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Elevated Plasma β-Amyloid Peptide Aβ42 Levels, Incident Dementia, and Mortality in Down Syndrome
Nicole Schupf, PhD;
Bindu Patel, MPH;
Deborah Pang, MPH;
Warren B. Zigman, PhD;
Wayne Silverman, PhD;
Pankaj D. Mehta, PhD;
Richard Mayeux, MD
Arch Neurol. 2007;64(7):1007-1013.
Background Deposition of the β-amyloid peptide Aβ42 is thought to be an important initial step in the pathogenesis of Alzheimer disease (AD). Individuals with Down syndrome have increased levels of β-amyloid peptides and an increased risk for AD.
Objective To examine the relation of plasma levels of Aβ42 and Aβ40 to the risk of dementia in nondemented participants and all-cause mortality in adults with Down syndrome.
Design Prospective, community-based longitudinal cohort study.
Setting State and voluntary service providers in New York State.
Participants Adults with Down syndrome (N = 204).
Main Outcome Measure Plasma Aβ42 and Aβ40 levels were measured at initial examination. Participants were assessed for cognitive and functional abilities, behavioral/psychiatric conditions, and health and vital status at 14- to 18-month intervals for 4 cycles of data collection.
Results Among participants who were nondemented at baseline, those in the middle and highest tertiles of plasma Aβ42 levels were more than 2 times as likely to develop AD as those in the lowest tertile. Compared with participants without AD, participants with prevalent AD had higher levels of plasma Aβ42 but not Aβ40. Among all participants, those in the highest tertile of plasma Aβ42 level at baseline were more than twice as likely to die during the study period as those in the lowest tertile, whereas there was no difference in risk of death between those in the middle and lowest tertiles of plasma Aβ42 level.
Conclusion Elevations in plasma Aβ42 peptide levels are associated with earlier onset of AD and increased risk of death.
Author Affiliations: Taub Institute for Research on Alzheimer's Disease and the Aging Brain, G. H. Sergievsky Center (Drs Schupf and Mayeux and Mss Patel and Pang), and Departments of Epidemiology (Dr Mayeux), Neurology (Dr Mayeux), and Psychiatry (Drs Schupf and Mayeux), Columbia University Medical Center, New York, New York; Departments of Psychology (Drs Schupf, Zigman, and Silverman and Ms Patel) and Immunology (Dr Mehta), New York State Institute for Basic Research in Developmental Disabilities, Staten Island; and Kennedy Krieger Institute and The Johns Hopkins University School of Medicine, Baltimore, Maryland (Dr Silverman).
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