Injury markers predict time to dementia in subjects with MCI and amyloid pathology.
Objectives: Alzheimer disease (AD) can now be diagnosed in subjects with mild cognitive impairment (MCI) using biomarkers. However, little is known about the rate of decline in those subjects. In this cohort study, we aimed to assess the conversion rate to dementia and identify prognostic markers in...
| Publicado en: | Neurology Vol. 79; no. 17; pp. 1809 - 1817 |
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| Autores principales: | , , , , , , , , , , , , , , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Lippincott Williams & Wilkins
10/23/2012
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=108083423&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 108083423 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00283878 NRO jtl: Neurology issn: 00283878 maglogo: N pubinfo: dt: 10/23/2012 vid: 79 iid: 17 pid: 433 pub: Lippincott Williams & Wilkins place: Baltimore, Maryland artinfo: ui: 108083423 108083423 NLM23019259 2011791484 10.1212/WNL.0b013e3182704056 NLM23019259 PMC3475623 108083423 ppf: 1809 ppct: 8 formats: tig: atl: Injury markers predict time to dementia in subjects with MCI and amyloid pathology. aug: au: van Rossum IA Vos SJ Burns L Knol DL Scheltens P Soininen H Wahlund LO Hampel H Tsolaki M Minthon L L'italien G van der Flier WM Teunissen CE Blennow K Barkhof F Rueckert D Wolz R Verhey F Visser PJ van Rossum, Ineke A affil: Department of Neurology, Alzheimer Center, VU University Medical Center, Amsterdam, the Netherlands sug: subj: Alzheimer's Disease Pathology Peptides Metabolism Apolipoproteins Hippocampus Pathology Cognition Disorders Aged Alzheimer's Disease Cerebrospinal Fluid Alzheimer's Disease Biological Markers Cerebrospinal Fluid Prospective Studies Disease Progression Female Human Male Cognition Disorders Cerebrospinal Fluid Cognition Disorders Diagnosis Multicenter Studies Neuropsychological Tests Predictive Value of Tests Psychological Tests Time Factors Nerve Tissue Proteins Cerebrospinal Fluid Aged: 65+ years Female Male ab: Objectives: Alzheimer disease (AD) can now be diagnosed in subjects with mild cognitive impairment (MCI) using biomarkers. However, little is known about the rate of decline in those subjects. In this cohort study, we aimed to assess the conversion rate to dementia and identify prognostic markers in subjects with MCI and evidence of amyloid pathology.Methods: We pooled subjects from the VU University Medical Center Alzheimer Center and the Development of Screening Guidelines and Criteria for Predementia Alzheimer's Disease (DESCRIPA) study. We included subjects with MCI, an abnormal level of β-amyloid(1-42) (Aβ(1-42)) in the CSF, and at least one diagnostic follow-up visit. We assessed the effect of APOE genotype, CSF total tau (t-tau) and tau phosphorylated at threonine 181 (p-tau) and hippocampal volume on time to AD-type dementia using Cox proportional hazards models and on decline on the Mini-Mental State Examination (MMSE) using linear mixed models.Results: We included 110 subjects with MCI with abnormal CSF Aβ(1-42) and a mean MMSE score of 26.3 ± 2.8. During a mean follow-up of 2.2 ± 1.0 (range 0.4-5.0) years, 63 subjects (57%) progressed to AD-type dementia. Abnormal CSF t-tau (hazard ratio [HR] 2.3, 95% confidence interval [CI] 1.1-4.6, p = 0.03) and CSF p-tau (HR 3.5, 95% CI 1.3-9.2, p = 0.01) concentration and hippocampal atrophy (HR 2.5, 95% CI 1.1-5.6, p = 0.02) predicted time to dementia. For subjects with both abnormal t-tau concentration and hippocampal atrophy, HR was 7.3 (95% CI 1.0-55.9, p = 0.06). Furthermore, abnormal CSF t-tau and p-tau concentrations and hippocampal atrophy predicted decline in MMSE score.Conclusions: In subjects with MCI and evidence of amyloid pathology, the injury markers CSF t-tau and p-tau and hippocampal atrophy can predict further cognitive decline. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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