INS NYC 2024 Program

Poster	Poster Session 06 Program Schedule 02/15/2024 04:00 pm - 05:15 pm Room: Majestic Complex (Posters 61-120) Poster Session 06: Aging \| MCI \| Neurodegenerative Disease - PART 2 Final Abstract #67 Self-Reported Change in Memory, Attention, and Spatial Navigation is not Associated with Alzheimer Disease Biomarker Positivity in Clinically Normal Adults Taylor Levine, Washington University, St. Louis, United States Kianna Zucker, Washington University, St. Louis, United States Samantha Allison, Neurocognitive Specialty Group, Taylorsville, United States Suzanne Schindler, Washington University, St. Louis, United States Denise Head, Washington University, St. Louis, United States Category: Dementia (Alzheimer's Disease) Keyword 1: dementia - Alzheimer's disease Keyword 2: self-report Keyword 3: psychometrics Objective: Preclinical Alzheimer disease (pAD) has been associated with subtle deficits in memory, attention, and spatial navigation (Allison et al., 2019; Aschenbrenner et al., 2015; Hedden et al., 2013). Current methods (i.e., PET scans and lumbar punctures) for detecting AD-biomarker burden associated with the preclinical stage are invasive and expensive, therefore not feasible for widespread clinical use. As such, there is a need to develop a time- and cost-effective screening tool for pAD. Self-reported cognitive change may represent such a tool, but most of the available literature focuses on the MCI and symptomatic AD stages and there have not been self-reported questionnaires developed specifically to detect preclinical related cognitive change. The goal of this study was to refine existing questionnaires that have demonstrated strong reliability and validity in order to more specifically measure subtle cognitive change associated with pAD to determine whether self-reported change in relevant cognitive domains could represent robust clinical tools sensitive to pAD. Participants and Methods: Community dwelling, non-demented older adults (n=125, average age 68 +/- 6.20 years) completed refined versions of previous published questionnaires (spatial navigation: Allison, 2019; Attentional Control Scale: Judah, 2013; MAC-Q: Crook, 1992) to assess their reliability (Cronbach’s alpha) and validity (confirmatory factor analysis hypothesizing a three-factor structure). To better detect subtle cognitive change associated with pAD, the spatial navigation questionnaire was adjusted using previously collected data (Allison, 2019) and two items assessing semantic memory were added to the MAC-Q as the original version focused on episodic memory. Then, these questionnaires were applied in a non-overlapping cohort of clinically normal adults recruited from the Washington University ADRC with biomarker data (CSF n=46 and hippocampal volume n=44, average age 69.27 +/- 10.17 years). Receiver operating characteristics (ROC) and area under the curve (AUC) analyses were used to determine the diagnostic accuracy of the questionnaires in detecting pAD, either defined by cerebrospinal fluid (CSF) Aβ42/Aβ40 ratio with a cutoff of <0.0673 or hippocampal volume in the bottom tertile of the sample collected within four years of completing questionnaires. 17 individuals (37%) were positive by CSF Aβ42/Aβ40 and 15 individuals (34%) were positive by hippocampal volume. Results: All questionnaires demonstrated good internal consistency (a range=0.91-0.95). The three-factor CFA models were a good fit to the data and were significantly better than one-factor models (self-report χ²(3)=109.138, p<0.001), suggesting that the questionnaires measured distinct constructs. None of the questionnaires were significant predictors of CSF Aβ42/Aβ40 biomarker positivity (memory: AUC=0.577, p=0.387; attention: AUC=0.544, p=0.625; navigation: AUC=0.643, p=0.109) or hippocampal volume biomarker positivity (memory: AUC=0.448, p=0.577; attention: AUC=0.422, p=0.400; navigation: AUC=0.522, p=0.814). None of the AUC values were significantly different from each other (all ps>0.075). Conclusions: Current versions of questionnaires were not sensitive to AD-associated biomarker burden in clinically normal adults. Continued work needs to be done to refine or develop a time- and cost-effective screening tool for biomarker burden in clinically normal adults.

