developing the symptoms of dementia (MCI to dementia), while in other individuals, atrophy may precede the detection of amyloid deposition (normals who converted to dementia), and consequently, they may need less amyloid to express clinical symptoms.

Authors/Disclosures
Oscar L. Lopez, MD, FAAN PRESENTER	Dr. Lopez has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Acumen.
William E. Klunk, MD, PhD (Western Psychiatric Institute and Clinic)	No disclosure on file
	No disclosure on file
Julie Price (University of Pittsburgh, PUH B938)	No disclosure on file
Howard Aizenstein, MD, PhD	No disclosure on file
Steven T. DeKosky, MD, FAAN (McKnight Brain Institute)	Dr. DeKosky has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Acumen. Dr. DeKosky has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. DeKosky has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Cognition Therapeutics. Dr. DeKosky has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Prevail Pharamceuticls. Dr. DeKosky has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Vaccinex, Inc. Dr. DeKosky has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Up-To-Date. Dr. DeKosky has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Neurotherapeutics .
Emmanuelle Waubant, MD, PhD, FAAN (USCF MS Center)	The institution of Dr. Waubant has received research support from NIH. The institution of Dr. Waubant has received research support from NMSS. The institution of Dr. Waubant has received research support from PCORI. The institution of Dr. Waubant has received research support from Race to Erase MS. The institution of Dr. Waubant has received research support from Roche. The institution of Dr. Waubant has received research support from Department of Defense. Dr. Waubant has received publishing royalties from a publication relating to health care.
	No disclosure on file
	No disclosure on file
	No disclosure on file
Milos D. Ikonomovic, MD, FAAN (University of Pittsburgh)	No disclosure on file
Eric M. McDade, DO (Washington University At St. Louis School of Medicine)	Dr. McDade has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sanofi. Dr. McDade has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. Dr. McDade has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alector. Dr. McDade has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alzamend. Dr. McDade has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Fondation Alzheimer. Dr. McDade has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alnylam. Dr. McDade has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Dr. McDade has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Ionis. The institution of Dr. McDade has received research support from NIA. The institution of Dr. McDade has received research support from Eli Lilly. The institution of Dr. McDade has received research support from Hoffman-La Roche. The institution of Dr. McDade has received research support from Eisai. The institution of Dr. McDade has received research support from Eisai. Dr. McDade has received intellectual property interests from a discovery or technology relating to health care. Dr. McDade has received personal compensation in the range of $500-$4,999 for serving as a Advisory Board Member with Fondation Alzheimer.
James T. Becker, PhD (University of Pittsburgh)	No disclosure on file
	No disclosure on file
	No disclosure on file

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