Markers of Alzheimer's disease in a population attending a memory clinic.
BACKGROUND
New marker-based criteria for the diagnosis of Alzheimer's disease (AD) were recently proposed. We describe their operational translation in 144 consecutive patients referred to our Memory Clinic.


METHODS
Visual ratings of hippocampal atrophy and of cortical glucose hypometabolism in magnetic resonance imaging and positron emission tomography, and concentrations of total tau and Abeta1-42 in cerebrospinal fluid were assessed in 12 patients with subjective memory complaints (SMCs) (Mini-Mental State Examination [MMSE] score, 28.0 +/- 1.1 [mean +/- SD]), 37 with mild cognitive impairment (MCI) (MMSE, 25.1 +/- 3.6), 55 with AD (MMSE, 21.1 +/- 3.5), and 40 with non-AD dementia (MMSE, 21.6 +/- 5.5).


RESULTS
The sensitivity for AD of each individual biomarker was higher (65% to 87%) than for MCI (18% to 50%). Each biomarker's specificity for SMC and non-AD dementias was good to moderate (83% and 53%). Positivity for at least one marker increased the probability 38 times of belonging to the AD group (P < 0.0001).


CONCLUSIONS
The new diagnostic criteria can be operationalized in clinical routines, but longitudinal studies of MCI patients will need to assess the criteria's prognostic value.
Frisoni
Giovanni B
GB
Laboratory of Epidemiology Neuroimaging and Telemedicine, IRCCS Centro San Giovanni di Dio FBF, Brescia, Italy. gfrisoni@fatebenefratelli.it
Prestia
Annapaola
A
Zanetti
Orazio
O
Galluzzi
Samantha
S
Romano
Melissa
M
Cotelli
Maria
M
Gennarelli
Massimo
M
Binetti
Giuliano
G
Bocchio
Luisella
L
Paghera
Barbara
B
Amicucci
Giovanni
G
Bonetti
Matteo
M
Benussi
Luisa
L
Ghidoni
Roberta
R
Geroldi
Cristina
C
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000134:cerebrospinal fluid / Q000000981:diagnostic imaging / Q000473:pathology*; D016229:Amyloid beta-Peptides / Q000032:analysis / Q000134:cerebrospinal fluid*; D001284:Atrophy / Q000134:cerebrospinal fluid / Q000000981:diagnostic imaging / Q000473:pathology; D015415:Biomarkers / Q000032:analysis / Q000134:cerebrospinal fluid; D002540:Cerebral Cortex / Q000000981:diagnostic imaging / Q000378:metabolism / Q000503:physiopathology; D003072:Cognition Disorders / Q000134:cerebrospinal fluid / Q000000981:diagnostic imaging / Q000473:pathology; D015331:Cohort Studies; D005260:Female; D005947:Glucose / Q000378:metabolism*; D006624:Hippocampus / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008569:Memory Disorders / Q000134:cerebrospinal fluid / Q000000981:diagnostic imaging / Q000473:pathology*; D008875:Middle Aged; D009483:Neuropsychological Tests; D010446:Peptide Fragments / Q000032:analysis / Q000134:cerebrospinal fluid*; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D016875:tau Proteins / Q000032:analysis / Q000134:cerebrospinal fluid*
D016229:Amyloid beta-Peptides; D015415:Biomarkers; D010446:Peptide Fragments; C075222:amyloid beta-protein (1-42); D016875:tau Proteins; D005947:Glucose