The Use of F-18 FDG PET-Based Cognitive Reserve to Evaluate Cognitive Decline in Alzheimer’s Disease, Independent of Educational Influence
Abstract
:1. Background
2. Materials and Methods
2.1. Dataset from the Alzheimer’s Disease Neuroimaging Initiative
2.2. Statistical Analyses
3. Results
3.1. Baseline Demographics
3.2. Differences in Variables between the Low and High Education Subgroups Using Four Cut-Offs for EDU
3.3. Correlation between Demographics, FDGSUVR, FBBSUVR, and Neuropsychological Tests
3.4. Multivariable Analyses for Correlations between Demographics, FDGSUVR, FBBSUVR, and Neuropsychological Tests
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Normal | MCI | AD | Total | |
---|---|---|---|---|
No. | 3 | 91 | 30 | 124 |
Age, years | 79.4 ± 15.9 | 71.8 ± 7.9 | 73.9 ± 7.8 | 72.5 ± 8.0. |
Sex, n (%) | ||||
Male | 2 (67) | 51 (56) | 19 (63) | 72 (58) |
Female | 1 (33) | 40 (44) | 11 (37) | 52 (42) |
EDU | 17.7 ± 2.1 | 16.3 ± 2.5 | 16.2 ± 2.5 | 16.3 ± 2.5 |
APOE, n * (%) | ||||
0 | 2 (100) | 37 (54) | 4 (14) | 43 (43) |
1 | 0 (0) | 26 (38) | 15 (54) | 41 (41) |
2 | 0 (0) | 6 (8) | 9 (32) | 15 (16) |
CDR * | 2.3 ± 4.0 | 1.6 ± 1.0 | 4.1 ± 1.8 | 2.2 ± 1.7 |
ADAS11 * | 13.9 ± 13.9 | 8.7 ± 3.7 | 19.2 ± 5.5 | 11.4 ± 6.4 |
ADAS13 * | 19.6 ± 19.6 | 13.7 ± 5.7 | 29.8 ± 7.1 | 17.8 ± 9.5 |
MMSE * | 25.3 ± 4.7 | 28.1 ± 7.5 | 23.8 ± 2.8 | 27.0 ± 2.8 |
FDGSUVR * | 1.118 ± 0.210 | 1.243 ± 0.077 | 1.135 ± 0.111 | 1.214 ± 0.102 |
FBBSUVR * | 1.302 ± 0.295 | 1.200 ± 0.252 | 1.482 ± 0.275 | 1.271 ± 0.283 |
EDU | G12 | G14 | G16 | G18 | ||||
---|---|---|---|---|---|---|---|---|
≤12 | >12 | ≤24 | >14 | ≤46 | >16 | ≤68 | >18 | |
No. | 15 | 109 | 31 | 93 | 67 | 57 | 102 | 22 |
Age | 70.0 ± 5.6 | 72.8 ± 8.2 | 70.6 ± 7.6 | 73.1 ± 8.1 | 70.4 ± 8.3 * | 74.9 ± 6.9 * | 71.9 ± 7.9 | 75.3 ± 8.3 |
Sex, n (%) | ||||||||
Male | 9 (60) | 63 (58) | 16 (52) | 56 (60) | 34 (51) | 38 (67) | 57 (56) | 15 (68) |
Female | 6 (40) | 46 (42) | 15 (48) | 37 (40) | 33 (49) | 19 (33) | 45 (44) | 7 (32) |
Diagnosis, n (%) | ||||||||
AD | 3 (20) | 27 (25) | 10 (32) | 20 (22) | 15 (22) | 15 (26) | 26 (25) | 4 (18) |
MCI | 12 (80) | 79 (72) | 21 (68) | 70 (75) | 51 (76) | 40 (70) | 74 (73) | 17 (77) |
Normal | 0 (0) | 3 (3) | 0 (0) | 3 (3) | 1 (2) | 2 (4) | 2 (2) | 1 (5) |
APOE, n † (%) | ||||||||
