Moderator of 2 Sessions
Presenter of 2 Presentations
MasterClass 1: A Call to Action to Improve the Early Detection and Diagnosis of AD in the Era of Disease-Modifying Therapies
PROGNOSTIC USE OF PLASMA PHOSPHORYLATED TAU FOR INCIDENT MILD COGNITIVE IMPAIRMENT AMONG COGNITIVELY UNIMPAIRED PARTICIPANTS
Abstract
Aims
We examined plasma phosphorylated tau (P-tau) 181 and 217 as prognostic biomarkers of incident mild cognitive impairment (MCI) in a community-based study and assessed whether the prognostic value differed by elevated brain amyloid.
Methods
We included 999 cognitively unimpaired participants enrolled in the Mayo Clinic Study on Aging (median age of 73; 54% male, 25% APOE Ɛ4 carriers). P-tau 181 and 217 was measured on the MSD platform; previously developed cutpoints for P-tau181≥1.62 [P-tau181+] and P-tau217≥0.25 [P-tau217+]) were used for analyses. Cox Proportional Hazard models examined P-tau181+ and P-tau217+for risk of incident MCI within 2 years after adjusting for age, sex, APOE, chronic kidney disease, body mass index, stroke, and myocardial infarction. Elevated amyloid (A+) was defined as SUVR≥1.48 using PiB PET in 874 subjects. The risk of MCI among P-tau181+ and P-tau217+ was determined by brain amyloid status (A+ and A-).
Results
There were 64 incident cases of MCI within 2 years. Among all participants the P-tau measures performed similarly for risk of MCI at 2 years (P-tau181: HR 2.49, 95% CI: 1.47, 4.20; P-tau217: HR 2.24, 95% CI: 1.30, 3.85). Among those with amyloid PET, neither P-tau181+ (interactive p-value = 0.64) nor P-tau217+ (interactive p-value = 0.52) for risk of MCI differed by A+ status.
Conclusions
In this community-based sample of cognitively unimpaired participants, plasma P-tau levels can inform on risk of incident MCI within 2 years independent of amyloid PET status.