Background: Lack of awareness of cognitive decline (ACD) has been described at the preclinical and prodromal stages of Alzheimer's disease (AD). In this study, we introduced a meta-memory ratio (MMR) and explored how it is associated with neuroimaging AD biomarkers in asymptomatic individuals at risk for AD.

Method: Four hundred forty-eight cognitively healthy participants from two cohorts of subjective memory complainers (INSIGHT-PreAD and ADNI) were included. Regression models were used to assess the impact of AD biomarkers on the MMR.

Result: In both cohorts, there was a significant quadratic effect of cerebral amyloidosis on the MMR value. In particular, participants had a high ACD up to the amyloid positivity threshold, above which a decrease of ACD was eventually observed as the amyloid load increased.

Conclusion: This nonlinear evolution of ACD in very early AD must be taken into account in clinical care and for trial enrollment as well.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7222501PMC
http://dx.doi.org/10.1186/s13195-020-00626-1DOI Listing

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