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The ARIC-PET amyloid imaging study: Brain amyloid differences by age, race, sex, and APOE.
Neurology 2016; 87(5):473-80Neur

Abstract

OBJECTIVE

To evaluate differences in amyloid deposition in a community-based cohort without dementia by age, sex, race, education, and APOE ε4 allele status.

METHODS

Recruited from the longitudinal Atherosclerosis Risk in Communities study, 329 participants without dementia, ages 67-88 years, were imaged using florbetapir PET at 3 US community sites (Washington County, Maryland; Forsyth County, North Carolina; and Jackson, Mississippi). Standardized uptake value ratios (SUVRs) were calculated; global cortical SUVR >1.2 was evaluated as the primary outcome. Age, race, sex, education level, and number of APOE ε4 alleles were evaluated in multivariable models including vascular risk factors, brain white matter hyperintensity and total intracranial volume, and cognitive status.

RESULTS

A total of 141 of the participants (43%) were black. In multivariable models, odds of elevated SUVR was increased in participants with increasing age (odds ratio [OR] 1.63, 95% confidence interval [CI] 1.01-2.65 per 10 years of age) and black race (OR 2.08, 95% CI 1.23-3.51) but did not differ by educational level. Each ε4 allele was associated with increased odds of elevated SUVR (OR 2.65, 95% CI 1.61-4.39).

CONCLUSIONS

In this community-based cohort without dementia, florbetapir uptake is associated with older age and APOE genotype. Black race was associated with higher SUVR, after adjusting for demographics, vascular risk factors, cognitive status, white matter hyperintensity volume, and APOE genotype, with effect sizes nearing those seen for APOE ε4. Replication of these findings is needed in other cohorts, and reasons for and consequences of these observed differences by race warrant further study.

