Prevalence and prognostic value of CSF markers of Alzheimer's disease pathology in patients with subjective cognitive impairment or mild cognitive impairment in the DESCRIPA study: a prospective cohort study
Prevalence and prognostic value of CSF markers of Alzheimer's disease pathology in patients with subjective cognitive impairment or mild cognitive impairment in the DESCRIPA study: a prospective cohort study
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DOI：
10.1016/s1474-4422(09)70139-5
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发表时间：
2009-07-01
期刊：
影响因子：
48
通讯作者：
Blennow, Kaj
中科院分区：
文献类型：
--
作者：
Visser, Pieter Jelle;Verhey, Frans;Blennow, Kaj
背景阿尔茨海默病（AD）病理学在无痴呆的遗忘型轻度认知损害（aMCI）患者中很常见，但AD病理学在主观认知损害（SCI）和非遗忘型轻度认知损害（naMCI）患者中的患病率尚不清楚。AD的特征是CSF中A β浓度降低（42）和tau浓度升高。我们调查的患病率与SCI，naMCI，或aMCI患者的CSF AD配置文件，并在每个group.Methods与SCI，naMCI，aMCI，神经系统健康的对照组患者的认知结果的关联，从20个记忆诊所在欧洲，2003年1月，2005年6月，招募到这个前瞻性队列研究。CSF AD特征定义为A β（42）：tau比值异常。每年对患者进行评估，最长持续3年。结果指标为记忆、整体认知、简易精神状态检查（MMSE）评分、日常功能和AD型痴呆进展的变化。（60例中的31例[52%]）、naMCI（37例中的25例[68%]）和aMCI（71例中的56例[79%]），而健康对照组（89例中的28例[31%]）。该特征与naMCI患者（记忆、MMSE和日常功能）和aMCI患者（MMSE和日常功能）的认知下降相关。在aMCI患者中，CSF AD特征预测AD型痴呆（OR 26.8，95%CI 1.6-456.4）AD是SCI、naMCI和aMCI的常见原因，并且与naMCI或aMCI患者的认知下降相关。SCI患者可能处于AD的早期阶段，只有经过较长时间的随访，认知能力下降才可能变得明显。
Background Alzheimer's disease (AD) pathology is common in patients with amnestic mild cognitive impairment (aMCI) without dementia, but the prevalence of AD pathology in patients with subjective cognitive impairment (SCI) and non-amnestic mild cognitive impairment (naMCI) is unknown. AD is characterised by decreased CSF concentrations of A beta(42) and increased concentrations of tau. We investigated the prevalence of a CSF AD profile in patients with SCI, naMCI, or aMCI and the association of this profile with cognitive outcome in each group.Methods Patients with SCI, naMCI, aMCI, and neurologically healthy controls were recruited from 20 memory clinics across Europe, between January, 2003, and June, 2005, into this prospective cohort study. A CSF AD profile was defined as an abnormal ratio of A beta(42):tau. Patients were assessed annually up to 3 years. Outcome measures were changes in memory, overall cognition, mini-mental state examination (MMSE) score, daily function, and progression to AD-type dementia.Findings The CSF AD profile was more common in patients with SCI (31 of 60 [52%]), naMCI (25 of 37 [68%]), and aMCI (56 of 71 [79%]) than in healthy controls (28 of 89 [31%]). The profile was associated with cognitive decline in patients with naMCI (memory, MMSE, and daily function) and in patients with aMCI (MMSE and daily function). In patients with aMCI, a CSF AD profile was predictive of AD-type dementia (OR 26.8, 95% CI 1.6-456.4).Interpretation AD is a common cause of SCI, naMCI, and aMCI and is associated with cognitive decline in patients with naMCI or aMCI. Patients with SCI might be in the early stages of AD, and cognitive decline might become apparent only after longer follow-up.