Prevalence of cerebral amyloid pathology in persons without dementia: a meta-analysis. Jansen, W. J., Ossenkoppele, R., Knol, D. L., Tijms, B. M., Scheltens, P., Verhey, F. R. J., Visser, P. J., Amyloid Biomarker Study Group, Aalten, P., Aarsland, D., Alcolea, D., Alexander, M., Almdahl, I. S., Arnold, S. E., Baldeiras, I., Barthel, H., van Berckel, B. N. M., Bibeau, K., Blennow, K., Brooks, D. J., van Buchem, M. A., Camus, V., Cavedo, E., Chen, K., Chetelat, G., Cohen, A. D., Drzezga, A., Engelborghs, S., Fagan, A. M., Fladby, T., Fleisher, A. S., van der Flier, W. M., Ford, L., Förster, S., Fortea, J., Foskett, N., Frederiksen, K. S., Freund-Levi, Y., Frisoni, G. B., Froelich, L., Gabryelewicz, T., Gill, K. D., Gkatzima, O., Gómez-Tortosa, E., Gordon, M. F., Grimmer, T., Hampel, H., Hausner, L., Hellwig, S., Herukka, S., Hildebrandt, H., Ishihara, L., Ivanoiu, A., Jagust, W. J., Johannsen, P., Kandimalla, R., Kapaki, E., Klimkowicz-Mrowiec, A., Klunk, W. E., Köhler, S., Koglin, N., Kornhuber, J., Kramberger, M. G., Van Laere, K., Landau, S. M., Lee, D. Y., de Leon, M., Lisetti, V., Lleó, A., Madsen, K., Maier, W., Marcusson, J., Mattsson, N., de Mendonça, A., Meulenbroek, O., Meyer, P. T., Mintun, M. A., Mok, V., Molinuevo, J. L., Møllergård, H. M., Morris, J. C., Mroczko, B., Van der Mussele, S., Na, D. L., Newberg, A., Nordberg, A., Nordlund, A., Novak, G. P., Paraskevas, G. P., Parnetti, L., Perera, G., Peters, O., Popp, J., Prabhakar, S., Rabinovici, G. D., Ramakers, I. H. G. B., Rami, L., Resende de Oliveira, C., Rinne, J. O., Rodrigue, K. M., Rodríguez-Rodríguez, E., Roe, C. M., Rot, U., Rowe, C. C., Rüther, E., Sabri, O., Sanchez-Juan, P., Santana, I., Sarazin, M., Schröder, J., Schütte, C., Seo, S. W., Soetewey, F., Soininen, H., Spiru, L., Struyfs, H., Teunissen, C. E., Tsolaki, M., Vandenberghe, R., Verbeek, M. M., Villemagne, V. L., Vos, S. J. B., van Waalwijk van Doorn, L. J. C., Waldemar, G., Wallin, A., Wallin, Å. K., Wiltfang, J., Wolk, D. A., Zboch, M., & Zetterberg, H. JAMA, 313(19):1924--1938, May, 2015.