Authors+Show Affiliations

From the Department of Neurology (R.F.G., A.L.C.S.), Department of Radiology, Section of High-Resolution Brain PET Imaging (Y.Z., X.C., A.R., D.F.W.), and Departments of Psychiatry (D.F.W.) and Neuroscience (D.F.W.), Johns Hopkins University School of Medicine; Departments of Epidemiology (R.F.G., A.L.C.S., A.R.S.) and Environmental Health Sciences (D.F.W.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Departments of Radiology (E.G.) and Medicine (T.H.M.), University of Mississippi Medical Center, Jackson; Hagerstown Imaging (N.G.), MD; Department of Neurology (D.S.K.), Mayo Clinic, Rochester, MN; and Department of Radiology (A.M.) and Division of Public Health Sciences (L.E.W.), Wake Forest School of Medicine, Winston-Salem, NC. rgottesm@jhmi.edu.From the Department of Neurology (R.F.G., A.L.C.S.), Department of Radiology, Section of High-Resolution Brain PET Imaging (Y.Z., X.C., A.R., D.F.W.), and Departments of Psychiatry (D.F.W.) and Neuroscience (D.F.W.), Johns Hopkins University School of Medicine; Departments of Epidemiology (R.F.G., A.L.C.S., A.R.S.) and Environmental Health Sciences (D.F.W.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Departments of Radiology (E.G.) and Medicine (T.H.M.), University of Mississippi Medical Center, Jackson; Hagerstown Imaging (N.G.), MD; Department of Neurology (D.S.K.), Mayo Clinic, Rochester, MN; and Department of Radiology (A.M.) and Division of Public Health Sciences (L.E.W.), Wake Forest School of Medicine, Winston-Salem, NC.From the Department of Neurology (R.F.G., A.L.C.S.), Department of Radiology, Section of High-Resolution Brain PET Imaging (Y.Z., X.C., A.R., D.F.W.), and Departments of Psychiatry (D.F.W.) and Neuroscience (D.F.W.), Johns Hopkins University School of Medicine; Departments of Epidemiology (R.F.G., A.L.C.S., A.R.S.) and Environmental Health Sciences (D.F.W.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Departments of Radiology (E.G.) and Medicine (T.H.M.), University of Mississippi Medical Center, Jackson; Hagerstown Imaging (N.G.), MD; Department of Neurology (D.S.K.), Mayo Clinic, Rochester, MN; and Department of Radiology (A.M.) and Division of Public Health Sciences (L.E.W.), Wake Forest School of Medicine, Winston-Salem, NC.From the Department of Neurology (R.F.G., A.L.C.S.), Department of Radiology, Section of High-Resolution Brain PET Imaging (Y.Z., X.C., A.R., D.F.W.), and Departments of Psychiatry (D.F.W.) and Neuroscience (D.F.W.), Johns Hopkins University School of Medicine; Departments of Epidemiology (R.F.G., A.L.C.S., A.R.S.) and Environmental Health Sciences (D.F.W.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Departments of Radiology (E.G.) and Medicine (T.H.M.), University of Mississippi Medical Center, Jackson; Hagerstown Imaging (N.G.), MD; Department of Neurology (D.S.K.), Mayo Clinic, Rochester, MN; and Department of Radiology (A.M.) and Division of Public Health Sciences (L.E.W.), Wake Forest School of Medicine, Winston-Salem, NC.From the Department of Neurology (R.F.G., A.L.C.S.), Department of Radiology, Section of High-Resolution Brain PET Imaging (Y.Z., X.C., A.R., D.F.W.), and Departments of Psychiatry (D.F.W.) and Neuroscience (D.F.W.), Johns Hopkins University School of Medicine; Departments of Epidemiology (R.F.G., A.L.C.S., A.R.S.) and Environmental Health Sciences (D.F.W.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Departments of Radiology (E.G.) and Medicine (T.H.M.), University of Mississippi Medical Center, Jackson; Hagerstown Imaging (N.G.), MD; Department of Neurology (D.S.K.), Mayo Clinic, Rochester, MN; and Department of Radiology (A.M.) and Division of Public Health Sciences (L.E.W.), Wake Forest School of Medicine, Winston-Salem, NC.From the Department of Neurology (R.F.G., A.L.C.S.), Department of Radiology, Section of High-Resolution Brain PET Imaging (Y.Z., X.C., A.R., D.F.W.), and Departments of Psychiatry (D.F.W.) and Neuroscience (D.F.W.), Johns Hopkins University School of Medicine; Departments of Epidemiology (R.F.G., A.L.C.S., A.R.S.) and Environmental Health Sciences (D.F.W.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Departments of Radiology (E.G.) and Medicine (T.H.M.), University of Mississippi Medical Center, Jackson; Hagerstown Imaging (N.G.), MD; Department of Neurology (D.S.K.), Mayo Clinic, Rochester, MN; and Department of Radiology (A.M.) and Division of Public Health Sciences (L.E.W.), Wake Forest School of Medicine, Winston-Salem, NC.From the Department of Neurology (R.F.G., A.L.C.S.), Department of Radiology, Section of High-Resolution Brain PET Imaging (Y.Z., X.C., A.R., D.F.W.), and Departments of Psychiatry (D.F.W.) and Neuroscience (D.F.W.), Johns Hopkins University School of Medicine; Departments of Epidemiology (R.F.G., A.L.C.S., A.R.S.) and Environmental Health Sciences (D.F.W.