Clinical and biological predictors of Alzheimer's disease in patients with amnestic mild cognitive impairment
Clinical and biological predictors of Alzheimer's disease in patients with amnestic mild cognitive impairment
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DOI：
10.1590/s1516-44462010005000002
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发表时间：
2010-09-01
影响因子：
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通讯作者：
Gattaz, Wagner F.
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文献类型：
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作者：
Forlenza, Orestes V.;Diniz, Breno S.;Gattaz, Wagner F.
目的探讨阿尔茨海默病痴呆前阶段认知功能障碍进展的预测因素与临床管理相关，为抗痴呆药物的处方决策提供依据。方法采用纵向研究方法，对老年遗忘性轻度认知障碍患者与健康对照者进行队列研究，评估其发展为阿尔茨海默病的风险及预测因素特征损伤有较高风险发展年代老年痴呆症在跟进(优势比= 4 5 CI95% [1 3 13 6] p = 0 010)在基线年龄降低记忆力测试得分和载脂蛋白e * 4的等位基因预测遗忘轻度认知障碍的发展年代老年痴呆症的子样本遗忘型轻度认知障碍患者的人发展为阿尔茨海默病脑脊液浓度较低的β淀粉样蛋白肽(β(42)p = 0 020)更高浓度的总τ(p = 0 030)和磷酸化τ(p = 0 010)相比non-converters讨论这是第一个巴西脑脊液生物标志物的研究报告预测MCI年代老年痴呆症我们转换的数据是按照这些其他设置测量报告的脑脊液总τ磷τ和β(42)可能有助于确定患有轻度认知障碍的风险更高阿尔茨海默病
Objective To identify predictors of the progression from pre-dementia stages of cognitive impairment in Alzheimer s disease is relevant to clinical management and to substantiate the decision of prescribing antidementia drugs Method Longitudinal study of a cohort of elderly adults with amnestic mild cognitive impairment and healthy controls carried out to estimate the risk and characterize predictors of the progression to Alzheimer s disease Results Patients with amnestic mild cognitive impairment had a higher risk to develop Alzheimer s disease during follow up (odds ratio = 4 5 CI95% [1 3 13 6] p = 0 010) At baseline older age lower scores on memory tests and presence of the APOE*4 allele predicted the progression from amnestic mild cognitive impairment to Alzheimer s disease In a sub sample of amnestic mild cognitive impairment patients those who progressed to Alzheimer s disease had lower cerebrospinal fluid concentrations of amyloid beta peptide (A beta(42) p = 0 020) and higher concentrations of total TAU (p = 0 030) and phosphorylated TAU (p = 0 010) as compared to non-converters Discussion This is the first Brazilian study to report cerebrospinal fluid biomarkers in the prediction of the conversion from MCI to Alzheimer s disease Our data are in accordance with those reported in other settings The measurement of cerebrospinal fluid total TAU phospho TAU and A beta(42) may help identify patients with mild cognitive impairment at higher risk for developing Alzheimer s disease