title: Cognitive, genetic, and brain perfusion factors associated with four year incidence of Alzheimer's disease from mild cognitive impairment.
abstract: BACKGROUND
  There is a range of factors that predict the development of Alzheimer's disease (AD) dementia among patients with amnestic mild cognitive impairment (MCI).
  
  
  OBJECTIVE
  To identify the neuropsychological, genetic, and functional brain imaging data that best predict conversion to AD dementia in patients with amnestic MCI.
  
  
  METHODS
  From an initial group of 42 amnestic MCI patients assessed with neurological, neuropsychological, and brain SPECT, 39 (25 converters, 14 non-converters) were followed for 4 years, and 36 had APOE ε4 genotyping. Baseline neuropsychological data and brain SPECT data were used to predict which of the MCI patients would develop dementia by the end of the 4 years of observation.
  
  
  RESULTS
  The MCI patients who had converted to AD dementia had poorer performance on long-term visual memory and Semantic Fluency tests. The MCI subjects who developed dementia were more likely to carry at least one copy of the APOE ε4 allele (Hazard Risk = 4.22). There was lower brain perfusion in converters than non-converters, mainly in postcentral gyrus. An additional analysis of the SPECT data found differences between the MCI subjects and controls in the posterior cingulate gyrus and the basal forebrain. When the brain imaging and neuropsychological test data were combined in the same Cox regression model, only the neuropsychological test data were significantly associated with time to dementia.
  
  
  CONCLUSIONS
  Although the presence of reduced brain perfusion in postcentral gyrus and basal forebrain indicated an at-risk condition, it was the extent of memory impairment that was linked to the speed of decline from MCI to AD.
authors.affiliation: Memory Clinic of Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain.
authors.forename: Montserrat
authors.initials: M
authors.lastname: Alegret
authors.affiliation: Nuclear Medicine Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain Hospital Universitari Vall d'Hebron-Institut de Recerca, Universitat Autònoma de Barcelona (VHIR-UAB), Barcelona, Spain.
authors.forename: Gemma
authors.initials: G
authors.lastname: Cuberas-Borrós
authors.affiliation: Memory Clinic of Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Espinosa
authors.affiliation: Memory Clinic of Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain Psychiatry Department, Hospital Universitari Vall d'Hebron, CIBERSAM, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Sergi
authors.initials: S
authors.lastname: Valero
authors.affiliation: Memory Clinic of Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain.
authors.forename: Isabel
authors.initials: I
authors.lastname: Hernández
authors.affiliation: Memory Clinic of Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain.
authors.forename: Agustín
authors.initials: A
authors.lastname: Ruíz
authors.affiliation: Departments of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA Departments of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA Departments of Psychology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
authors.forename: James T
authors.initials: JT
authors.lastname: Becker
authors.affiliation: Memory Clinic of Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain.
authors.forename: Maitée
authors.initials: M
authors.lastname: Rosende-Roca
authors.affiliation: Memory Clinic of Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Mauleón
authors.affiliation: Memory Clinic of Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain.
authors.forename: Oscar
authors.initials: O
authors.lastname: Sotolongo
authors.affiliation: Nuclear Medicine Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain Hospital Universitari Vall d'Hebron-Institut de Recerca, Universitat Autònoma de Barcelona (VHIR-UAB), Barcelona, Spain.
authors.forename: Joan
authors.initials: J
authors.lastname: Castell-Conesa
authors.affiliation: Nuclear Medicine Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain Hospital Universitari Vall d'Hebron-Institut de Recerca, Universitat Autònoma de Barcelona (VHIR-UAB), Barcelona, Spain.
authors.forename: Isabel
authors.initials: I
authors.lastname: Roca
authors.affiliation: Memory Clinic of Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain.
authors.forename: Lluís
authors.initials: L
authors.lastname: Tárraga
authors.affiliation: Memory Clinic of Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain.
authors.forename: Mercè
authors.initials: M
authors.lastname: Boada
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis / Q000235:genetics / Q000503:physiopathology; D001057:Apolipoproteins E / Q000235:genetics*; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology*; D060825:Cognitive Dysfunction / Q000235:genetics / Q000473:pathology / Q000503:physiopathology; D018450:Disease Progression; D005260:Female; D007839:Functional Laterality; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D009483:Neuropsychological Tests; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D001057:Apolipoproteins E
keywords: Alzheimer's disease; brain SPECT; cerebral perfusion; four-year follow-up; longitudinal; mild cognitive impairment; prospective; visual memory