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Departments of Radiology (E.G.) and Medicine (T.H.M.), University of Mississippi Medical Center, Jackson; Hagerstown Imaging (N.G.), MD; Department of Neurology (D.S.K.), Mayo Clinic, Rochester, MN; and Department of Radiology (A.M.) and Division of Public Health Sciences (L.E.W.), Wake Forest School of Medicine, Winston-Salem, NC.From the Department of Neurology (R.F.G., A.L.C.S.), Department of Radiology, Section of High-Resolution Brain PET Imaging (Y.Z., X.C., A.R., D.F.W.), and Departments of Psychiatry (D.F.W.) and Neuroscience (D.F.W.), Johns Hopkins University School of Medicine; Departments of Epidemiology (R.F.G., A.L.C.S., A.R.S.) and Environmental Health Sciences (D.F.W.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Departments of Radiology (E.G.) and Medicine (T.H.M.), University of Mississippi Medical Center, Jackson; Hagerstown Imaging (N.G.), MD; Department of Neurology (D.S.K.), Mayo Clinic, Rochester, MN; and Department of Radiology (A.M.) and Division of Public Health Sciences (L.E.W.), Wake Forest School of Medicine, Winston-Salem, NC.From the Department of Neurology (R.F.G., A.L.C.S.), Department of Radiology, Section of High-Resolution Brain PET Imaging (Y.Z., X.C., A.R., D.F.W.), and Departments of Psychiatry (D.F.W.) and Neuroscience (D.F.W.), Johns Hopkins University School of Medicine; Departments of Epidemiology (R.F.G., A.L.C.S., A.R.S.) and Environmental Health Sciences (D.F.W.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Departments of Radiology (E.G.) and Medicine (T.H.M.), University of Mississippi Medical Center, Jackson; Hagerstown Imaging (N.G.), MD; Department of Neurology (D.S.K.), Mayo Clinic, Rochester, MN; and Department of Radiology (A.M.) and Division of Public Health Sciences (L.E.W.), Wake Forest School of Medicine, Winston-Salem, NC.From the Department of Neurology (R.F.G., A.L.C.S.), Department of Radiology, Section of High-Resolution Brain PET Imaging (Y.Z., X.C., A.R., D.F.W.), and Departments of Psychiatry (D.F.W.) and Neuroscience (D.F.W.), Johns Hopkins University School of Medicine; Departments of Epidemiology (R.F.G., A.L.C.S., A.R.S.) and Environmental Health Sciences (D.F.W.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Departments of Radiology (E.G.) and Medicine (T.H.M.), University of Mississippi Medical Center, Jackson; Hagerstown Imaging (N.G.), MD; Department of Neurology (D.S.K.), Mayo Clinic, Rochester, MN; and Department of Radiology (A.M.) and Division of Public Health Sciences (L.E.W.), Wake Forest School of Medicine, Winston-Salem, NC.From the Department of Neurology (R.F.G., A.L.C.S.), Department of Radiology, Section of High-Resolution Brain PET Imaging (Y.Z., X.C., A.R., D.F.W.), and Departments of Psychiatry (D.F.W.) and Neuroscience (D.F.W.), Johns Hopkins University School of Medicine; Departments of Epidemiology (R.F.G., A.L.C.S., A.R.S.) and Environmental Health Sciences (D.F.W.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Departments of Radiology (E.G.) and Medicine (T.H.M.), University of Mississippi Medical Center, Jackson; Hagerstown Imaging (N.G.), MD; Department of Neurology (D.S.K.), Mayo Clinic, Rochester, MN; and Department of Radiology (A.M.) and Division of Public Health Sciences (L.E.W.), Wake Forest School of Medicine, Winston-Salem, NC.From the Department of Neurology (R.F.G., A.L.C.S.), Department of Radiology, Section of High-Resolution Brain PET Imaging (Y.Z., X.C., A.R., D.F.W.), and Departments of Psychiatry (D.F.W.) and Neuroscience (D.F.W.), Johns Hopkins University School of Medicine; Departments of Epidemiology (R.F.G., A.L.C.S., A.R.S.) and Environmental Health Sciences (D.F.W.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Departments of Radiology (E.G.) and Medicine (T.H.M.), University of Mississippi Medical Center, Jackson; Hagerstown Imaging (N.G.), MD; Department of Neurology (D.S.K.), Mayo Clinic, Rochester, MN; and Department of Radiology (A.M.) and Division of Public Health Sciences (L.E.W.), Wake Forest School of Medicine, Winston-Salem, NC.From the Department of Neurology (R.F.G., A.L.C.S.), Department of Radiology, Section of High-Resolution Brain PET Imaging (Y.Z., X.C., A.R., D.F.W.), and Departments of Psychiatry (D.F.W.) and Neuroscience (D.F.W.), Johns Hopkins University School of Medicine; Departments of Epidemiology (R.F.G., A.L.C.S., A.R.S.) and Environmental Health Sciences (D.F.W.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Departments of Radiology (E.G.) and Medicine (T.H.M.), University of Mississippi Medical Center, Jackson; Hagerstown Imaging (N.G.), MD; Department of Neurology (D.S.K.), Mayo Clinic, Rochester, MN; and Department of Radiology (A.M.) and Division of Public Health Sciences (L.E.W.), Wake Forest School of Medicine, Winston-Salem, NC.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27371485

