Relationship between brain amyloid deposition and instrumental activities of daily living in older adults: a longitudinal study from the multidomain Alzheimer prevention trial
- Autores: Matthieu Lilamand, Matteo Cesari, Christelle Cantet, Pierre Payoux, Sandrine Andrieu, Bruno Vellas, The MAPT DSA study group
- Localización: Journal of the American Geriatrics Society, ISSN 0002-8614, Vol. 66, Nº. 10, 2018, págs. 1940-1947
- Idioma: inglés
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Resumen
Objectives To examine the evolution of instrumental activity of daily living (IADL) performance according to the presence of brain amyloid deposition.
Design Longitudinal analysis of a randomized controlled trial.
Setting Neuroimaging ancillary study from the Multidomain Alzheimer Prevention Trial (MAPT).
Participants Community‐dwelling individuals aged 70 and older without dementia (N = 269; 60% female, mean age 75±4).
Measurements Linear mixed models were used to assess the 36‐month evolution of the performance of an IADL questionnaire for primary prevention studies in dementia, the Activity of Daily Living Prevention Instrument (ADL‐PI), according to the presence of amyloid deposition using florbetapir positron emission tomography (PET) (standardized uptake value≥1.17). Additional analyses were also conducted to examine the changes in specific domains of daily functioning with and without adjustment for age, sex, apolipoprotein E, randomization group, and time between baseline and PET examination.
Results One hundred two (37.9%) participants were amyloid positive. Amyloid‐negative participants had statistically significant improvement in ADL‐PI total score between baseline and 36 months (p=.04). The difference after 3 years between amyloid‐positive and ‐negative participants was not significant (β=–0.95±0.53 at 36 months, p=.08; adjusted models: β=–1.07±0.56, p=.06). Amyloid‐negative participants also improved in memory‐related IADLs (p<.001) throughout the study, unlike amyloid‐positive participants.
Conclusion Amyloid‐positive and ‐negative older adults are likely to have different trajectories in IADL performance. Future research is needed to better understand the relationship between amyloid plaques and functional limitations.
