Professor David Ames BA, MD, FRCPsych, FRANZCP

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Three year follow up results from the
Australian Imaging Biomarkers and Lifestyle
(AIBL) study of Ageing
Professor David Ames BA, MD, FRCPsych,
FRANZCP University of Melbourne Professor of
Ageing and HealthDirector National Ageing
Research Institute Co-leader Australian Imaging
Biomarkers and Lifestyle (AIBL) flagship study of
ageing dames_at_unimelb.edu.au
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Sites
Major Sponsor
MELBOURNE
PERTH
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What is the AIBL study?

• Australian Imaging Biomarkers and Lifestyle study
  of ageing
• Launched in November 2006, largest study of its
  kind in Australia
• Initial cohort of 1112 participants (minimum age
  60 years)
• 211 Patients with Alzheimers disease (AD), 133
  with Mild Cognitive Impairment (MCI) and 768
  healthy volunteers cohort assessed in multiple
  modalities and undergoing follow-up every 18
  months
• 2 site study 40 Perth and 60 Melbourne

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Assessments

• BP, HR, weight, height, abdominal girth
• 80 ml blood
• 2 hours neuropsychological testing
• HADS and GDS
• Medication list
• Diet and lifestyle questionnaires
• PiB PET scan and MRI for ¼
• Diagnostic panel evaluation
• DA file review
• Repeat every 18 months

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Progress

• AIBL 1 initial phase of the study 2006-2010
• Recruit cohort of 1000 people (1112 by August
  2008)
• Conduct thorough assessment at baseline
• Repeat assessment at 18-months
• AIBL-2 refunded by SIEF 2011-2014
• Repeat assessments at 36 months
• Repeat assessments at 54 months
• Recruit 200 replenishment/expansion
• Image most of cohort
• LPs for 100
• ROCS study
• AIBL active study

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AIBL Longitudinal cohort
396 SMC
133 MCI
211 AD
372 NMC
Baseline (1,112)
Psychometrics Bloods MRI/PET Lifestyle Genotype
(33)
(29)
(51)
(30)
Non-Return 115 Deceased NMC 2 SMC 4 MCI 5 AD 17
(1 PDD)
(97)
(114)
(7)
(14)
(4)
(1)
(3)
(32)
(220)
(253)
(159)
(63)
318 NMC
374 SMC
81 MCI
196 AD
1 Non-AD Dementia
18M (968)
Psychometrics Bloods MRI/PET
(39)
(40)
(61)
(23)
Non-Return 120 Deceased NMC 3 SMC 3 MCI 4 AD 33
(1)VaD
(1)
(79)
(64)
(5)
(4)
(14)
(1)
(16)
(211)
(240)
(37)
(133)
(1)PDD
(2)VaD
301 NMC
310 SMC
58 MCI
154 AD
4 Non-AD Dementia
36M (824)
(1)
(2)
(5)
(11)
Psychometrics Bloods MRI/PET
Returned at 36 months 19
November 2011 (NMC) Non-Memory Complainer, (SMC)
Subjective-Memory Complainer, (MCI) Mild
Cognitive Impairment, (AD) Alzheimers disease,
PDD (Parkinsons Disease Dementia), VaD (Vascular
Dementia).
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• Imaging results

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11C-PIB for Ab imaging
AD
HC
Villemagne / Rowe
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BASELINE Ab burden correlates with memory decline
over 3 years in HC
Neocortical SUVR
Episodic memory decline
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AIBL Prediction of Progression HC to MCI/AD
36 months n195
PiB-ve Subjects 129 Converters to
MCI/AD 7
PiBve Subjects 66 Converters to
MCI/AD 19
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AIBL Prediction of Progression MCI to Dementia
36 Months n92
PiB -ve 34 Converters to AD
10 Other dementia 17 No dementia 73
PiB ve 58 Converters to AD
56 No dementia 44
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• Cognitive stream results

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Anticholinergics

• Anticholinergic drugs associated with modest
  cognitive difficulty Sittirannorit et al. 2011

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Predictors of rapid decline in AD

