en
Scientific article
Open access
English

The impact of tau deposition and hypometabolism on cognitive impairment and longitudinal cognitive decline

Published inAlzheimer's & dementia, vol. 20, no. 1, p. 221-233
Publication date2024-01
First online date2023-08-09
Abstract

Introduction: Tau and neurodegeneration strongly correlate with cognitive impairment, as compared to amyloid. However, their contribution in explaining cognition and predicting cognitive decline in memory clinics remains unclarified.

Methods: We included 94 participants with Mini-Mental State Examination (MMSE), tau positron emission tomography (PET), amyloid PET, fluorodeoxyglucose (FDG) PET, and MRI scans from Geneva Memory Center. Linear regression and mediation analyses tested the independent and combined association between biomarkers, cognitive performance, and decline. Linear mixed-effects and Cox proportional hazards models assessed biomarkers' prognostic values.

Results: Metabolism had the strongest association with cognition (r = 0.712; p < 0.001), followed by tau (r = -0.682; p < 0.001). Neocortical tau showed the strongest association with cognitive decline (r = -0.677; p < 0.001). Metabolism mediated the association between tau and cognition and marginally mediated the one with decline. Tau positivity represented the strongest risk factor for decline (hazard ratio = 32).

Discussion: Tau and neurodegeneration synergistically contribute to global cognitive impairment while tau drives decline. The tau PET superior prognostic value supports its implementation in memory clinics.

Highlights: Hypometabolism has the strongest association with concurrent cognitive impairment. Neocortical tau pathology is the main determinant of cognitive decline over time. FDG-PET has a superior value compared to MRI as a measure of neurodegeneration. The prognostic value of tau-PET exceeded all other neuroimaging modalities.

eng
Keywords
  • Alzheimer's disease biomarkers
  • Cognitive decline
  • Neuroimaging
  • Positron emission tomography
  • Humans
  • Alzheimer Disease / pathology
  • Tau Proteins / metabolism
  • Fluorodeoxyglucose F18 / metabolism
  • Positron-Emission Tomography / methods
  • Cognitive Dysfunction / metabolism
  • Amyloid / metabolism
  • Biomarkers / metabolism
  • Amyloid beta-Peptides
Citation (ISO format)
BOCCALINI, Cécilia et al. The impact of tau deposition and hypometabolism on cognitive impairment and longitudinal cognitive decline. In: Alzheimer’s & dementia, 2024, vol. 20, n° 1, p. 221–233. doi: 10.1002/alz.13355
Main files (1)
Article (Published version)
Secondary files (2)
Identifiers
ISSN of the journal1552-5260
20views
2downloads

Technical informations

Creation03/22/2024 3:53:57 PM
First validation05/24/2024 7:35:18 AM
Update time05/24/2024 7:35:18 AM
Status update05/24/2024 7:35:18 AM
Last indexation05/24/2024 7:35:39 AM
All rights reserved by Archive ouverte UNIGE and the University of GenevaunigeBlack