Abnormal cerebrospinal fluid (CSF) and magnetic resonance imaging (MRI) findings are highly predictive of Alzheimer disease (AD) dementia risk in patients with mild cognitive impairment, according to a study published in JAMA Neurology.
Investigators analyzed patient data from the Amsterdam Dementia Cohort, including only patients with mild cognitive impairment (n=525). Specifically, the researchers examined patient characteristics, such as age, gender, Mini-Mental State Examination (MMSE) score, and MRI scans to determine associative risk for AD dementia.
The investigators found that younger men with an MMSE score of 29 had a lower risk for 3-year progression to AD dementia compared with older women with a 24 MMSE score (26% [95% CI, 19%-34%] vs 76% [95% CI, 65%-84%], respectively).
Abnormal MRI results were associated with an 86% (95% CI, 71%-95%) progression to disease risk at 3 years and a 27% (95% CI, 17%-41%) progression to disease risk at 1 year. Normal MRI results correlated with 3- and 1-year progression to disease risks of 18% (95% CI, 13%-27%) and 3% (95% CI, 2%-5%).
In addition, abnormal CSF test results were associated with 3- and 1-year progression to AD dementia risk of 82% (95% CI, 73%-89%) and 26% (95% CI, 20%-33%), respectively. Lower 3- and 1-year progression to disease risk was found in the presence of normal CSF results (6% [95% CI, 3%-9%] and 1% [95% CI, 0.5%-2%], respectively).
The average follow-up in this study was 2.4 years, which may be too short to provide insight into longer-term progression to disease risks in this cohort. In addition, the investigators note that the generalizability of the findings remains a current challenge.
Despite these limitations, the prognostic models used in this study “show how biomarker research can be translated into clinical practice in a tractable manner” and may “help determine AD dementia and any type of dementia in patients with mild cognitive impairment at the individual level.”
van Maurik IS, Zwan MD, Tijms BM; Alzheimer’s Disease Neuroimaging Initiative. Interpreting biomarker results in individual patients with mild cognitive impairment in the Alzheimer’s Biomarkers in Daily Practice (ABIDE) project [published online October 16, 2017]. JAMA Neurol. doi:10.1001/jamaneurol.2017.2712