Investigating the Association Between Verbal Forgetting and Pathological Markers of Alzheimer’s and Lewy Body Diseases

Abstract

Background: The percentage of verbal forgetting (VF%) measure of the Rey Auditory Verbal Learning Test (RAVLT) has been proposed to differentiate patients diagnosed clinically with Alzheimer's disease (AD) and dementia with Lewy bodies (DLB). Objective: To determine if VF% aligns with gold-standard biomarker and autopsy evidence of AD and DLB neuropathology. Methods: Clinical, cognitive, sociodemographic, and biomarker data were collected from 315 patients with baseline cognitive impairment and 485 normal controls from the Alzheimer's Disease Neuroimaging Initiative (ADNI). AD markers included reduced cerebrospinal fluid (CSF) amyloid-␤, elevated total-tau and phosphorylated-tau, hippocampal atrophy, and the presence of amyloid plaques and neurofibrillary tangles at autopsy. DLB markers included reduced CSF ␣-synuclein, preserved hippocampus, atrophied putamen, occipital glucose metabolism, and the presence of Lewy bodies at autopsy. Cognitively impaired participants were classified as AD VF% (n = 190) or DLB VF% (n = 125) based on their RAVLT VF% scores using a 75% cut-off (≥75% = AD VF% , <75% = DLB VF% ). Postmortem data were available for 13 AD VF% participants, 13 DLB VF% patients, and six healthy controls. Results: AD VF% and DLB VF% participants did not differ on CSF or neuroimaging biomarkers, with the exception of total tau levels which were higher in AD VF% . In the subset of participants with autopsy data, comorbid AD and DLB pathology was most frequent in AD VF% participants, and pure DLB pathology was most frequent in DLB VF% participants, however, these differences were not statistically significant. Conclusion:The RAVLT VF% measure does not reliably align with AD and DLB neuropathology in ADNI participants.

Alcohol Use Disorder and Dementia: A Review

“…[308][309][310] Levels of CSF tau, p-tau, and their epitopes are high in people with Alzheimer's disease compared to unaffected subjects and may indicate hippocampal atrophy, but levels of these CSF proteins are also high relative to healthy controls in other neurodegenerative diseases. [311][312][313] Combinations and ratios (e.g., A-beta-42/A-beta-40) of CSF A-beta-42, total tau, and p-tau and their variants are under investigation to improve success of differential diagnoses. 314,315 Total tau is significantly elevated in people with acute Wernicke's encephalopathy, but the overall pattern of CSF changes (involving A-beta, total tau, and p-tau) can clearly distinguish acute and chronic WKS from Alzheimer's disease.…”