0 | 6 (40) | 37 (34) | 12 (39) | 31 (33) | 26 (39) | 17 (30) | 34 (33) | 9 (41) |
1 | 3 (20) | 38 (35) | 10 (32) | 31 (33) | 23 (34) | 18 (31) | 39 (38) | 2 (9) |
2 | 3 (20) | 12 (11) | 6 (20) | 9 (10) | 9 (13) | 6 (11) | 11 (11) | 4 (18) |
CDR | 2.2 ± 1.4 | 2.2 ± 1.8 | 2.5 ± 2.1 | 2.1 ± 1.6 | 2.2 ± 1.7 | 2.3 ± 1.8 | 2.3 ± 1.8 | 2.0 ± 1.4 |
ADAS11 | 13.2 ± 6.8 | 11.1 ± 6.4 | 13.8 ± 7.7 * | 10.6 ± 5.7 * | 11.6 ± 6.8 | 11.1 ± 6.0 | 11.5 ± 6.5 | 10.9 ± 6.1 |
ADAS13 | 19.8 ± 9.9 | 17.5 ± 9.4 | 20.9 ± 11.1 * | 16.7 ± 8.7 * | 17.8 ± 9.8 | 17.7 ± 9.1 | 18.0 ± 9.6 | 17.0 ± 9.1 |
MMSE | 26.5 ± 2.6 | 27.1 ± 2.8 | 25.9 ± 3.3 * | 27.3 ± 2.6 * | 26.7 ± 2.9 | 27.3 ± 2.8 | 26.8 ± 2.9 | 27.6 ± 2.4 |
FDGSUVR | 1.236 ± 0.069 | 1.211 ± 0.105 | 1.204 ± 0.105 | 1.217 ± 0.101 | 1.213 ± 0.108 | 1.215 ± 0.095 | 1.211 ± 0.104 | 1.229 ± 0.089 |
FBBSUVR | 1.253 ± 0.269 | 1.273 ± 0.286 | 1.314 ± 0.293 | 1.256 ± 0.280 | 1.281 ± 0.295 | 1.259 ± 0.271 | 1.275 ± 0.289 | 1.249 ± 0.261 |
CDR (Correlation Coefficient) | |||||||||
G12 | G14 | G16 | G18 | Total | |||||
≤12 | >12 | ≤14 | >14 | ≤16 | >16 | ≤18 | >18 | ||
Age † | −0.374 | 0.178 | −0.006 | 0.225 * | 0.120 | 0.153 | 0.156 | 0.116 | 0.142 |
Sex ‡ | −0.016 | −0.129 | 0.069 | −0.188 | 0.037 | −0.300* | −0.086 | −0.295 | −0.117 |
EDU † | −0.066 | −0.076 | 0.132 | 0.019 | −0.129 | −0.181 | −0.028 | 0.254 | −0.047 |
APOE ‡ | 0.358 | 0.290 * | 0.446 * | 0.226 | 0.406 * | 0.118 | 0.252 * | 0.436 | 0.290 * |
FDGSUVR † | −0.570 * | −0.444 * | −0.586 * | −0.391 * | −0.514 * | −0.373 * | −0.489 * | −0.163 | −0.451 * |
FBBSUVR † | 0.164 | 0.286 * | 0.489 * | 0.172 | 0.513 * | −0.019 | 0.262 * | 0.359 | 0.275 * |
ADAS11 (Correlation Coefficient) | |||||||||
G12 | G14 | G16 | G18 | Total | |||||
≤12 | >12 | ≤14 | >14 | ≤16 | >16 | ≤18 | >18 | ||
Age † | −0.311 | 0.255 * | −0.041 | 0.343 * | 0.092 | 0.392 * | 0.194 | 0.193 | 0.189 * |
Sex ‡ | 0.000 | −0.164 | −0.029 | −0.210 * | −0.098 | −0.272 * | −0.157 | −0.177 | −0.159 |
EDU † | −0.018 | −0.120 | 0.068 | 0.042 | −0.269 * | −0.110 | −0.191 | 0.128 | −0.155 |
APOE ‡ | 0.330 | 0.319 * | 0.309 | 0.332 * | 0.342 * | 0.292 | 0.300 * | 0.434 | 0.327 * |
FDGSUVR † | −0.737 * | −0.565 * | −0.578 * | −0.561 * | −0.496 * | −0.653 * | −0.570 * | −0.491 * | −0.559 * |
FBBSUVR † | 0.325 | 0.462 * | 0.450 * | 0.431 * | 0.477 * | 0.385 * | 0.409 * | 0.612 * | 0.440 * |
