Self-, Partner-Reported Cognitive Decline Associated With Greater Tau, β-Amyloid Levels

In a cross-sectional study, cognitively unimpaired individuals who self-reported and whose study partners reported cognitive decline show greater accumulations of tau, which is a major characteristic of Alzheimer disease (AD).

“Previous work shows cross-sectional associations with β-amyloid status and self-reported and study partner-reported cognitive decline, but less is known about their associations with tau deposition, particularly among those with preclinical AD,” the authors wrote in their study.

To fill this gap, researchers examined those from the Anti-Amyloid Treatment in Asymptomatic AD/Longitudinal Evaluation of Amyloid Risk and Neurodegeneration studies (n = 444) and the Harvard Aging Brain Study and affiliated studies (n = 231), which resulted in a sample of 675 cognitively unimpaired study participants.

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To determine cognitive function, all participants and study partners completed the Cognitive Function Index (CFI). Researchers measured tau and β-amyloid levels by using imaging, specifically averaging flortaucipir positron emission tomography (PET) uptake in the medial temporal lobe (MTL) and neocortex (NEO).

The results showed that greater levels of tau was associated with greater self-reported CFI scores (MTL: β = 0.28 [0.12 to 0.44], p < 0.001, and NEO: β = 0.26 [0.09 to 0.42], p = 0.002) as well as study partner-reported CFI scores (MTL: β = 0.28 [0.14 to 0.41], p < 0.001, and NEO: β = 0.31 [0.17 to 0.44], p < 0.001).

Additionally, the authors noted that “significant associations between both CFI measures and MTL/NEO tau PET were driven by elevated β-amyloid.” Indeed, the results showed that continuous β-amyloid had an independent effect on the CFI, as well as the MTL and NEO tau, for both self-CFI and study partner-CFI measures.

“Both self-report and study partner report showed associations with tau in addition to Aβ,” the authors concluded. “Additionally, self-report and study partner report were associated with tau above and beyond performance on a neuropsychological composite. Stratification analyses by Aβ status indicate that associations between self-reported and study partner-reported cognitive concerns with regional tau are driven by those at the preclinical stage of AD, suggesting that both are useful to collect on the early AD continuum.”

Reference
Jadick MF, Robinson T, Farrell ME, et al. Associations between self and study partner report of cognitive decline with regional tau in a multicohort study. Neurology. 2024;102(12):e209447. doi:10.1212/WNL.0000000000209447