Combination of PET, clinical factors predicts MCI progression

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Takeaway

  • Patients with amnestic mild cognitive impairment (MCI) had high risk for progression to probable Alzheimer’s disease if they had a combination of β-amyloid on positive emission tomography (PET), low hippocampal volume, and poorer cognitive status.

Why this matters

  • Biomarkers have been incorporated into criteria for assessing nature of mild cognitive impairment.

Key results

  • Overall, 42.2% of cohort had positive PET result.
  • 36-month rate of progression to probable Alzheimer’s disease: 36.2% overall, 53.6% in patients with positive PET, 22.8% in patients with negative PET.
  • Risk for progression increased going from positive PET result alone (HR, 2.51; P<.001 then addition of low hippocampal volume p and further poorer cognitive status mild impairment defined by logical memory scale ii score>

Study design

  • Prospective multicenter European and US cohort study of 232 patients with amnestic mild cognitive impairment who underwent flutemetamol F 18, labeled PET, then had local clinical assessments every 6 months for up to 3 years.
  • Physicians strictly blinded to PET results.
  • Main outcome: probable Alzheimer’s disease (independently adjudicated without knowledge of imaging, PET results).
  • Funding: GE Healthcare.

Limitations

  • Fairly high progression rate among patients with negative PET.
  • Possible misclassification regarding probable Alzheimer’s disease.