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Principal Investigator  
Principal Investigator's Name: Shana Stites
Institution: UPenn
Department: Psychiatry
Country:
Proposed Analysis: DATA SOURCES: ADNI-2 and MCSA Persons who do not have knowledge of amyloid scan result (D-): ADNI-277 (NCT01231971), a rigorous, multi-site cohort study of A+ and A- persons (N=450), and MCSA,78,79 a population-based epidemiological cohort study of A+ and A- persons (N=483). Neither cohort study includes disclosure of biomarker results. To be eligible for this study, participants from ADNI-2 and MCSA must be cognitively unimpaired. All data (e.g., self-report, MRI, cognitive testing) will be individual-level, collected at or following (<3 months) the visit for the first available amyloid PET scan, and, for A4 and LEARN, obtained after amyloid result disclosure. Outcome variables: The Everyday Cognition (ECog) questionnaire is used in MCSA and ADNI-2. The ECog questionnaire is a 39-item tool to assess person-reported cognitive function.82 Items ask a person to compare current everyday cognitive functioning to 10 years earlier on six domain-specific factors (i.e., Everyday Memory, Language, Visuospatial Abilities, Planning, Organization, and Divided Attention).82 Total intracranial volume, total medial temporal lobe (MTL) volume (i.e. hippocampus proper and entorhinal, perirhinal, and parahippocampal cortices). A measure of cortical thinning in BA35, the medial wall of the perirhinal cortex, which is also referred to as transentorhinal cortex, the earliest region of tangle pathology.98–100 I will calculate these measures from MRI data obtained from the A4, ADNI-2, and LEARN studies. Final volumes will be adjusted for age and total intracranial volume (thickness will not require this). Each data source has brain amyloid measured by PET imaging, using either PiB or florbetapir-F18 (AV45) ligands. In D- samples (ADNI-2 and MCSA), amyloid will be categorized as follows: A+ will be defined as SUVR of >1.5 for PiB scans and SUVR of >1.1 for AV45 scans and A- will be defined by SUVR <1.5 for PiB scans and <1.1 for AV45 scans. Covariates: age, gender, race, objective cognitive function (PACC), neurobehavioral symptoms (anxiety, depression). depression in ADNI-2 using the Geriatric Depression Scale (GDS),and in MSCA using the Beck Depression Index (BDI). in MSCA using the Beck Anxiety Index (BDI),106 and in ADNI-2 using the Neuropsychiatric Inventory (NPI). Objective cognitive function: The PACC is a composite score derived using an established normalization method, from tests of episodic memory, timed executive function, and global cognition. A one-standard-deviation (1SD) change on a component equates to a 4-point change on the PACC. The PACC composite can be estimated as described for the A4, LEARN, and MSCA samples. The ADNI battery does not include one of the measures (Free and Cued Selective Reminding Test (FCSRT)), but it does include a similar measure that can be substituted to construct a reasonable alternative PACC.
Additional Investigators  
Investigator's Name: Mehek Dedhia
Proposed Analysis: Analyze Total intracranial volume, total medial temporal lobe (MTL) volume (i.e. hippocampus proper and entorhinal, perirhinal, and parahippocampal cortices) to characterize sex related differences in this sample.