Relationship between ¹⁸F-Flutemetamol uptake and RBANS performance in non-demented community-dwelling older adults

Abstract

Objective The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) has been used extensively for clinical care and in research for patients with Mild Cognitive Impairment and Alzheimer’s disease (AD), however relatively few studies have evaluated the relationship between RBANS performance and AD imaging biomarkers. The purpose of the current study was to evaluate the association between a relatively new amyloid positron emission tomography imaging biomarker and performance on the RBANS. Methods Twenty-seven non-demented community-dwelling adults over the age of 65 underwent 18F-Flutemetamol amyloid- positron emission tomography imaging, along with cognitive testing using the RBANS and select behavioral measures. Partial correlation coefficients were used to identify relationships between the imaging and behavioral markers. Results After controlling for age and education, amyloid deposition and RBANS Indexes of Immediate Memory, Delayed Memory, and Total Scale score were significantly correlated (p’s <.001, r’s =−0.73 to −0.77, d’s =2.13–2.39), with greater amyloid burden being associated with lower RBANS scores. The Delayed Memory Index was particularly highly associated with 18F-Flutemetamol binding (r2 =.59, p <.001, d =2.39). Neither 18F-Flutemetamol binding nor RBANS performance was significantly correlated with levels of depression, subjective cognitive difficulties, or premorbid intellect. Conclusions Because of the limited use of amyloid imaging in clinical settings due to high cost and lack of reimbursement, these findings suggest that in particular RBANS Delayed Memory Index may be a cost-efficient tool to identify early signs of AD pathology, and its use may enlighten clinical decision making regarding potential progression to dementia due to AD.

Discordant Amyloid Status Diagnosis in Alzheimer’s Disease

“…Regarding neuropsychology tests, they are mainly used to detect cognitive impairment cases and to evaluate disease progression [ 27 ]. In this sense, the CDR test is the most used classification system in clinical dementia research [ 28 ].…”

“…An episodic memory assessment (RBANS.DM) would allow us to establish the phase of the disease (the lower score obtained in this area, the greater memory deficit), as the study by Hammers et al already pointed out. In fact, they claimed that RBANS.DM could illuminate clinical decision making regarding the possible progression to dementia due to AD [ 27 ]. In addition, evaluations of episodic memory with tests such as the RBANS.DM scale would remain a key tool to identify patients with AD, even when specific amyloid detection techniques are fully available.…”

The Benefits of Neurocognitive Training in a Diagnosed Dementia Population, an Ongoing Study since 2011

“…The RBANS has been used extensively for critical care and in research with patients diagnosed with cognitive deficits or dementia [8,9]. The Doors and People is an accepted memory test for visual and verbal retrieval and recognition [10].…”

Long-term Changes in 18F-Flutemetamol Uptake in Nondemented Older Adults

“…18 F-Flutemetamol binding has been used to successfully differentiate cognitively intact individuals from those with AD [10][11][12][13]. It has also been associated with a variety of cognitive outcome measures [14][15][16].…”