ADAS13 (Correlation Coefficient) | |||||||||
G12 | G14 | G16 | G18 | Total | |||||
≤12 | >12 | ≤14 | >14 | ≤16 | >16 | ≤18 | >18 | ||
Age † | −0.230 | 0.283 * | 0.015 | 0.359 * | 0.139 | 0.381 * | 0.230 * | 0.237 | 0.225 * |
Sex ‡ | 0.063 | −0.130 | 0.058 | −0.188 | −0.056 | −0.224 | −0.120 | −0.131 | −0.114 |
EDU † | 0.032 | −0.116 | 0.089 | 0.037 | −0.263 * | −0.161 | −0.155 | 0.061 | −0.133 |
APOE ‡ | 0.467 | 0.349 * | 0.379 * | 0.350 * | 0.425 * | 0.287 | 0.336 * | 0.422 | 0.366 * |
FDGSUVR † | −0.806 * | −0.598 * | −0.622 * | −0.596 * | −0.564 * | −0.649 * | −0.617 * | −0.487 * | −0.599 * |
FBBSUVR † | 0.445 | 0.511 * | 0.510 * | 0.490 * | 0.554 * | 0.425 * | 0.474 * | 0.639 * | 0.499 * |
MMSE (Correlation Coefficient) | |||||||||
G12 | G14 | G16 | G18 | Total | |||||
≤12 | >12 | ≤14 | >14 | ≤16 | >16 | ≤18 | >18 | ||
Age † | 0.404 | −0.109 | −0.028 | −0.120 | −0.060 | −0.142 | −0.062 | −0.172 | −0.062 |
Sex ‡ | 0.100 | 0.018 | 0.022 | 0.041 | −0.045 | 0.137 | −0.014 | 0.267 | 0.023 |
EDU † | −0.162 | 0.185 | −0.183 | 0.042 | 0.184 | 0.109 | 0.165 | −0.417 | 0.171 |
APOE ‡ | 0.095 | −0.300 * | −0.179 | −0.296 * | −0.299 * | −0.237 | −0.239 * | −0.339 | −0.268 * |
FDGSUVR † | 0.348 | 0.527 * | 0.395 * | 0.555 * | 0.434 * | 0.603 * | 0.510 * | 0.435 * | 0.503 * |
FBBSUVR † | −0.201 | −0.418 * | −0.494 * | −0.340 * | −0.444 * | −0.325 * | −0.409 * | −0.287 | −0.394 * |
CDR (p-Value) | ||||||||||
G12 | G14 | G16 | G18 | Total | ||||||
Mode | EDU | ≤12 | >12 | ≤14 | >14 | ≤16 | >16 | ≤18 | >18 | |
Enter | ||||||||||
Age | 0.155 | 0.044 * | 0.552 | 0.059 | 0.401 | 0.300 | 0.108 | 0.372 | 0.089 | |
Sex (dummy) | 0.976 | 0.868 | 0.419 | 0.460 | 0.321 | 0.130 | 0.682 | 0.525 | 0.873 | |
EDU | 0.747 | 0.598 | 0.406 | 0.820 | 0.317 | 0.072 | 0.628 | 0.362 | 0.573 | |
APOE (dummy1) | 0.838 | 0.738 | 0.452 | 0.630 | 0.899 | 0.653 | 0.946 | 0.535 | 0.891 | |
APOE (dummy2) | 0.416 | 0.097 | 0.419 | 0.182 | 0.630 | 0.166 | 0.466 | 0.188 | 0.164 | |
FDGSUVR | 0.119 | <0.001 * | 0.012 * | 0.002 * | 0.002 * | 0.018 * | <0.001 * | 0.767 | <0.001 * | |
FBBSUVR | 0.846 | 0.847 | 0.044 * | 0.597 | 0.063 | 0.152 | 0.817 | 0.370 | 0.853 | |
R2 | 0.578 | 0.257 | 0.473 | 0.215 | 0.387 | 0.273 | 0.264 | 0.464 | 0.242 | |
Stepwise † | ||||||||||
