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Prevalence and prognostic value of CSF markers of Alzheimer's disease pathology in patients with subjective cognitive impairment or mild cognitive impairment in the DESCRIPA study: a prospective cohort study
Department of Psychiatry and Neuropsychology, Alzheimer Center Limburg, University of Maastricht, Netherlands; Department of Neurology, Alzheimer Center, VU University Medical Center, Amsterdam, Netherlands.
Department of Psychiatry and Neuropsychology, Alzheimer Center Limburg, University of Maastricht, Netherlands.
Department of Clinical Epidemiology and Statistics, VU University Medical Center, Amsterdam, Netherlands.
Department of Neurology, Alzheimer Center, VU University Medical Center, Amsterdam, Netherlands.
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2009 (English)In: Lancet Neurology, ISSN 1474-4422, E-ISSN 1474-4465, Vol. 8, no 7, p. 619-627Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Alzheimer's disease (AD) pathology is common in patients with amnestic mild cognitive impairment (aMCI) without dementia, but the prevalence of AD pathology in patients with subjective cognitive impairment (SCI) and non-amnestic mild cognitive impairment (naMCI) is unknown. AD is characterised by decreased CSF concentrations of Abeta(42) and increased concentrations of tau. We investigated the prevalence of a CSF AD profile in patients with SCI, naMCI, or aMCI and the association of this profile with cognitive outcome in each group.

METHODS: Patients with SCI, naMCI, aMCI, and neurologically healthy controls were recruited from 20 memory clinics across Europe, between January, 2003, and June, 2005, into this prospective cohort study. A CSF AD profile was defined as an abnormal ratio of Abeta(42):tau. Patients were assessed annually up to 3 years. Outcome measures were changes in memory, overall cognition, mini-mental state examination (MMSE) score, daily function, and progression to AD-type dementia.

FINDINGS: The CSF AD profile was more common in patients with SCI (31 of 60 [52%]), naMCI (25 of 37 [68%]), and aMCI (56 of 71 [79%]) than in healthy controls (28 of 89 [31%]). The profile was associated with cognitive decline in patients with naMCI (memory, MMSE, and daily function) and in patients with aMCI (MMSE and daily function). In patients with aMCI, a CSF AD profile was predictive of AD-type dementia (OR 26.8, 95% CI 1.6-456.4).

INTERPRETATION: AD is a common cause of SCI, naMCI, and aMCI and is associated with cognitive decline in patients with naMCI or aMCI. Patients with SCI might be in the early stages of AD, and cognitive decline might become apparent only after longer follow-up.

Place, publisher, year, edition, pages
The Lancet Publishing Group , 2009. Vol. 8, no 7, p. 619-627
National Category
Neurology
Identifiers
URN: urn:nbn:se:oru:diva-74162DOI: 10.1016/S1474-4422(09)70139-5ISI: 000267643700018PubMedID: 19523877Scopus ID: 2-s2.0-67649628753OAI: oai:DiVA.org:oru-74162DiVA, id: diva2:1314558
Note

Funding agencies:

European Commission 5th Framework Programme (QLK-6-CT-2002-02455)

Ana Aslan International Foundation

Available from: 2019-05-09 Created: 2019-05-09 Last updated: 2019-05-27Bibliographically approved

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Freund-Levi, Yvonne

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