Associations of the Harvard Automated Phone Task and Alzheimer’s Disease Pathology in Cognitively Normal Older Adults: Preliminary Findings

Article type: Research Article

Authors: Gonzalez, Christopher^a | Mimmack, Kayden J.^b | Amariglio, Rebecca E.^{b; h; i} | Becker, J. Alex^c | Chhatwal, Jasmeer P.^{b; h; i} | Fitzpatrick, Colleen D.^b | Gatchel, Jennifer R.^{d; e} | Johnson, Keith A.^{b; c; h; i} | Katz, Zoe S.^b | Kuppe, Madeline K.^f | Locascio, Joseph J.^b | Udeogu, Onyinye J.^b | Papp, Kathryn V.^{b; h; i} | Premnath, Pranitha^g | Properzi, Michael J.^b | Rentz, Dorene M.^{b; h; i} | Schultz, Aaron P.^b | Sperling, Reisa A.^{b; h; i} | Vannini, Patrizia^{b; h; i} | Wang, Sharon^b | Marshall, Gad A.^{b; h; i; *}

Affiliations: [a] Department of Psychology, Illinois Institute of Technology, Chicago, IL, USA | [b] Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA | [c] Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA | [d] Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA | [e] Division of Geriatric Psychiatry, McLean Hospital, Harvard Medical School, Belmont, MA, USA | [f] Cognitive Neuroimaging Laboratory, Graduate Program for Neuroscience, Boston University, Boston, MA, USA | [g] Department of Psychology, The Graduate Center, City University of New York, New York, NY, USA | [h] Center for Alzheimer Research and Treatment, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA | [i] Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

Correspondence: [*] Correspondence to: Gad A. Marshall, MD, Center for Alzheimer Research and Treatment, Brigham and Women’s Hospital, 60 Fenwood Road, 9016P, Boston, MA 02115, USA. Tel.: +1 617 732 8085; Fax: +1 617 264 6831; E-mail: gamarshall@partners.org.

Abstract: Background:Detecting clinically meaningful changes in instrumental activities of daily living (IADL) at the earliest stages of Alzheimer’s disease (AD) is critical. Objective:The objective of this exploratory study was to examine the cross-sectional relationship between a performance-based IADL test, the Harvard Automated Phone Task (APT), and cerebral tau and amyloid burden in cognitively normal (CN) older adults. Methods:Seventy-seven CN participants underwent flortaucipir tau and Pittsburgh Compound B amyloid PET. IADL were assessed using the three Harvard APT tasks: prescription refill (APT-Script), health insurance company call (APT-PCP), and bank transaction (APT-Bank). Linear regression models were used to determine associations between each APT task and entorhinal cortex, inferior temporal, or precuneus tau with or without an interaction with amyloid. Results:Significant associations were found between APT-Bank task rate and interaction between amyloid and entorhinal cortex tau, and APT-PCP task and interactions between amyloid and inferior temporal and precuneus tau. No significant associations were found between the APT tasks and tau or amyloid alone. Conclusion:Our preliminary findings suggest an association between a simulated real-life IADL test and interactions of amyloid and several regions of early tau accumulation in CN older adults. However, some analyses were underpowered due to the small number of participants with elevated amyloid, and findings should be interpreted with caution. Future studies will further explore these associations cross-sectionally and longitudinally in order to determine whether the Harvard APT can serve as a reliable IADL outcome measure for preclinical AD prevention trials and ultimately in the clinic setting.

Keywords: Alzheimer’s disease, amyloid, cognition, dementia, early detection, imaging, instrumental activities of daily living, positron emission tomography, tau

DOI: 10.3233/JAD-220885

Journal: Journal of Alzheimer's Disease, vol. 94, no. 1, pp. 217-226, 2023