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Age-accelerated cognitive decline in asymptomatic adults with CSF β-amyloid
Clark LR, Berman SE, Norton D, Koscik RL, Jonaitis E, Blennow K, Bendlin BB, Asthana S et al.. Neurology, 2018-03-09
Topic: Amyloid, tau and blood-test diagnosis
Objective Compare cognitive and hippocampal volume trajectories in asymptomatic middle-aged and older adults with positive CSF markers of β-amyloid (Aβ) or tau to adults without an Alzheimer disease (AD)-associated biomarker profile. Methods Three hundred ninety-two adults enrolled in a longitudinal cohort study (Wisconsin Registry for Alzheimer's Prevention or Wisconsin Alzheimer's Disease Research Center) completed a lumbar puncture and at least 2 biennial or annual neuropsychological evaluations. Cutoffs for Aβ 42 , total tau, and phosphorylated tau were developed via receiver operating characteristic curve analyses on a sample of 78 participants (38 dementia, 40 controls).
Key findings
- Methods Three hundred ninety-two adults enrolled in a longitudinal cohort study (Wisconsin Registry for Alzheimer's Prevention or Wisconsin Alzheimer's Disease Research Center) completed a lumbar puncture and at least 2 biennial or annual neuropsychological evaluations.
- Cutoffs for Aβ 42 , total tau, and phosphorylated tau were developed via receiver operating characteristic curve analyses on a sample of 78 participants (38 dementia, 40 controls).
- These cutoffs were applied to a separate sample of 314 cognitively healthy adults (mean age at CSF collection = 61.5 years), and mixed-effects regression analyses tested linear and quadratic interactions of biomarker group × age at each visit on cognitive and hippocampal volume outcomes.
- Results Two hundred fifteen participants (69%) were biomarker negative (preclinical AD stage 0), 46 (15%) were Aβ+ only (preclinical AD stage 1), 25 (8%) were Aβ+ and tau+ (preclinical AD stage 2), and 28 (9%) were tau+ only.
Why it matters
This study found that asymptomatic middle-aged and older adults with positive cerebrospinal fluid markers of amyloid beta showed faster cognitive decline with age. It is an observational cohort study and does not test any treatment, cure, or prevention.
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Study details
- Study designcohort study
- Participants78
- Evidence strengthModerate
How this study scored 60/100
Published in a leading specialty journal, and it is a cohort study following people over time. Scored zero for effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Neurology) |
| Journal's citation record | 4 / 4 | Neurology: journal h-index 525 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A cohort study following people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 2 / 5 | 2018 — within 10 year(s) of the newest study here |
| Sample size | 1 / 4 | 78 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 4 / 7 | Cited 52 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 5.2 citations a year over 10 year(s) since 2018 |
| Impact for its field and year | 3 / 6 | Cited 6.6× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 4 other studies in this library |
| Still being cited | 1 / 4 | Cited 7 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Cynthia M. Carlsson: h-index 92 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University College London: institution h-index 2,029 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 6 institution(s) in 3 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 29523644) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 60 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Clark, L. R., Berman, S. E., Norton, D., Koscik, R. L., Jonaitis, E., Blennow, K., et al. (2018). Age-accelerated cognitive decline in asymptomatic adults with CSF β-amyloid. Neurology. https://doi.org/10.1212/wnl.0000000000005291
Vancouver
Clark LR, Berman SE, Norton D, Koscik RL, Jonaitis E, Blennow K, et al. Age-accelerated cognitive decline in asymptomatic adults with CSF β-amyloid. Neurology. 2018. doi:10.1212/wnl.0000000000005291. PMID: 29523644.
BibTeX
@article{clark2018-29523644,
author = {Clark, L. R. and Berman, S. E. and Norton, D. and Koscik, R. L. and Jonaitis, E. and Blennow, K. and Bendlin, B. B. and Asthana, S. and others},
title = {{Age-accelerated cognitive decline in asymptomatic adults with CSF β-amyloid}},
journal = {Neurology},
year = {2018},
doi = {10.1212/wnl.0000000000005291},
pmid = {29523644},
url = {https://doi.org/10.1212/wnl.0000000000005291}
}
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