We investigated whether telomere length (TL) reflecting physical rather than chronological aging is associated with disease progression in the different cognitive stages of Alzheimer's disease (AD). Study participants included 89 subjects with amyloid pathology (A+), determined through amyloid PET or cerebrospinal fluid analysis, including 26 cognitively unimpaired (CU A+) individuals, 28 subjects with mild cognitive impairment (MCI A+), and 35 subjects with AD dementia (ADD A+). As controls, 104 CU A-individuals were selected. The participants were evaluated annually over two years from baseline. Compared to the highest TL quartile group of MCI A+ participants, the lowest TL quartile group yielded 2-year differences of-9.438 (95% confidence interval [CI] =-14.567 ~-4.309),-26.708 (-41.576 ~-11.839), 3.198 (1.323 ~ 5.056), and 2.549 (0.527 ~ 4.571) on the Mini-Mental State Examination, Consortium to Establish a Registry for AD, Clinical Dementia Rating-Sum of Boxes, and Blessed Dementia Scale-Activities of Daily Living, respectively. With this group, the lowest TL quartile group had a significantly greater probability of progressing to ADD than the highest TL quartile group (hazard ratio = 13.16, 95% CI = 1.11 ~ 156.61). Telomere shortening may be associated with rapid cognitive decline and conversion to dementia in MCI A+.
Bibliographical noteFunding Information:
The authors thank Hyelan Na, Jina Lee, Hyeran Hwang, Kyung Hee Bae, Ji Yeon Park, Ju Yeon Kim, JeongHyun Kim, Jieun Park, Munjung Choi, Sumin Jeon, Minkyung Jo, Minsun Kim, Rayoung Yoo, Mi Jeong Lee, and Ja Young Kim who contributed to data collection in this study. This study was supported by grants from the National Research Foundation of Korea (NRF) funded by the Ministry of Science and ICT, Republic of Korea (NRF-2014M3C7A1064752, NRF-2018M3A9F1023697, NRF-2018R1A2A2A15023219, and NRF-2017R1A5A2015395) and the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health and Welfare, Republic of Korea (HI18C0479). The funding sources were not involved in the study design, data acquisition, data analysis, or article writing.
© Koh et al.
- Alzheimer's disease
- Mild cognitive impairment