Prevalence of the Preclinical Stages of Alzheimer’s Disease in Cognitively Intact Older Adults: The CABLE Study

Article type: Research Article

Authors: Huang, Shu-Yi^{a; 1} | Zhu, Jun-Xia^{b; 1} | Shen, Xue-Ning^a | Xu, Wei^c | Ma, Ya-Hui^c | Li, Hong-Qi^a | Dong, Qiang^a | Tan, Lan^{c; *} | Yu, Jin-Tai^{a; *}

Affiliations: [a] Department of Neurology and Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China | [b] Department of Prevention and Health Protection, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China | [c] Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China

Correspondence: [*] Correspondence to: Prof. Jin-Tai Yu, MD, PhD, Department of Neurology and Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, 12th Wulumuqi Zhong Road, Shanghai 200040, China. Tel.: +86 21 52888160; Fax: +86 21 62483421; E-mail: jintai_yu@fudan.edu.cn and Dr. Lan Tan, Department of Neurology, Qingdao Municipal Hospital, Qingdao University, No. 5 Donghai Middle Road, Qingdao, China. E-mail: dr.tanlan@163.com.

Note: [1] These authors contributed equally to this work.

Abstract: Background:The National Institute on Aging and Alzheimer’s Association proposed an ATN classification system which divided Alzheimer’s disease biomarkers into three binary classes: amyloid deposition (A), tauopathy (T), and neurodegeneration or neuronal injury (N). Objective:To estimate the prevalence of each profile and to describe the demographic characteristics of each group in Chinese cognitively intact older adults. Methods:In this cross-sectional study, 561 cognitively intact participants from the Chinese Alzheimer’s Biomarker and LifestylE (CABLE) study were classified into eight groups using cerebrospinal fluid amyloid-β 42/40 as A, phosphorylated tau as T, and total tau as N. Multinomial models were used to determine the estimated prevalence of the eight groups. Results:The number and proportion of 561 participants in each ATN profile were 254 A-T-N- (45.3%), 28 A-T+N- (5.0%), 21 A-T-N+ (3.7%), 71 A-T+N+ (12.7%), 78 A + T-N- (13.9%), 14 A + T+N- (2.5%), 21 A + T-N+ (3.7%), and 74 A + T+N+ (13.2%). Individuals in N+ groups tend to be older than N- groups. A+ groups included more female individuals. The prevalence of A-T-N- profile declined with age, while that of A + T+N+ increased continuously. Conclusion:This is the first work to estimate the prevalence of each ATN profile and describe the demographic characteristics of ATN profiles based on a Chinese cohort. The clinical implications of our findings need to be scrutinized further in longitudinal studies of the ATN classification system.

Keywords: Alzheimer’s disease, ATN classification system, biomarkers, prevalence

DOI: 10.3233/JAD-200059

Journal: Journal of Alzheimer's Disease, vol. 75, no. 2, pp. 483-492, 2020