The EPAD team has published a new paper entitled “Prediction of Alzheimer’s disease biomarker status defined by the ‘ATN framework’ among cognitively healthy individuals: results from the EPAD longitudinal cohort study” in the journal Alzheimer’s Research Therapy.
In this paper, authors from the University of Oxford and the Alzheimer Center Amsterdam tested the predictive utility of validated composite risk scores in their association with the Amyloid/Tau/Neurodegeneration (ATN)-defined biomarker group status in a cognitively healthy ageing sample drawn from the EPAD longitudinal cohort study (LCS). The main aim was to investigate independent risk factors for Alzheimer’s disease (AD) and vascular-related composite risk scores, in relation to prediction of ATN pathology.
The sample is drawn from 1,500 adult participants aged over 50 years from EPAD LCS (dataset V1500.0). It recruited participants across 21 European sites across the full range of anticipated probability for AD development.
Background: The Amyloid/Tau/Neurodegeneration (ATN) framework has been proposed as a means of evidencing the biological state of Alzheimer’s disease (AD). Predicting ATN status in pre-dementia individuals therefore provides an important opportunity for targeted recruitment into AD interventional studies. We investigated the extent to which ATN-defined biomarker status can be predicted by known AD risk factors as well as vascular-related composite risk scores.
Methods: One thousand ten cognitively healthy older adults were allocated to one of five ATN-defined biomarker categories. Multinomial logistic regression tested risk factors including age, sex, education, APOE4, family history of dementia, cognitive function, vascular risk indices (high systolic blood pressure, body mass index (BMI), high cholesterol, physical inactivity, ever smoked, blood pressure medication, diabetes, prior cardiovascular disease, atrial fibrillation and white matter lesion (WML) volume), and three vascular-related composite scores, to predict five ATN subgroups; ROC curve models estimated their added value in predicting pathology.
Results: Age, APOE4, family history, BMI, MMSE and white matter lesions (WML) volume differed between ATN biomarker groups. Prediction of Alzheimer’s disease pathology (versus normal AD biomarkers) improved by 7% after adding family history, BMI, MMSE and WML to a ROC curve that included age, sex and APOE4. Risk composite scores did not add value.
Conclusions: ATN-defined Alzheimer’s disease biomarker status prediction among cognitively healthy individuals is possible through a combination of constitutional and cardiovascular risk factors but established dementia composite risk scores do not appear to add value in this context.
You can read the open-access article here: http://dx.doi.org/10.1186/s13195-020-00711-5