Citation

Gottesman, Rebecca F., et al. "The ARIC-PET Amyloid Imaging Study: Brain Amyloid Differences By Age, Race, Sex, and APOE." Neurology, vol. 87, no. 5, 2016, pp. 473-80.
Gottesman RF, Schneider AL, Zhou Y, et al. The ARIC-PET amyloid imaging study: Brain amyloid differences by age, race, sex, and APOE. Neurology. 2016;87(5):473-80.
Gottesman, R. F., Schneider, A. L., Zhou, Y., Chen, X., Green, E., Gupta, N., ... Mosley, T. H. (2016). The ARIC-PET amyloid imaging study: Brain amyloid differences by age, race, sex, and APOE. Neurology, 87(5), pp. 473-80. doi:10.1212/WNL.0000000000002914.
Gottesman RF, et al. The ARIC-PET Amyloid Imaging Study: Brain Amyloid Differences By Age, Race, Sex, and APOE. Neurology. 2016 Aug 2;87(5):473-80. PubMed PMID: 27371485.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The ARIC-PET amyloid imaging study: Brain amyloid differences by age, race, sex, and APOE. AU - Gottesman,Rebecca F, AU - Schneider,Andrea L C, AU - Zhou,Yun, AU - Chen,Xueqi, AU - Green,Edward, AU - Gupta,Naresh, AU - Knopman,David S, AU - Mintz,Akiva, AU - Rahmim,Arman, AU - Sharrett,A Richey, AU - Wagenknecht,Lynne E, AU - Wong,Dean F, AU - Mosley,Thomas H,Jr Y1 - 2016/07/01/ PY - 2015/10/30/received PY - 2016/03/11/accepted PY - 2016/7/3/entrez PY - 2016/7/3/pubmed PY - 2017/6/1/medline SP - 473 EP - 80 JF - Neurology JO - Neurology VL - 87 IS - 5 N2 - OBJECTIVE: To evaluate differences in amyloid deposition in a community-based cohort without dementia by age, sex, race, education, and APOE ε4 allele status. METHODS: Recruited from the longitudinal Atherosclerosis Risk in Communities study, 329 participants without dementia, ages 67-88 years, were imaged using florbetapir PET at 3 US community sites (Washington County, Maryland; Forsyth County, North Carolina; and Jackson, Mississippi). Standardized uptake value ratios (SUVRs) were calculated; global cortical SUVR >1.2 was evaluated as the primary outcome. Age, race, sex, education level, and number of APOE ε4 alleles were evaluated in multivariable models including vascular risk factors, brain white matter hyperintensity and total intracranial volume, and cognitive status. RESULTS: A total of 141 of the participants (43%) were black. In multivariable models, odds of elevated SUVR was increased in participants with increasing age (odds ratio [OR] 1.63, 95% confidence interval [CI] 1.01-2.65 per 10 years of age) and black race (OR 2.08, 95% CI 1.23-3.51) but did not differ by educational level. Each ε4 allele was associated with increased odds of elevated SUVR (OR 2.65, 95% CI 1.61-4.39). CONCLUSIONS: In this community-based cohort without dementia, florbetapir uptake is associated with older age and APOE genotype. Black race was associated with higher SUVR, after adjusting for demographics, vascular risk factors, cognitive status, white matter hyperintensity volume, and APOE genotype, with effect sizes nearing those seen for APOE ε4. Replication of these findings is needed in other cohorts, and reasons for and consequences of these observed differences by race warrant further study. SN - 1526-632X UR - https://www.unboundmedicine.com/medline/citation/27371485/The_ARIC_PET_amyloid_imaging_study:_Brain_amyloid_differences_by_age_race_sex_and_APOE_ L2 - http://www.neurology.org/cgi/pmidlookup?view=long&pmid=27371485 DB - PRIME DP - Unbound Medicine ER -