|
Title
|
|
|
|
Prevalence and prognosis of Alzheimer's disease at the mild cognitive impairment stage
| |
|
Author
|
|
|
|
| |
|
Abstract
|
|
|
|
| Three sets of research criteria are available for diagnosis of Alzheimers disease in subjects with mild cognitive impairment: the International Working Group-1, International Working Group-2, and National Institute of Aging-Alzheimer Association criteria. We compared the prevalence and prognosis of Alzheimers disease at the mild cognitive impairment stage according to these criteria. Subjects with mild cognitive impairment (n = 1607), 766 of whom had both amyloid and neuronal injury markers, were recruited from 13 cohorts. We used cognitive test performance and available biomarkers to classify subjects as prodromal Alzheimers disease according to International Working Group-1 and International Working Group-2 criteria and in the high Alzheimers disease likelihood group, conflicting biomarker groups (isolated amyloid pathology or suspected non-Alzheimer pathophysiology), and low Alzheimers disease likelihood group according to the National Institute of Ageing-Alzheimer Association criteria. Outcome measures were the proportion of subjects with Alzheimers disease at the mild cognitive impairment stage and progression to Alzheimers disease-type dementia. We performed survival analyses using Cox proportional hazards models. According to the International Working Group-1 criteria, 850 (53%) subjects had prodromal Alzheimers disease. Their 3-year progression rate to Alzheimers disease-type dementia was 50% compared to 21% for subjects without prodromal Alzheimers disease. According to the International Working Group-2 criteria, 308 (40%) subjects had prodromal Alzheimers disease. Their 3-year progression rate to Alzheimers disease-type dementia was 61% compared to 22% for subjects without prodromal Alzheimers disease. According to the National Institute of Ageing-Alzheimer Association criteria, 353 (46%) subjects were in the high Alzheimers disease likelihood group, 49 (6%) in the isolated amyloid pathology group, 220 (29%) in the suspected non-Alzheimer pathophysiology group, and 144 (19%) in the low Alzheimers disease likelihood group. The 3-year progression rate to Alzheimers disease-type dementia was 59% in the high Alzheimers disease likelihood group, 22% in the isolated amyloid pathology group, 24% in the suspected non-Alzheimer pathophysiology group, and 5% in the low Alzheimers disease likelihood group. Our findings support the use of the proposed research criteria to identify Alzheimers disease at the mild cognitive impairment stage. In clinical settings, the use of both amyloid and neuronal injury markers as proposed by the National Institute of Ageing-Alzheimer Association criteria offers the most accurate prognosis. For clinical trials, selection of subjects in the National Institute of Ageing-Alzheimer Association high Alzheimers disease likelihood group or the International Working Group-2 prodromal Alzheimers disease group could be considered. |
| |
|
Language
|
|
|
|
English
| |
|
Source (journal)
|
|
|
|
Brain. - London
| |
|
Publication
|
|
|
|
London
:
2015
| |
|
ISSN
|
|
|
|
0006-8950
| |
|
DOI
|
|
|
|
10.1093/BRAIN/AWV029
| |
|
Volume/pages
|
|
|
|
138
:5
(2015)
, p. 1327-1338
| |
|
ISI
|
|
|
|
000353834100027
| |
|
Pubmed ID
|
|
|
|
25693589
| |
|
Full text (Publisher's DOI)
|
|
|
|
| |
|
Full text (open access)
|
|
|
|
| |
|
Full text (publisher's version - intranet only)
|
|
|
|
| |
|