Comparison of Brief Cognitive Tests and CSF Biomarkers in Predicting Alzheimer’s Disease in Mild Cognitive Impairment: Six-Year Follow-Up StudyReport as inadecuate




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Introduction

Early identification of Alzheimer’s disease AD is needed both for clinical trials and in clinical practice. In this study, we compared brief cognitive tests and cerebrospinal fluid CSF biomarkers in predicting conversion from mild cognitive impairment MCI to AD.

Methods

At a memory clinic, 133 patients with MCI were followed until development of dementia or until they had been stable over a mean period of 5.9 years range 3.2–8.8 years. The Mini-Mental State Examination MMSE, the clock drawing test, total tau, tau phosphorylated at Thr181 P-tau and amyloid-β1–42 Aβ42 were assessed at baseline.

Results

During clinical follow-up, 47% remained cognitively stable and 53% developed dementia, with an incidence of 13.8%-year. In the group that developed dementia the prevalence of AD was 73.2%, vascular dementia 14.1%, dementia with Lewy bodies DLB 5.6%, progressive supranuclear palsy PSP 4.2%, semantic dementia 1.4% and dementia due to brain tumour 1.4%. When predicting subsequent development of AD among patients with MCI, the cognitive tests classified 81% of the cases correctly AUC, 0.85; 95% CI, 0.77–0.90 and CSF biomarkers 83% AUC, 0.89; 95% CI, 0.82–0.94. The combination of cognitive tests and CSF AUC, 0.93; 95% CI 0.87 to 0.96 was significantly better than the cognitive tests p = 0.01 and the CSF biomarkers p = 0.04 alone when predicting AD.

Conclusions

The MMSE and the clock drawing test were as accurate as CSF biomarkers in predicting future development of AD in patients with MCI. Combining both instruments provided significantly greater accuracy than cognitive tests or CSF biomarkers alone in predicting AD.



Author: Sebastian Palmqvist , Joakim Hertze, Lennart Minthon, Carina Wattmo, Henrik Zetterberg, Kaj Blennow, Elisabet Londos, Oskar Hanss

Source: http://plos.srce.hr/



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