doi  abstract   bibtex   
IMPORTANCE: Cerebral amyloid-β aggregation is an early pathological event in Alzheimer disease (AD), starting decades before dementia onset. Estimates of the prevalence of amyloid pathology in persons without dementia are needed to understand the development of AD and to design prevention studies. OBJECTIVE: To use individual participant data meta-analysis to estimate the prevalence of amyloid pathology as measured with biomarkers in participants with normal cognition, subjective cognitive impairment (SCI), or mild cognitive impairment (MCI). DATA SOURCES: Relevant biomarker studies identified by searching studies published before April 2015 using the MEDLINE and Web of Science databases and through personal communication with investigators. STUDY SELECTION: Studies were included if they provided individual participant data for participants without dementia and used an a priori defined cutoff for amyloid positivity. DATA EXTRACTION AND SYNTHESIS: Individual records were provided for 2914 participants with normal cognition, 697 with SCI, and 3972 with MCI aged 18 to 100 years from 55 studies. MAIN OUTCOMES AND MEASURES: Prevalence of amyloid pathology on positron emission tomography or in cerebrospinal fluid according to AD risk factors (age, apolipoprotein E [APOE] genotype, sex, and education) estimated by generalized estimating equations. RESULTS: The prevalence of amyloid pathology increased from age 50 to 90 years from 10% (95% CI, 8%-13%) to 44% (95% CI, 37%-51%) among participants with normal cognition; from 12% (95% CI, 8%-18%) to 43% (95% CI, 32%-55%) among patients with SCI; and from 27% (95% CI, 23%-32%) to 71% (95% CI, 66%-76%) among patients with MCI. APOE-ε4 carriers had 2 to 3 times higher prevalence estimates than noncarriers. The age at which 15% of the participants with normal cognition were amyloid positive was approximately 40 years for APOE ε4ε4 carriers, 50 years for ε2ε4 carriers, 55 years for ε3ε4 carriers, 65 years for ε3ε3 carriers, and 95 years for ε2ε3 carriers. Amyloid positivity was more common in highly educated participants but not associated with sex or biomarker modality. CONCLUSIONS AND RELEVANCE: Among persons without dementia, the prevalence of cerebral amyloid pathology as determined by positron emission tomography or cerebrospinal fluid findings was associated with age, APOE genotype, and presence of cognitive impairment. These findings suggest a 20- to 30-year interval between first development of amyloid positivity and onset of dementia.
@article{jansen_prevalence_2015,
	title = {Prevalence of cerebral amyloid pathology in persons without dementia: a meta-analysis},
	volume = {313},
	issn = {1538-3598},
	shorttitle = {Prevalence of cerebral amyloid pathology in persons without dementia},
	doi = {10.1001/jama.2015.4668},
	abstract = {IMPORTANCE: Cerebral amyloid-β aggregation is an early pathological event in Alzheimer disease (AD), starting decades before dementia onset. Estimates of the prevalence of amyloid pathology in persons without dementia are needed to understand the development of AD and to design prevention studies.
OBJECTIVE: To use individual participant data meta-analysis to estimate the prevalence of amyloid pathology as measured with biomarkers in participants with normal cognition, subjective cognitive impairment (SCI), or mild cognitive impairment (MCI).
DATA SOURCES: Relevant biomarker studies identified by searching studies published before April 2015 using the MEDLINE and Web of Science databases and through personal communication with investigators.
STUDY SELECTION: Studies were included if they provided individual participant data for participants without dementia and used an a priori defined cutoff for amyloid positivity.
DATA EXTRACTION AND SYNTHESIS: Individual records were provided for 2914 participants with normal cognition, 697 with SCI, and 3972 with MCI aged 18 to 100 years from 55 studies.
MAIN OUTCOMES AND MEASURES: Prevalence of amyloid pathology on positron emission tomography or in cerebrospinal fluid according to AD risk factors (age, apolipoprotein E [APOE] genotype, sex, and education) estimated by generalized estimating equations.
RESULTS: The prevalence of amyloid pathology increased from age 50 to 90 years from 10\% (95\% CI, 8\%-13\%) to 44\% (95\% CI, 37\%-51\%) among participants with normal cognition; from 12\% (95\% CI, 8\%-18\%) to 43\% (95\% CI, 32\%-55\%) among patients with SCI; and from 27\% (95\% CI, 23\%-32\%) to 71\% (95\% CI, 66\%-76\%) among patients with MCI. APOE-ε4 carriers had 2 to 3 times higher prevalence estimates than noncarriers. The age at which 15\% of the participants with normal cognition were amyloid positive was approximately 40 years for APOE ε4ε4 carriers, 50 years for ε2ε4 carriers, 55 years for ε3ε4 carriers, 65 years for ε3ε3 carriers, and 95 years for ε2ε3 carriers. Amyloid positivity was more common in highly educated participants but not associated with sex or biomarker modality.
