Date of Award

8-8-2017

Degree Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

Public Health

First Advisor

Dr. RUIYAN LUO

Second Advisor

Dr. RICHARD ROTHENBERG

Abstract

As life expectancy is increasing, the prevalence of Alzheimer's disease (AD) is expected to escalate. However, there are still no specific markers to confirm AD diagnosis, nor effective treatment for AD, nor an established way to slow down the rate of degeneration.

This study aims to first examine the effect of positive AD family history (FH+) on cerebral metabolic rate of glucose (CMRglc) over a 5-year period among Mild Cognitive Impaired (MCI) subjects. It also assesses whether there are parent gender effects on CMRglc when the groups negative family history (FH-) vs paternal family history (FHp) vs maternal family history (FHm) are compared. Finally, this paper tests whether there is effect modification with APOE4 allele interaction.

Data are drawn from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database. A sample size of 177 subjects with a maximum of 30 observations was used. Wilcoxon rank-sum test and Chi-square test had been used to test for baseline differences between FH+ and FH- groups for the continuous and categorical variables respectively. To analyze the effects of FH on CMRglc, multivariate generalized linear mixed-effects models were used.

The results showed that, compared to subjects who are FH-, FH+ participants presented greater CMRglc decline over the 5-year period after controlling for the other covariates. After adding APOE4 in the model, FH+ subjects showed significantly lower glucose metabolism rate compared to FH- participants. The sample did not have enough statistical power to detect any parental FH differences. Heritability from FH status for explaining CMRglc decline in MCI people is small but statistically significant.

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