RESUMO
BACKGROUND: Plasma NfL (pNfL) levels are elevated in many neurological disorders. However, the utility of pNfL in a clinical setting has not been established. OBJECTIVE: In a cohort of diverse older participants, we examined: 1) the association of pNfL to age, sex, Hispanic ethnicity, diagnosis, and structural and amyloid imaging biomarkers; and 2) its association to baseline and longitudinal cognitive and functional performance. METHODS: 309 subjects were classified at baseline as cognitively normal (CN) or with cognitive impairment. Most subjects had structural MRI and amyloid PET scans. The most frequent etiological diagnosis was Alzheimer's disease (AD), but other neurological and neuropsychiatric disorders were also represented. We assessed the relationship of pNfL to cognitive and functional status, primary etiology, imaging biomarkers, and to cognitive and functional decline. RESULTS: pNfL increased with age, degree of hippocampal atrophy, and amyloid load, and was higher in females among CN subjects, but was not associated with Hispanic ethnicity. Compared to CN subjects, pNfL was elevated among those with AD or FTLD, but not those with neuropsychiatric or other disorders. Hippocampal atrophy, amyloid positivity and higher pNfL levels each added unique variance in predicting greater functional impairment on the CDR-SB at baseline. Higher baseline pNfL levels also predicted greater cognitive and functional decline after accounting for hippocampal atrophy and memory scores at baseline. CONCLUSION: pNfL may have a complementary and supportive role to brain imaging and cognitive testing in a memory disorder evaluation, although its diagnostic sensitivity and specificity as a stand-alone measure is modest. In the absence of expensive neuroimaging tests, pNfL could be used for differentiating neurodegenerative disease from neuropsychiatric disorders.
Assuntos
Doença de Alzheimer/sangue , Encéfalo/diagnóstico por imagem , Disfunção Cognitiva/sangue , Estado Funcional , Proteínas de Neurofilamentos/sangue , Negro ou Afro-Americano , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/diagnóstico por imagem , Doença de Alzheimer/fisiopatologia , Peptídeos beta-Amiloides/metabolismo , Atrofia , Encéfalo/metabolismo , Encéfalo/patologia , Cognição , Disfunção Cognitiva/diagnóstico por imagem , Disfunção Cognitiva/fisiopatologia , Estudos de Coortes , Demência Vascular/sangue , Demência Vascular/diagnóstico por imagem , Demência Vascular/fisiopatologia , Feminino , Degeneração Lobar Frontotemporal/sangue , Degeneração Lobar Frontotemporal/diagnóstico por imagem , Degeneração Lobar Frontotemporal/fisiopatologia , Hipocampo/diagnóstico por imagem , Hipocampo/patologia , Hispânico ou Latino , Humanos , Doença por Corpos de Lewy/sangue , Doença por Corpos de Lewy/diagnóstico por imagem , Doença por Corpos de Lewy/fisiopatologia , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Tomografia por Emissão de Pósitrons , Fatores Sexuais , População BrancaRESUMO
With drug abuse among Hispanic youth on the rise, examining cultural factors such as acculturation may provide insight into understanding and addressing this problem. This study examined the relationship between acculturation and severity of drug use among a sample of severely impaired Hispanic adolescents referred for residential substance abuse treatment. As recent studies with clinical samples have found, it was hypothesized that lower levels of acculturation would be associated with higher levels of substance use. Results indicated that youth born outside the United States reported greater frequency of drug use at intake into treatment than those born in the United States, supporting the hypothesis.