FDGSUVR | 0.027 | <0.001 | 0.001 | <0.001 | 0.003 | 0.005 | <0.001 | - | <0.001 | |
FBBSUVR | - | - | - | - | 0.003 | - | - | - | - | |
Age | - | 0.048 | - | 0.045 | - | - | - | - | - | |
R2 | 0.325 | 0.227 | 0.343 | 0.190 | 0.360 | 0.138 | 0.239 | - | 0.204 | |
ADAS11 (p-value) | ||||||||||
G12 | G14 | G16 | G18 | Total | ||||||
Mode | EDU | ≤12 | >12 | ≤14 | >14 | ≤16 | >16 | ≤18 | >18 | |
Enter | ||||||||||
Age | 0.623 | 0.007 * | 0.498 | 0.004* | 0.536 | 0.005 * | 0.034 * | 0.271 | 0.015 * | |
Sex (dummy) | 0.875 | 0.995 | 0.530 | 0.854 | 0.555 | 0.547 | 0.648 | 0.565 | 0.988 | |
EDU | 0.676 | 0.436 | 0.363 | 0.658 | 0.023 * | 0.992 | 0.012 * | 0.515 | 0.040 * | |
APOE (dummy1) | 0.538 | 0.853 | 0.106 | 0.448 | 0.414 | 0.328 | 0.965 | 0.162 | 0.622 | |
APOE (dummy2) | 0.702 | 0.260 | 0.418 | 0.283 | 0.632 | 0.261 | 0.499 | 0.554 | 0.188 | |
FDGSUVR | 0.022 * | <0.001 * | 0.009 * | <0.001 * | 0.002 * | <0.001 * | <0.001 * | 0.105 | <0.001 * | |
FBBSUVR | 0.649 | 0.056 | 0.040 * | 0.162 | 0.061 | 0.382 | 0.378 | 0.017 * | 0.079 | |
R2 | 0.712 | 0.437 | 0.495 | 0.447 | 0.410 | 0.558 | 0.417 | 0.718 | 0.419 | |
Stepwise † | ||||||||||
FDGSUVR | 0.002 | <0.001 | 0.001 | <0.001 | 0.002 | <0.001 | <0.001 | 0.031 | <0.001 | |
FBBSUVR | - | 0.005 | - | 0.001 | 0.009 | - | - | 0.002 | 0.002 | |
Age | - | 0.011 | - | 0.035 | - | 0.004 | 0.015 | - | - | |
EDU | - | - | - | - | 0.011 | - | 0.005 | - | - | |
R2 | 0.534 | 0.427 | 0.334 | 0.435 | 0.392 | 0.516 | 0.401 | 0.575 | 0.368 | |
ADAS13 (p-value) | ||||||||||
G12 | G14 | G16 | G18 | Total | ||||||
Mode | EDU | ≤12 | >12 | ≤14 | >14 | ≤16 | >16 | ≤18 | >18 | |
Enter | ||||||||||
Age | 0.601 | 0.001 * | 0.753 | 0.002 * | 0.300 | 0.007 * | 0.016 * | 0.166 | 0.004 * | |
Sex (dummy) | 0.724 | 0.516 | 0.489 | 0.706 | 0.347 | 0.852 | 0.461 | 0.862 | 0.634 | |
EDU | 0.512 | 0.617 | 0.303 | 0.493 | 0.013* | 0.735 | 0.023* | 0.548 | 0.074 | |
APOE (dummy1) | 0.785 | 0.648 | 0.216 | 0.335 | 0.614 | 0.379 | 0.684 | 0.148 | 0.907 | |
APOE (dummy2) | 0.565 | 0.286 | 0.568 | 0.388 | 0.567 | 0.337 | 0.554 | 0.402 | 0.184 | |
FDGSUVR | 0.015 * | <0.001 * | 0.004 * | <0.001 * | <0.001 * | <0.001 * | <0.001 * | 0.068 | <0.001 * | |
FBBSUVR | 0.666 | 0.019 * | 0.038 * | 0.052 | 0.026 * | 0.210 | 0.171 | 0.011 * | 0.023 * | |
R2 | 0.753 | 0.506 | 0.542 | 0.515 | 0.509 | 0.559 | 0.485 | 0.759 | 0.487 | |
