Prevalence of preclinical Alzheimer disease: Comparison of current classification systems.
Prevalence of preclinical Alzheimer disease: Comparison of current classification systems.
复制标题
DOI：
10.1212/wnl.0000000000005476
复制
发表时间：
2018-05-08
期刊：
影响因子：
9.9
通讯作者：
Skoog I
中科院分区：
文献类型：
--
作者：
Kern S;Zetterberg H;Kern J;Zettergren A;Waern M;Höglund K;Andreasson U;Wetterberg H;Börjesson-Hanson A;Blennow K;Skoog I
根据当前分类系统，通过检查来自瑞典哥德堡的70岁代表性一般人群样本的CSF，确定临床前阿尔茨海默病（AD）的患病率。样本来自瑞典哥德堡基于人群的H70哥德堡出生队列研究。参与者（n = 322，年龄70岁）进行了全面的神经精神，认知和躯体检查。测量β-淀粉样蛋白（Aβ）42、Aβ40、总tau和磷酸化tau的CSF水平。临床前AD根据A/T/N系统标准（Dubois 2016）、美国国家老龄化研究所-阿尔茨海默氏症协会（NIA-AA）标准和国际工作组-2（IWG-2）标准进行分类。临床痴呆评分>0的个体被排除，留下259名认知未受损的个体。淀粉样蛋白病理的患病率为22.8%，总tau病理的患病率为33.2%，磷酸化tau病理的患病率为6.9%。在A/T/N系统中，A+/T−/N−的患病率为13.1%，A+/T−/N+为7.3%，A+/T+/N+为2.3%，A−/T−/N+为18.9%，A−/T+/N+为4.6%。当应用Dubois标准时，无症状AD风险的患病率为36.7%，临床前AD的患病率为9.7%。根据NIA-AA标准，1期的患病率为13.1%，2期为9.7%。根据IWG-2标准，无症状AD风险的患病率为9.7%。APOE ε4等位基因与几个类别相关。根据Dubois 2016，男性更常患有总tau病理学、A+/T−/N+、临床前AD、根据IWG-2标准无症状的AD风险和NIA-AA 2期。在70岁的代表性人群样本中，病理性AD标志物的患病率非常常见（46%）。这些发现的临床意义需要在纵向研究中进一步审查。
To determine the prevalence of preclinical Alzheimer disease (AD) according to current classification systems by examining CSF from a representative general population sample of 70-year-olds from Gothenburg, Sweden. The sample was derived from the population-based H70 Gothenburg Birth Cohort Studies in Gothenburg, Sweden. The participants (n = 322, age 70 years) underwent comprehensive neuropsychiatric, cognitive, and somatic examinations. CSF levels of β-amyloid (Aβ)42, Aβ40, total tau, and phosphorylated tau were measured. Preclinical AD was classified according to criteria of the A/T/N system, Dubois 2016, National Institute on Aging–Alzheimer's Association (NIA-AA) criteria, and International Working Group-2 (IWG-2) criteria. Individuals with Clinical Dementia Rating score >0 were excluded, leaving 259 cognitively unimpaired individuals. The prevalence of amyloid pathology was 22.8%, of total tau pathology was 33.2%, and of phosphorylated tau pathology was 6.9%. With the A/T/N system, the prevalence of A+/T−/N− was 13.1%, A+/T−/N+ was 7.3%, A+/T+/N+ was 2.3%, A−/T−/N+ was 18.9%, and A−/T+/N+ was 4.6%. When the Dubois criteria were applied, the prevalence of asymptomatic at risk for AD was 36.7% and of preclinical AD was 9.7%. With the NIA-AA criteria, the prevalence of stage 1 was 13.1% and stage 2 was 9.7%. With the IWG-2 criteria, the prevalence of asymptomatic at risk for AD was 9.7%. The APOE ε4 allele was associated with several of the categories. Men more often had total tau pathology, A+/T−/N+, preclinical AD according to Dubois 2016, asymptomatic at risk for AD according to the IWG-2 criteria, and NIA-AA stage 2. The prevalence of pathologic AD markers was very common (46%) in a representative population sample of 70-year-olds. The clinical implications of these findings need to be scrutinized further in longitudinal studies.