Changes in cognition during the preclinical phase of Alzheimer's Disease: Findings from the Wisconsin Registry for Alzheimer's Prevention (WRAP)

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Educational Objectives
  1. Summarize the techniques used to assess Alzheimer’s disease proteinopathy including imaging and biofluids.
  2. Describe the biological processes that appear to drive cognitive decline and their temporal scale in the presymptomatic stage of Alzheimer’s disease.
  3. Compare the relative value of a biological definition of AD to a clinical definition.


Course Information
Target Audience:Intermediate
Availability:Date Available: 2022-10-18
  You may obtain CE for this webinar at any time.
Offered for CE Yes
Cost Members $20
Non-Members $30
Refund Policy This webinar is not eligible for refunds
CE Credits 1.0
The cognitively unimpaired stage of Alzheimer’s disease (AD) is quite long in duration, but the interval varies widely from person to person. This talk will describe some of the brain and cognitive changes that we have observed from over a decade of biomarker imaging within the Wisconsin Registry for Alzheimer’s Prevention (WRAP) and related studies. The talk will give an overview of the WRAP study including its approach to measuring cognition, and describe the approaches to biomarker imaging we and others use to characterize AD proteinopathy. I’ll describe how we have derived temporal information from biomarker imaging such that age of onset of AD proteinopathy and disease duration can be estimated. I’ll also describe some of the factors that influence age of onset and duration of the pre-symptomatic stage of AD duration of the pre-symptomatic stage of AD.

  1. Betthauser, T. J., Bilgel, M., Koscik, R. L., Jedynak, B. M., An, Y., Kellett, K. A., . . . Alzheimer's Disease Neuroimaging, I. (2022). Multi-method investigation of factors influencing amyloid onset and impairment in three cohorts. Brain. doi:10.1093/brain/awac213
  2. Jack, C. R., Jr., Bennett, D. A., Blennow, K., Carrillo, M. C., Dunn, B., Haeberlein, S. B., . . . Contributors. (2018). NIA-AA Research Framework: Toward a biological definition of Alzheimer's disease. Alzheimers Dement, 14(4), 535-562. doi:10.1016/j.jalz.2018.02.018
  3. Johnson, S. C., Koscik, R. L., Jonaitis, E. M., Clark, L. R., Mueller, K. D., Berman, S. E., . . . Sager, M. A. (2018). The Wisconsin Registry for Alzheimer's Prevention: A review of findings and current directions. Alzheimers Dement (Amst), 10, 130-142. doi:10.1016/j.dadm.2017.11.007
  4. Koscik, R. L., Betthauser, T. J., Jonaitis, E. M., Allison, S. L., Clark, L. R., Hermann, B. P., . . . Johnson, S. C. (2020). Amyloid duration is associated with preclinical cognitive decline and tau PET. Alzheimers Dement (Amst), 12(1), e12007. doi:10.1002/dad2.12007
  5. Schindler, S. E., Li, Y., Buckles, V. D., Gordon, B. A., Benzinger, T. L. S., Wang, G., . . . Xiong, C. (2021). Predicting Symptom Onset in Sporadic Alzheimer Disease With Amyloid PET. Neurology, 97(18), e1823-e1834. doi:10.1212/WNL.0000000000012775

Dr. Johnson receives a consulting fee from Roche Diagnostics, Prothena and Merck.

  • Sterling Johnson, PhD is a clinical neuropsychologist and the Jean R. Finley Professor of Geriatrics and Dementia in the University of Wisconsin School of Medicine and Public Health where he has worked since 2002. He is the Associate Director and Biomarker Core leader of the Wisconsin Alzheimer’s Disease Research Center. He is also the principal investigator of the Wisconsin Registry for Alzheimer’s Prevention (or WRAP) which is a long-running observational longitudinal cohort study of 1700 adults who are enriched for risk of Alzheimer’s Disease due to parental family history. Johnson’s lab is interested in longitudinal brain changes in preclinical AD that define its window, and in disambiguating the brain and cognitive changes that take place in AD and related disorders including vascular disease from normal aging as early as possible using imaging and fluid biomarkers and cognitive measures. His research has been continuously funded by the NIH since 1997. He has authored or coauthored over 350 peer reviewed publications.