title: Role of cerebrospinal fluid biomarkers to predict conversion to dementia in patients with mild cognitive impairment: a clinical cohort study.
abstract: BACKGROUND
  Cerebrospinal fluid (CSF) levels assessment of Aβ1-42 and Tau proteins may be accurate diagnostic biomarkers for the differentiation of preclinical Alzheimer's disease (AD) from age-associated memory impairment, depression and other forms of dementia in patients with mild cognitive impairment (MCI). The aim of our study was to explore the utility of CSF biomarkers in combination with common cognitive markers as predictors for the risk of AD development, and other forms of dementia, and the time to conversion in community patients with MCI.
  
  
  METHODS
  A group of 71 MCI patients underwent neurological assessment, extended neuropsychological evaluation, routine blood tests, ApoE determination, and lumbar puncture to dose t-tau, p-tau181, Aβ1-42. We investigated baseline CSF and neuropsychological biomarker patterns according to groups stratified with later diagnoses of AD conversion (MCI-AD), other dementia (MCI-NAD) conversion, or clinical stability (sMCI).
  
  
  RESULTS
  Baseline Aβ1-42 CSF levels were significantly lower in MCI-AD patients compared to both sMCI and MCI-NAD. Additionally, p-tau181 was higher in the MCI-AD group compared to sMCI. The MCI-AD subgroup analysis confirmed the role of Aβ1-42 in its predictive role of time to conversion: rapid converters had lower Aβ1-42 levels compared to slow converters. Logistic regression and survival analysis further supported the key predictive role of baseline Aβ1-42 for incipient AD and dementia-free survival.
  
  
  CONCLUSIONS
  Our results confirm the key role of CSF biomarkers in predicting patient conversion from MCI to dementia. The study suggests that CSF biomarkers may also be reliable in a real world clinical setting.
authors.forename: Manuela
authors.initials: M
authors.lastname: Tondelli
authors.forename: Roberta
authors.initials: R
authors.lastname: Bedin
authors.forename: Annalisa
authors.initials: A
authors.lastname: Chiari
authors.forename: Maria Angela
authors.initials: MA
authors.lastname: Molinari
authors.forename: Guendalina
authors.initials: G
authors.lastname: Bonifacio
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Lelli
authors.forename: Tommaso
authors.initials: T
authors.lastname: Trenti
authors.forename: Paolo
authors.initials: P
authors.lastname: Nichelli
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000032:analysis; D002555:Cerebrospinal Fluid / Q000737:chemistry*; D060825:Cognitive Dysfunction / Q000134:cerebrospinal fluid* / Q000175:diagnosis*; D015331:Cohort Studies; D003704:Dementia / Q000134:cerebrospinal fluid* / Q000175:diagnosis*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D012044:Regression Analysis
chemical_list: D015415:Biomarkers