• Alessandro Sona, Ping Zhang et al. (Int
  Psychogeriatrics, 2012, 24 197-204)
• 211 AD at baseline 156 followed at 18 months
• 33 (51) rapid decliners (lost 6 MMSE points in
  18 months)
• Higher CDR and CDR box score plus baseline
  prescription of a CheI predicted faster decline
  (OR 3.4 univariate)

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Predictors of subjective memory complaints in
AIBL

• 672 HC and 64 MCI completed a subjective memory
  questionnaire at 18 month follow up.
• MMSE, CVLT, RCFT, BNT, GDS, HADS, group
  membership and APOE e4 status were used to
  determine predictors of SMC scores.
• Group membership explained 20 of variance.
  Adding affective measures explained 27. Only
  group membership and HADS were significant
  individual predictors.
• In HCs SMCs reflect mood rather than objectively
  measured cognitive performance.
• R. Buckley, M. Saling, K. Ellis, N.
  Lautenschlager, P Marruff, R. Martins, C Masters,
  C. Rowe, G. Savage, C. Szoeke, D. Ames and the
  AIBL group

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AIBL collaborators

• Study is conducted between Perth (40) and
  Melbourne (60)
• CSIRO P-Health
• University of Melbourne
• Neurosciences Australia Ltd (NSA)
• Edith Cowan University (ECU)
• Mental Health Research Institute (MHRI)
• National Ageing Research Institute (NARI)
• Austin Health
• University of WA (UWA)
• CogState Ltd.
• Charles Gairdner Hospital radiology and nuclear
  medicine
• Alzheimers Australia
• Macquarie University
• denotes signatories to the AIBL study contract

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Financial Supporters

• CSIRO (AUS)
• National Health and Medical Research Council
  (NHMRC) (AUS)
• Alzheimers Association (USA)
• Alzheimers Drug Discovery Foundation (USA)
• An Anonymous Foundation (USA)
• Pfizer
• GE Healthcare
• Astra Zeneca
• Science and Industry Endowment Fund

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The AIBL management team
AIBL management committee Prof. David Ames
Prof Ashley Bush Prof. Richard Head Dr.
Kathryn Ellis Prof. Ralph Martins Prof.
Colin Masters Dr. Andrew Milner Prof.
Christopher Rowe Dr. Cassandra Szoeke Dr.
Lance Macauley Dr. Tim OMeara The AIBL
study team comprises 80 scientists (see
www.aibl.csiro.au) and 1112 Australian research
volunteers
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The AIBL Study Team www.aibl.csiro.au
Svetlana Pejoska Kelly Pertile Kerryn Pike
Lorien Porter Roger Price Stephanie
Rainey-Smith Parnesh Raniga Alan Rembach
Miroslava Rimajova Jo Robertson Mark
Rodrigues Elizabeth Ronsisvalle Rebecca Rumble
Christopher Rowe Olivier Salvado Jack Sach Greg
Savage Cassandra Szoeke Kevin Taddei Tania
Taddei Brett Trounson Marinos Tsikkos Victor
Villemagne Stacey Walker Vanessa Ward Michael
Woodward Olga Yastrubetskaya
Osca Acosta David Ames Jennifer Ames Manoj
Agarwal David Baxendale Kiara Bechta-Metti Carlita
Bevage Lindsay Bevege Pierrick Bourgeat Belinda
Brown Rachel Buckley Ashley Bush Tiffany
Cowie Kathleen Crowley Andrew Currie David
Darby Daniela De Fazio Harriet Downing Denise El-
Sheikh Kathryn Ellis Kerryn Dickinson   Noel
Faux Jurgen Fripp Christopher Fowler Veer Gupta
Karra Harrington Gareth Jones
Adrian Kamer Jane Khoo Asawari Killedar Neil
Killeen Tae Wan Kim Eleftheria
Kotsopoulos Gobhathai Kunarak Rebecca
Lachovitski Nat Lenzo Qiao-Xin Li Xiao Liang
Kathleen Lucas James Lui Georgia Martins Ralph
Martins Paul Maruff Colin Masters Sabine
Matthaes Andrew Milner Claire Montague Lynette
Moore Audrey Muir Christopher OHalloran Graeme
O'Keefe  Anita Panayiotou Athena Paton Jacqui
Paton Jeremiah Peiffer