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Prediction of AD dementia by biomarkers following the NIA-AA and IWG diagnostic criteria in MCI patients from three European memory clinics.

Journal article
Authors Annapaola Prestia
Anna Caroli
Sara K Wade
Wiesjie M van der Flier
Rik Ossenkoppele
Bart Van Berckel
Frederik Barkhof
Charlotte E Teunissen
Anders Wall
Stephen F Carter
Michael Schöll
Il Han Choo
Agneta Nordberg
Philip Scheltens
Giovanni B Frisoni
Published in Alzheimer's & dementia : the journal of the Alzheimer's Association
Volume 11
Issue 10
Pages 1191-201
ISSN 1552-5279
Publication year 2015
Published at
Pages 1191-201
Language en
Links dx.doi.org/10.1016/j.jalz.2014.12.0...
www.ncbi.nlm.nih.gov/entrez/query.f...
Keywords Aged, Aged, 80 and over, Alzheimer Disease, diagnosis, Amyloid beta-Peptides, cerebrospinal fluid, Amyloidosis, Atrophy, Biomarkers, cerebrospinal fluid, Disease Progression, Fluorodeoxyglucose F18, Hippocampus, pathology, Humans, Male, Middle Aged, Positron-Emission Tomography, Predictive Value of Tests, Prognosis, Sensitivity and Specificity, tau Proteins, cerebrospinal fluid
Subject categories Medical Biotechnology, Clinical Medicine

Abstract

Proposed diagnostic criteria (international working group and National Institute on Aging and Alzheimer's Association) for Alzheimer's disease (AD) include markers of amyloidosis (abnormal cerebrospinal fluid [CSF] amyloid beta [Aβ]42) and neurodegeneration (hippocampal atrophy, temporo-parietal hypometabolism on [18F]-fluorodeoxyglucose-positron emission tomography (FDG-PET), and abnormal CSF tau). We aim to compare the accuracy of these biomarkers, individually and in combination, in predicting AD among mild cognitive impairment (MCI) patients.In 73 MCI patients, followed to ascertain AD progression, markers were measured. Sensitivity and specificity, positive (LR+) and negative (LR-) likelihood ratios, and crude and adjusted hazard ratios were computed.Twenty-nine MCI patients progressed and 44 remained stable. Positivity to any marker achieved the lowest LR- (0.0), whereas the combination Aβ42 plus FDG-PET achieved the highest LR+ (6.45). In a survival analysis, positivity to any marker was associated with 100% conversion rate, whereas negativity to all markers was associated with 100% stability.The best criteria combined amyloidosis and neurodegeneration biomarkers, whereas the individual biomarker with the best performance was FDG-PET.

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