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

被引:450
作者
Visser, Pieter Jelle [1 ,2 ,3 ]
Verhey, Frans [2 ]
Knol, Dirk L. [4 ]
Scheltens, Philip [3 ]
Wahlund, Lars-Olof [7 ]
Freund-Levi, Yvonne [7 ]
Tsolaki, Magda [10 ]
Minthon, Lennart [8 ]
Wallin, Asa K. [8 ]
Hampel, Harald [11 ,12 ,13 ]
Buerger, Katharina [11 ]
Pirttila, Tuula [14 ,15 ]
Soininen, Hilkka [14 ,15 ]
Rikkert, Marcel Olde [5 ]
Verbeek, Marcel M. [6 ]
Spiru, Luiza [16 ]
Blennow, Kaj [9 ]
机构
[1] Univ Maastricht, Dept Psychiat, NL-6200 MD Maastricht, Netherlands
[2] Univ Maastricht, Dept Psychiat & Neuropsychol, Alzheimer Ctr Limburg, NL-6200 MD Maastricht, Netherlands
[3] Vrije Univ Amsterdam Med Ctr, Dept Neurol, Alzheimer Ctr, Amsterdam, Netherlands
[4] Vrije Univ Amsterdam Med Ctr, Dept Clin Epidemiol & Stat, Amsterdam, Netherlands
[5] Radboud Univ Nijmegen, Med Ctr, Alzheimer Ctr,Nijmegen Ctr Evidence Based Practic, Dept Geriatr, NL-6525 ED Nijmegen, Netherlands
[6] Radboud Univ Nijmegen, Med Ctr, Donders Ctr Brain Cognit & Behav,Alzheimer Ctr, Dept Neurol, NL-6525 ED Nijmegen, Netherlands
[7] Karolinska Univ Hosp, Karolinska Inst, Dept NVS, Sect Clin Geriatr, Huddinge, Sweden
[8] Lund Univ, Dept Clin Sci Malmo, Clin Memory Res Unit, S-22100 Lund, Sweden
[9] Gothenburg Univ, Sahlgrenska Univ Hosp, Clin Neurochem Lab, Molndal, Sweden
[10] Aristotle Univ Thessaloniki, Dept Neurol 3, Memory & Dementia Ctr, G Papanicolaou Gen Hosp, GR-54006 Thessaloniki, Greece
[11] Univ Munich, Dept Psychiat, Alzheimer Mem Ctr, D-8000 Munich, Germany
[12] Univ Dublin Trinity Coll, Adelaide & Meath Hosp Incorporating, Natl Childrens Hosp, Discipline Psychiat,Sch Med, Dublin 2, Ireland
[13] Univ Dublin Trinity Coll, Adelaide & Meath Hosp Incorporating, Natl Childrens Hosp, Lab Neuroimaging & Biomarker Res,TCIN, Dublin 2, Ireland
[14] Univ Kuopio, Dept Neurol, Kuopio, Finland
[15] Kuopio Univ Hosp, SF-70210 Kuopio, Finland
[16] Carol Davila Univ Med & Pharm, Bucharest, Romania
关键词
CEREBROSPINAL-FLUID TAU; PHOSPHORYLATED-TAU; CLINICAL-DIAGNOSIS; NORMATIVE DATA; DEMENTIA; BIOMARKERS; CRITERIA; SCALE; PARTICIPANTS; ASSOCIATION;
D O I
10.1016/S1474-4422(09)70139-5
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
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 A beta(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 A beta(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.
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收藏
页码:619 / 627
页数:9
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