Initially improved MCI: Alzheimer's disease biomarkers may aid prognosis

  • Vermunt L & al.
  • Neurology
  • 8 May 2019

  • International Clinical Digest
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Takeaway

  • Among patients with mild cognitive impairment (MCI) who have had reversion to normal cognition, a set of biomarkers may help identify those who will go on to experience subsequent progression to MCI again or to dementia.

Why this matters

  • Importance of reliable prognostication for counseling, treatment planning.

Key results

  • After 3.2 years:
    • 71% of patients had stable normal cognition.
    • 29% of patients had decline (24% to MCI again, 5% to dementia).
  • Compared with stable patients, patients experiencing decline:
    • Were older (74 vs 69 years; P=.016).
    • Had higher amyloid positron emission tomography standard uptake value ratio (1.21 vs 1.08; P=.026).
    • Had higher Luminex cerebrospinal fluid total tau levels (84 vs 53 pg/mL; P=.042).

Study design

  • Longitudinal cohort study of 61 patients with MCI who had reversion to normal cognition during follow-up of more than 2 years in the Alzheimer’s Disease Neuroimaging Initiative.
  • Main outcome: persistent normal cognition vs decline (repeated MCI or dementia).
  • Funding: ZonMW Memorabel Grant Program; InnovativeMedicines Initiative Joint Undertaking.

Limitations

  • Small sample.
  • Relatively short follow-up.
  • Losses to follow-up.

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