1. in Younger and Older African Americans and Whites
Different CSF Total Tau and Phosphorylated Tau, but not Aβ,
in Younger and Older African Americans and Whites
Whitney Wharton, PhD Associate Professor, Nursing & Neurology
Emory University

2. Funding, Disclosures No Disclosures Funding
NIA K01, R01, Admin Supp to Address Health Disparities
NINR
Alzheimer’s Association PTC VA
Emory ADRC and School of Nursing

3. Early Detection MCI Mild AD Moderate AD Severe AD Increasing Age
Normal Cognition
MCI
Worse Cognitive Abilities  better
Mild AD
Moderate AD
Start Treatment HERE
Severe AD
95 Years
Increasing Age

4. Shifting the curve What factors can we identify that….
Are linked to cognitive decline
Are linked to AD pathology (plaques and tangles)
Occur during midlife
Treatable / reversible

5. Who is most at risk for AD?
African Americans
Women
Middle Age
Increased Vascular risk
Family History
Caregivers
To Help the Most People Possible, We Must Target Those Most at Risk!!

6. The meta-analysis showed that the AD rate for AAs was 64% higher than for Whites
(RR = 1.64 (95% CI )), with no evidence of heterogeneity.
We estimated the current US AD prevalence for ages 65–90
to be 5.5% for Whites, and 8.6% for AAs (prevalence ratio 1.56)
African Americans have increased incidence AND prevalence

9. Prevention Study for High Risk Individuals: ASCEND
Observational, NIA funded
N=80, 2 yrs, annual visits, 45-65yrs, parental history of AD
Determine the extent to which change in peripheral vascular function may influence 1) Aβ, tau in CSF 2) CSF and blood inflammation 3) cognition
EndoPAT, FMD, PWV, plasma RAS and ambulatory blood pressure
CSF, MRI, blood, cognitive testing, inflammatory markers, extensive Qs (sleep, exercise, nutrition, stress, discrimination, sexual and reproductive history)

10. Demographics and Clinical

11. AD Biomarkers in CSF

12. Race differences in CSF p-tau and t-tau, but not Aβ
Race modified the relationship between t-tau & IL-9 (p=0.018), and p-tau and IL-9 (p<0.001)

13. Take Away
This is the 3rd study to show reduced p and t tau, but not Aβ, in African Americans vs Whites
First study to show changes in middle age, healthy cohort
3 studies, different labs and platforms