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Self-reported confusion is related to global and regional β-amyloid: data from the Women’s healthy ageing project

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Abstract

Disease-modifying treatments for Alzheimer’s disease (AD) may require implementation during early stages of β-amyloid accumulation, well before patients have objective cognitive decline. In this study we aimed to assess the clinical value of subjective cognitive impairment (SCI) by examining the cross-sectional relationship between β-amyloid load and SCI. Cerebral β-amyloid and SCI was assessed in a cohort of 112 cognitively normal subjects. Subjective cognition was evaluated using specific questions on memory and cognition and the MAC-Q. Participants had cerebral β-amyloid load measured with 18F–Florbetaben Positron Emission Tomography (PET). No associations were found between measures of subjective memory impairment and cerebral β-amyloid. However, by self-reported confusion was predictive of a higher global β-amyloid burden (p = 0.002), after controlling for confounders. Regional analysis revealed significant associations of confusion with β-amyloid in the prefrontal region (p = 0.004), posterior cingulate and precuneus cortices (p = 0.004) and the lateral temporal lobes (p = 0.001) after controlling for confounders. An in vivo biomarker for AD pathology was associated with SCI by self-reported confusion on cross-sectional analysis. Whilst there has been a large body of research on SMC, our results indicate more research is needed to explore symptoms of confusion.

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Acknowledgements

We would like to acknowledge the contribution of participants, team members, partners and their supporters who have given their time and patience for over 20 years to the university. A full list of all researchers contributing to the WHAP and membership of our Scientific Advisory Board is available at www.whap.unimelb.edu.au. Funding for the WHAP has been provided by the Australian National Health and Medical Research Council (NHMRC 1062133, 547600, 1032350), Bayer Healthcare, the Ramaciotti Foundation, the Brain Foundation, the Alzheimer’s Association of Australia, the Australian Menopausal Society, the Shepherd Foundation, the Scobie and Claire Mackinnon Trust, the Collier Trust Fund, the J.O. & J.R. Wicking Trust, the Mason Foundation and the Alzheimer’s Association (NIA320312). Inaugural funding was provided by VicHealth and the NHMRC.

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Authors and Affiliations

  1. Centre for Medical Research, Royal Melbourne Hospital, Parkville, VIC, 3050, Australia

    Georgia E. McCluskey & Cassandra E. I. Szoeke

  2. Department of Medicine, University of Melbourne, Parkville, VIC, 3050, Australia

    Georgia E. McCluskey & Cassandra E. I. Szoeke

  3. Department of Nuclear Medicine and Centre for PET, Austin Health, Heidelberg, VIC, 3084, Australia

    Paul Yates, Victor L. Villemagne & Christopher Rowe

  4. Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, 3050, Australia

    Christopher Rowe

  5. Institute for Health and Ageing, Melbourne, 3000, Australia

    Cassandra E. I. Szoeke

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  1. Georgia E. McCluskey
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  2. Paul Yates
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  3. Victor L. Villemagne
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Correspondence to Cassandra E. I. Szoeke.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Appendix

Appendix

Table 4 Logistic regression model for reporting confusion including variables CESD score and global 18F–FBB uptake
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Table 5 Logistic regression model for reporting confusion including the variable global 18F–FBB uptake
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McCluskey, G.E., Yates, P., Villemagne, V.L. et al. Self-reported confusion is related to global and regional β-amyloid: data from the Women’s healthy ageing project. Brain Imaging and Behavior 12, 78–86 (2018). https://doi.org/10.1007/s11682-016-9668-5

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