HAI Book 2025 - Flipbook - Page 222
Felix, Cynthia
48
Subtle cognitive deficits detected through routine in-office tests are
associated with global Aβ and temporal tau in cognitively unimpaired
individuals
Cynthia Felix1, George Rebok2, Felix Kollasserry3, Beth Snitz4, Pamela Ferreira1, Dana
Tudorascu1, Guilherme Povala1, Pampa Saha1, Livia Amaral1, Firoza Lussier1, Joseph Masdeu5,
David Soleimani-Meigooni6, Juan Fortea7, Val Lowe8, Hwamee Oh9, Brian Gordon10, Pedro
Rosa-Nato11, Suzanne Baker12, Ziad Nasreddine13, Tharick Pascoal1,4
1
Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, US
Johns Hopkins School of Public Health, Baltimore, MD, US
3
Indian Statistical Institute, Bangalore, IN
4
Department of Neurology, University of Pittsburgh, Pittsburgh, PA, US
5
Houston Methodist Research Institute, Houston, TX, US
6
University of California San Francisco, San Francisco, CA, US
7
Hospital de la Santa Creu i Sant Pau, Barcelona, ES
8
Mayo Clinic, Rochester, MN, US
9
Brown University, Providence, RI, US
10
Washington University in St. Louis, St. Louis, MO, US
11
Translational Neuroimaging Laboratory, McGill University Research Centre for Studies in Aging, Montreal, QC, CA
12
Lawrence Berkeley National Laboratory, Berkeley, CA, US
13
MoCA Cognition, Greenfield Park, QC, US
2
Background: Studies show that individuals classified as cognitively unimpaired (CU) can exhibit a heterogeneous
pattern of subtle clinical abnormalities, potentially linked to early Alzheimer9s disease (AD). Identifying subtle
cognitive deficits in this population using widely used cognitive tests is crucial, as early treatment for AD has been
increasingly recognized to be potentially more effective. In this study, we aim to evaluate the link between
Montreal Cognitive Assessment (MoCA) scores and AD pathology in CU individuals.
Methods: We studied 204 cognitively unimpaired (CU) older adults who underwent both 18F-FTP and 18F-MK6240
scans. These individuals were stratified based on their amyloid PET status, determined by visual reading, into CU
A´+ (n = 35) and CU A´- (n = 137), as part of the ongoing HEAD study. CU adults had MMSE scores between 24-30
and Clinical Dementia Rating (CDR) of 0 and were clinically identified as non-MCI and non-demented. Voxel-wise
linear regression models tested the association between MoCA and tau pathology.
Results: CU A´+/TAU+ had significantly lower total MoCA scores than A´-/TAU- individuals (Fig. 1). Lesser MoCA
total score was significantly associated with greater mediobasal temporal tau deposition, using both 18F-MK6240
and 18F-FTP [Fig. 2]. When we separated the population by A´ status, we found that these results were driven by
the CU A´+ group (Fig. 3A) and were not present in CU A´- individuals (Fig. 3B).
Discussion: These findings indicate that the MoCA, a simple routine in-office clinical test, can detect subtle
cognitive dysfunction associated with AD in CU older adults. This suggests that simple cognitive testing can play a
role in the early detection of AD in clinical settings, potentially pre-screening individuals currently identified as
preclinical AD for early intervention.
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