DOI: 10.5061/dryad.fxpnvx0nf
title: Predicting resistance to amyloid-beta deposition and cognitive resilience in the oldest-old

description: Objective: To explore long-term predictors of avoiding amyloid-beta (Aβ)
 deposition and maintaining unimpaired cognition as outcomes in the oldest
 old. Methods:  In a longitudinal observational cohort study,
 N=100 former participants of the Ginkgo Evaluation of Memory Study (GEMS;
 2000-2008) completed biannual Pittsburgh Compound B (PiB)-PET imaging and
 annual clinical-cognitive evaluations beginning in 2010. Most recent Aβ
 status and cognitive status were selected for each participant.
 Longitudinal outcomes included change in serial Aβ and cognitive tests.
 Baseline predictors from GEMS included neuropsychological tests, daily
 functioning, APOE genotype, lifestyle variables, occupational measures,
 health history, sleep, subjective memory, physical and cognitive
 activities, depressive symptoms, physical performance and health indices,
 among others. Results:  Mean age at last cognitive evaluation was
 92.0 years (range 86-100). Mean follow-up time from baseline to last
 measured Aβ status was 12.3 (SD 1.9) years and to last cognitive
 evaluation was 14.1 (SD 1.9) years. The APOE*2 allele predicted last Aβ
 status (n=34 Aβ-negative vs. n=66 Aβ-positive). Baseline cognition
 predicted cognitive status (n=30 unimpaired vs. n=70 impaired). Predictors
 of cognitive status among Aβ-positive participants only (n=14 normal
 cognition vs. n=52 impaired) were baseline cognitive test scores and
 smoking history. Baseline pulse pressure predicted longitudinal Aβ
 increase; paid work engagement and life satisfaction predicted less
 cognitive decline. Conclusions: The APOE*2 allele and lower pulse pressure
 predicts resistance to Aβ deposition in advanced aging. Cognitive test
 scores 14 years prior, likely reflecting premorbid abilities, predict
 cognitive status and maintenance of unimpaired cognition in the presence
 of Aβ. Several lifestyle factors appear protective.
description: Dataset overview
 Supplemental Tables 1a and 1b.
 Longitudinal models predicting continuous Aβ deposition (global PiB SUVR)
 over time as the outcome Supplemental Tables 2a and 2b.
 Longitudinal models predicting verbal memory test performance (CVLT
 delayed recall) over time as the outcome Supplemental Tables 3a and 3b.
 Longitudinal models predicting visual memory test performance
 (Rey-Osterrieth figure delayed recall) over time as the outcome
 Supplemental Tables 4a and
 4b. Longitudinal models predicting language test (semantic fluency)
 performance over time as the outcome Supplemental Tables 5a and 5b.
 Longitudinal models predicting executive function test performance (Trails
 B) over time as the outcome Supplemental Tables 6a and 6b.
 Longitudinal models predicting verbal memory test performance (CVLT
 delayed recall) over time as the outcome, in n=66 Aβ-positive   
 participants Supplemental Tables 7a and 7b.
 Longitudinal models predicting visual memory test performance (Rey
 Osterrieth figure delayed recall) over time as the outcome, in n=66
 Aβ-positive participants Supplemental Tables 9a and 9b.
 Longitudinal models predicting executive function (Trails B) test
 performance over time as the outcome, in n=66 Aβ-positive
 participants