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Clinical outcomes u...
Clinical outcomes up to 9 years after [18F]flutemetamol amyloid-PET in a symptomatic memory clinic population
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- Collij, Lyduine E. (författare)
- Lund University,Lunds universitet,Klinisk minnesforskning,Forskargrupper vid Lunds universitet,LU profilområde: Proaktivt åldrande,Lunds universitets profilområden,Clinical Memory Research,Lund University Research Groups,LU Profile Area: Proactive Ageing,Lund University Profile areas,Amsterdam Neuroscience,Amsterdam UMC - Vrije Universiteit Amsterdam
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- Farrar, Gill (författare)
- GE Healthcare, UK
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- Zwan, Marissa (författare)
- Amsterdam Neuroscience,Amsterdam UMC - Vrije Universiteit Amsterdam
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- van de Giessen, Elsmarieke (författare)
- Amsterdam Neuroscience,Amsterdam UMC - Vrije Universiteit Amsterdam
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- Ossenkoppele, Rik (författare)
- Lund University,Lunds universitet,Klinisk minnesforskning,Forskargrupper vid Lunds universitet,LU profilområde: Proaktivt åldrande,Lunds universitets profilområden,Clinical Memory Research,Lund University Research Groups,LU Profile Area: Proactive Ageing,Lund University Profile areas,Amsterdam UMC - Vrije Universiteit Amsterdam,Amsterdam Neuroscience
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- Barkhof, Frederik (författare)
- Amsterdam UMC - Vrije Universiteit Amsterdam,University College London,Amsterdam Neuroscience
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- Rozemuller, Annemieke J.M. (författare)
- Amsterdam UMC - Vrije Universiteit Amsterdam
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- Pijnenburg, Yolande A.L. (författare)
- Amsterdam Neuroscience,Amsterdam UMC - Vrije Universiteit Amsterdam
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- van der Flier, Wiesje M. (författare)
- Amsterdam Neuroscience,Amsterdam UMC - Vrije Universiteit Amsterdam
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- Bouwman, Femke (författare)
- Amsterdam UMC - Vrije Universiteit Amsterdam,Amsterdam Neuroscience
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(creator_code:org_t)
- 2023
- 2023
- Engelska.
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Ingår i: Alzheimer's Research and Therapy. - 1758-9193. ; 15:1
- Relaterad länk:
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http://dx.doi.org/10... (free)
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https://lup.lub.lu.s...
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https://doi.org/10.1...
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Abstract
Ämnesord
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- Background: Previous studies demonstrated increases in diagnostic confidence and change in patient management after amyloid-PET. However, studies investigating longitudinal outcomes over an extended period of time are limited. Therefore, we aimed to investigate clinical outcomes up to 9 years after amyloid-PET to support the clinical validity of the imaging technique. Methods: We analyzed longitudinal data from 200 patients (M age = 61.8, 45.5% female, M MMSE = 23.3) suspected of early-onset dementia that underwent [18F]flutemetamol-PET. Baseline amyloid status was determined through visual read (VR). Information on mortality was available with a mean follow-up of 6.7 years (range = 1.1–9.3). In a subset of 108 patients, longitudinal cognitive scores and clinical etiological diagnosis (eDx) at least 1 year after amyloid-PET acquisition were available (M = 3.06 years, range = 1.00–7.02). VR − and VR + patients were compared on mortality rates with Cox Hazard’s model, prevalence of stable eDx using chi-square test, and longitudinal cognition with linear mixed models. Neuropathological data was available for 4 patients (mean delay = 3.59 ± 1.82 years, range = 1.2–6.3). Results: At baseline, 184 (92.0%) patients were considered to have dementia. The majority of VR + patients had a primary etiological diagnosis of AD (122/128, 95.3%), while the VR − group consisted mostly of non-AD etiologies, most commonly frontotemporal lobar degeneration (30/72, 40.2%). Overall mortality rate was 48.5% and did not differ between VR − and VR + patients. eDx at follow-up was consistent with baseline diagnosis for 92/108 (85.2%) patients, with most changes observed in VR − cases (VR − = 14/35, 40% vs VR + = 2/73, 2.7%, χ 2 = 26.03, p < 0.001), who at no time received an AD diagnosis. VR + patients declined faster than VR − patients based on MMSE (β = − 1.17, p = 0.004), episodic memory (β = − 0.78, p = 0.003), fluency (β = − 1.44, p < 0.001), and attention scores (β = 16.76, p = 0.03). Amyloid-PET assessment was in line with post-mortem confirmation in all cases; two cases were VR + and showed widespread AD pathology, while the other two cases were VR − and showed limited amyloid pathology. Conclusion: In a symptomatic population, we observed that amyloid-status did not impact mortality rates, but is predictive of cognitive functioning over time across several domains. Also, we show particular validity for a negative amyloid-PET assessment, as these patients did not receive an AD diagnosis at follow-up.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Neurologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Neurology (hsv//eng)
Nyckelord
- Diagnosis
- Early-onset dementia
- Neuropathology
- Survival
- [F]flutemetamol amyloid-PET
Publikations- och innehållstyp
- art (ämneskategori)
- ref (ämneskategori)
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Collij, Lyduine ...
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Farrar, Gill
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Zwan, Marissa
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van de Giessen, ...
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Ossenkoppele, Ri ...
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Barkhof, Frederi ...
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Rozemuller, Anne ...
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Pijnenburg, Yola ...
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van der Flier, W ...
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Bouwman, Femke
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