title: Searching for Primary Predictors of Conversion from Mild Cognitive Impairment to Alzheimer's Disease: A Multivariate Follow-Up Study.
abstract: Recent proposals of diagnostic criteria within the healthy aging-Alzheimer's disease (AD) continuum stressed the role of biomarker information. More importantly, such information might be critical to predict those mild cognitive impairment (MCI) patients at a higher risk of conversion to AD. Usually, follow-up studies utilize a reduced number of potential markers although the conversion phenomenon may be deemed as multifactorial in essence. In addition, not only biological but also cognitive markers may play an important role. Considering this background, we investigated the role of cognitive reserve, cognitive performance in neuropsychological testing, hippocampal volumes, APOE genotype, and magnetoencephalography power sources to predict the conversion to AD in a sample of 33 MCI patients. MCIs were followed up during a 2-year period and divided into two subgroups according to their outcome: The "stable" MCI group (sMCI, 21 subjects) and the "progressive" MCI group (pMCI, 12 subjects). Baseline multifactorial information was submitted to a hierarchical logistic regression analysis to build a predictive model of conversion to AD. Results indicated that the combination of left hippocampal volume, occipital cortex theta power, and clock drawing copy subtest scores predicted conversion to AD with a 100% of sensitivity and 94.7% of specificity. According to these results it might be suggested that anatomical, cognitive, and neurophysiological markers may be considered as "first order" predictors of progression to AD, while APOE or cognitive reserve proxies might play a more secondary role.
authors.affiliation: Laboratory of Neuropsychology, Universitat de les Illes Balears, Palma de Mallorca, Spain.|Laboratory of Cognitive and Computational Neuroscience, Center for Biomedical Technology, Complutense University of Madrid and Technical University of Madrid, Spain.|Institute of Sanitary Investigation [IdISSC], San Carlos University Hospital, Madrid, Spain.
authors.forename: María Eugenia
authors.initials: ME
authors.lastname: López
authors.affiliation: Institute of Sanitary Investigation [IdISSC], San Carlos University Hospital, Madrid, Spain.|Department of Biostatistics and Operational Investigation, Complutense University of Madrid, Spain.
authors.forename: Agustín
authors.initials: A
authors.lastname: Turrero
authors.affiliation: Laboratory of Cognitive and Computational Neuroscience, Center for Biomedical Technology, Complutense University of Madrid and Technical University of Madrid, Spain.
authors.forename: Pablo
authors.initials: P
authors.lastname: Cuesta
authors.affiliation: Laboratory of Cognitive and Computational Neuroscience, Center for Biomedical Technology, Complutense University of Madrid and Technical University of Madrid, Spain.|Department of Basic Psychology II, Complutense University of Madrid, Spain.
authors.forename: David
authors.initials: D
authors.lastname: López-Sanz
authors.affiliation: Laboratory of Cognitive and Computational Neuroscience, Center for Biomedical Technology, Complutense University of Madrid and Technical University of Madrid, Spain.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Bruña
authors.affiliation: Institute of Sanitary Investigation [IdISSC], San Carlos University Hospital, Madrid, Spain.|Neurology Department, San Carlos University Hospital, Madrid, Spain.
authors.forename: Alberto
authors.initials: A
authors.lastname: Marcos
authors.affiliation: Institute of Sanitary Investigation [IdISSC], San Carlos University Hospital, Madrid, Spain.|Geriatrics Department, San Carlos University Hospital, Madrid, Spain.
authors.forename: Pedro
authors.initials: P
authors.lastname: Gil
authors.affiliation: Institute of Sanitary Investigation [IdISSC], San Carlos University Hospital, Madrid, Spain.|Radiology Department, San Carlos University Hospital, Madrid, Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Yus
authors.affiliation: Institute of Sanitary Investigation [IdISSC], San Carlos University Hospital, Madrid, Spain.|Laboratory of Psychoneuroendocrinology and Molecular Genetics, Biomedical Research Foundation, San Carlos University Hospital, Madrid, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Barabash
authors.affiliation: Institute of Sanitary Investigation [IdISSC], San Carlos University Hospital, Madrid, Spain.|Laboratory of Psychoneuroendocrinology and Molecular Genetics, Biomedical Research Foundation, San Carlos University Hospital, Madrid, Spain.
authors.forename: José Antonio
authors.initials: JA
authors.lastname: Cabranes
authors.affiliation: Laboratory of Cognitive and Computational Neuroscience, Center for Biomedical Technology, Complutense University of Madrid and Technical University of Madrid, Spain.|Institute of Sanitary Investigation [IdISSC], San Carlos University Hospital, Madrid, Spain.|Department of Basic Psychology II, Complutense University of Madrid, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Maestú
authors.affiliation: Laboratory of Cognitive and Computational Neuroscience, Center for Biomedical Technology, Complutense University of Madrid and Technical University of Madrid, Spain.|Institute of Sanitary Investigation [IdISSC], San Carlos University Hospital, Madrid, Spain.|Department of Psychiatry, Faculty of Medicine, Complutense University of Madrid, Spain.
authors.forename: Alberto
authors.initials: A
authors.lastname: Fernández
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000235:genetics / Q000503:physiopathology; D001057:Apolipoproteins E / Q000235:genetics; D001921:Brain / Q000000981:diagnostic imaging / Q000503:physiopathology; D060825:Cognitive Dysfunction / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000235:genetics / Q000503:physiopathology; D058245:Cognitive Reserve; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D015225:Magnetoencephalography; D008297:Male; D008609:Mental Status Schedule; D015999:Multivariate Analysis; D009483:Neuropsychological Tests; D009929:Organ Size; D011379:Prognosis; D012680:Sensitivity and Specificity
chemical_list: D001057:Apolipoproteins E
keywords: APOE; Alzheimer’s disease; cognitive reserve; hippocampal volume; magnetoencephalography; mild cognitive impairment; neuropsychological tests; predictive model