Poster

02/15/2024
04:00 pm - 05:15 pm
Room: Majestic Complex (Posters 61-120)

Poster Session 06: Aging | MCI | Neurodegenerative Disease - PART 2

Final Abstract #67

Self-Reported Change in Memory, Attention, and Spatial Navigation is not Associated with Alzheimer Disease Biomarker Positivity in Clinically Normal Adults

Taylor Levine, Washington University, St. Louis, United States
Kianna Zucker, Washington University, St. Louis, United States
Samantha Allison, Neurocognitive Specialty Group, Taylorsville, United States
Suzanne Schindler, Washington University, St. Louis, United States
Denise Head, Washington University, St. Louis, United States

Category: Dementia (Alzheimer's Disease)

Keyword 1: dementia - Alzheimer's disease
Keyword 2: self-report
Keyword 3: psychometrics

Objective:

Preclinical Alzheimer disease (pAD) has been associated with subtle deficits in memory, attention, and spatial navigation (Allison et al., 2019; Aschenbrenner et al., 2015; Hedden et al., 2013). Current methods (i.e., PET scans and lumbar punctures) for detecting AD-biomarker burden associated with the preclinical stage are invasive and expensive, therefore not feasible for widespread clinical use. As such, there is a need to develop a time- and cost-effective screening tool for pAD. Self-reported cognitive change may represent such a tool, but most of the available literature focuses on the MCI and symptomatic AD stages and there have not been self-reported questionnaires developed specifically to detect preclinical related cognitive change. The goal of this study was to refine existing questionnaires that have demonstrated strong reliability and validity in order to more specifically measure subtle cognitive change associated with pAD to determine whether self-reported change in relevant cognitive domains could represent robust clinical tools sensitive to pAD.

Participants and Methods:

Community dwelling, non-demented older adults (n=125, average age 68 +/- 6.20 years) completed refined versions of previous published questionnaires (spatial navigation: Allison, 2019; Attentional Control Scale: Judah, 2013; MAC-Q: Crook, 1992) to assess their reliability (Cronbach’s alpha) and validity (confirmatory factor analysis hypothesizing a three-factor structure). To better detect subtle cognitive change associated with pAD, the spatial navigation questionnaire was adjusted using previously collected data (Allison, 2019) and two items assessing semantic memory were added to the MAC-Q as the original version focused on episodic memory. Then, these questionnaires were applied in a non-overlapping cohort of clinically normal adults recruited from the Washington University ADRC with biomarker data (CSF n=46 and hippocampal volume n=44, average age 69.27 +/- 10.17 years). Receiver operating characteristics (ROC) and area under the curve (AUC) analyses were used to determine the diagnostic accuracy of the questionnaires in detecting pAD, either defined by cerebrospinal fluid (CSF) Aβ42/Aβ40 ratio with a cutoff of <0.0673 or hippocampal volume in the bottom tertile of the sample collected within four years of completing questionnaires. 17 individuals (37%) were positive by CSF Aβ42/Aβ40 and 15 individuals (34%) were positive by hippocampal volume.

Results:

All questionnaires demonstrated good internal consistency (a range=0.91-0.95). The three-factor CFA models were a good fit to the data and were significantly better than one-factor models (self-report χ²(3)=109.138, p<0.001), suggesting that the questionnaires measured distinct constructs. None of the questionnaires were significant predictors of CSF Aβ42/Aβ40 biomarker positivity (memory: AUC=0.577, p=0.387; attention: AUC=0.544, p=0.625; navigation: AUC=0.643, p=0.109) or hippocampal volume biomarker positivity (memory: AUC=0.448, p=0.577; attention: AUC=0.422, p=0.400; navigation: AUC=0.522, p=0.814). None of the AUC values were significantly different from each other (all ps>0.075).

Conclusions:

Current versions of questionnaires were not sensitive to AD-associated biomarker burden in clinically normal adults. Continued work needs to be done to refine or develop a time- and cost-effective screening tool for biomarker burden in clinically normal adults.