CONCLUSIONS AND RELEVANCE: Among persons without dementia, the prevalence of cerebral amyloid pathology as determined by positron emission tomography or cerebrospinal fluid findings was associated with age, APOE genotype, and presence of cognitive impairment. These findings suggest a 20- to 30-year interval between first development of amyloid positivity and onset of dementia.},
	language = {eng},
	number = {19},
	journal = {JAMA},
	author = {Jansen, Willemijn J. and Ossenkoppele, Rik and Knol, Dirk L. and Tijms, Betty M. and Scheltens, Philip and Verhey, Frans R. J. and Visser, Pieter Jelle and {Amyloid Biomarker Study Group} and Aalten, Pauline and Aarsland, Dag and Alcolea, Daniel and Alexander, Myriam and Almdahl, Ina S. and Arnold, Steven E. and Baldeiras, Inês and Barthel, Henryk and van Berckel, Bart N. M. and Bibeau, Kristen and Blennow, Kaj and Brooks, David J. and van Buchem, Mark A. and Camus, Vincent and Cavedo, Enrica and Chen, Kewei and Chetelat, Gael and Cohen, Ann D. and Drzezga, Alexander and Engelborghs, Sebastiaan and Fagan, Anne M. and Fladby, Tormod and Fleisher, Adam S. and van der Flier, Wiesje M. and Ford, Lisa and Förster, Stefan and Fortea, Juan and Foskett, Nadia and Frederiksen, Kristian S. and Freund-Levi, Yvonne and Frisoni, Giovanni B. and Froelich, Lutz and Gabryelewicz, Tomasz and Gill, Kiran Dip and Gkatzima, Olymbia and Gómez-Tortosa, Estrella and Gordon, Mark Forrest and Grimmer, Timo and Hampel, Harald and Hausner, Lucrezia and Hellwig, Sabine and Herukka, Sanna-Kaisa and Hildebrandt, Helmut and Ishihara, Lianna and Ivanoiu, Adrian and Jagust, William J. and Johannsen, Peter and Kandimalla, Ramesh and Kapaki, Elisabeth and Klimkowicz-Mrowiec, Aleksandra and Klunk, William E. and Köhler, Sebastian and Koglin, Norman and Kornhuber, Johannes and Kramberger, Milica G. and Van Laere, Koen and Landau, Susan M. and Lee, Dong Young and de Leon, Mony and Lisetti, Viviana and Lleó, Alberto and Madsen, Karine and Maier, Wolfgang and Marcusson, Jan and Mattsson, Niklas and de Mendonça, Alexandre and Meulenbroek, Olga and Meyer, Philipp T. and Mintun, Mark A. and Mok, Vincent and Molinuevo, José Luis and Møllergård, Hanne M. and Morris, John C. and Mroczko, Barbara and Van der Mussele, Stefan and Na, Duk L. and Newberg, Andrew and Nordberg, Agneta and Nordlund, Arto and Novak, Gerald P. and Paraskevas, George P. and Parnetti, Lucilla and Perera, Gayan and Peters, Oliver and Popp, Julius and Prabhakar, Sudesh and Rabinovici, Gil D. and Ramakers, Inez H. G. B. and Rami, Lorena and Resende de Oliveira, Catarina and Rinne, Juha O. and Rodrigue, Karen M. and Rodríguez-Rodríguez, Eloy and Roe, Catherine M. and Rot, Uros and Rowe, Christopher C. and Rüther, Eckart and Sabri, Osama and Sanchez-Juan, Páscual and Santana, Isabel and Sarazin, Marie and Schröder, Johannes and Schütte, Christin and Seo, Sang W. and Soetewey, Femke and Soininen, Hilkka and Spiru, Luiza and Struyfs, Hanne and Teunissen, Charlotte E. and Tsolaki, Magda and Vandenberghe, Rik and Verbeek, Marcel M. and Villemagne, Victor L. and Vos, Stephanie J. B. and van Waalwijk van Doorn, Linda J. C. and Waldemar, Gunhild and Wallin, Anders and Wallin, Åsa K. and Wiltfang, Jens and Wolk, David A. and Zboch, Marzena and Zetterberg, Henrik},
	month = may,
	year = {2015},
	pmid = {25988462},
	pages = {1924--1938}
}
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