Combination of clinical and neuropsychologic information as a better predictor of the progression to Alzheimer disease in questionable dementia individuals.
OBJECTIVE
This study aimed to examine the clinical outcomes of questionable dementia (QD) elderly subjects after three years of follow-up and to compare the ability of a standardized clinical assessment, neuropsychologic tests, the ApoE genotyping, and possible combinations of these methods to predict their progression to Alzheimer disease (AD).


METHODS
One hundred six elderly subjects with QD were evaluated with a standardized clinical assessment, neuropsychologic tests, and ApoE genotyping and followed up annually. The Clinical Dementia Rating Sum of Boxes (CDR-SOB) score was used as a quantitative summary score of the standardized clinical assessment on the overall functioning of the subjects.


RESULTS
Among the individuals remaining in the study after the 3-year follow-up period, 8.3% had improved to a state of normal cognition, 72.7% were still in the QD state. and 19.4% had progressed to clinically evident AD. Although each of CDR-SOB, Word List Recall (WLR), and ApoE epsilon4 genotype was predictive for AD, the combination of CDR-SOB and WLR was found to predict AD better than any single variable. However, the addition of the ApoE epsilon4 genotype information to CDR-SOB or WLR did not improve their predictive ability.


CONCLUSIONS
The combination of clinical assessment on function and episodic memory test can improve the predictive ability of each measure for progression to AD in QD individuals. However, ApoE genotyping dose not make an additional contribution to AD prediction in QD individuals when used in combination with clinical assessment or memory test.
Department of Neuropsychiatry and Clinical Research Institute, Seoul National University Hospital, Seoul, Korea.
Dong Young
DY
Lee
Jong Choul
JC
Youn
Il Han
IH
Choo
Ki Woong
KW
Kim
Jin Hyeong
JH
Jhoo
Yong Su
YS
Pak
Kwon Woo
KW
Suh
Jong Inn
JI
Woo
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D001057:Apolipoproteins E / Q000097:blood / Q000235:genetics; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology; D003072:Cognition Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D003704:Dementia / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology; D003937:Diagnosis, Differential; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005838:Genotype; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed
D001057:Apolipoproteins E