Stepwise † | ||||||||||
FDGSUVR | <0.001 | <0.001 | 0.002 | <0.001 | <0.001 | <0.001 | <0.001 | 0.028 | <0.001 | |
FBBSUVR | - | <0.001 | 0.040 | 0.001 | 0.001 | 0.045 | 0.005 | 0.001 | 0.001 | |
Age | - | 0.003 | - | 0.004 | - | 0.008 | - | - | 0.028 | |
EDU | - | - | - | - | 0.007 | - | - | - | - | |
R2 | 0.650 | 0.497 | 0.475 | 0.504 | 0.491 | 0.544 | 0.429 | 0.615 | 0.462 | |
MMSE (p-value) | ||||||||||
G12 | G14 | G16 | G18 | Total | ||||||
Mode | EDU | ≤12 | >12 | ≤14 | >14 | ≤16 | >16 | ≤18 | >18 | |
Enter | ||||||||||
Age | 0.187 | 0.174 | 0.448 | 0.266 | 0.839 | 0.551 | 0.771 | 0.031 * | 0.432 | |
Sex (dummy) | 0.472 | 0.787 | 0.976 | 0.611 | 0.721 | 0.726 | 0.755 | 0.407 | 0.941 | |
EDU | 0.463 | 0.158 | 0.902 | 0.752 | 0.176 | 0.750 | 0.089 | 0.283 | 0.060 | |
APOE (dummy1) | 0.768 | 0.896 | 0.204 | 0.623 | 0.454 | 0.552 | 0.579 | 0.950 | 0.734 | |
APOE (dummy2) | 0.896 | 0.172 | 0.547 | 0.177 | 0.826 | 0.259 | 0.905 | 0.010 | 0.317 | |
FDGSUVR | 0.532 | <0.001 * | 0.280 | <0.001 * | 0.017 * | <0.001 * | <0.001 * | 0.113 | <0.001 * | |
FBBSUVR | 0.713 | 0.138 | 0.033 * | 0.786 | 0.055 | 0.669 | 0.061 | 0.672 | 0.092 | |
R2 | 0.477 | 0.356 | 0.354 | 0.340 | 0.303 | 0.397 | 0.326 | 0.685 | 0.323 | |
Stepwise † | ||||||||||
FDGSUVR | - | <0.001 | - | <0.001 | 0.019 | <0.001 | <0.001 | - | <0.001 | |
FBBSUVR | - | 0.006 | 0.005 | - | 0.013 | - | 0.019 | - | 0.010 | |
R2 | 0.325 | 0.328 | 0.244 | 0.308 | 0.263 | 0.362 | 0.300 | - | 0.294 |
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Choi, H.J.; Seo, M.; Kim, A.; Park, S.H. The Use of F-18 FDG PET-Based Cognitive Reserve to Evaluate Cognitive Decline in Alzheimer’s Disease, Independent of Educational Influence. Medicina 2023, 59, 945. https://doi.org/10.3390/medicina59050945
Choi HJ, Seo M, Kim A, Park SH. The Use of F-18 FDG PET-Based Cognitive Reserve to Evaluate Cognitive Decline in Alzheimer’s Disease, Independent of Educational Influence. Medicina. 2023; 59(5):945. https://doi.org/10.3390/medicina59050945
Chicago/Turabian StyleChoi, Hyung Jin, Minjung Seo, Ahro Kim, and Seol Hoon Park. 2023. "The Use of F-18 FDG PET-Based Cognitive Reserve to Evaluate Cognitive Decline in Alzheimer’s Disease, Independent of Educational Influence" Medicina 59, no. 5: 945. https://doi.org/10.3390/medicina59050945