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Comparative Study
. 2013 Aug;74(2):199-208.
doi: 10.1002/ana.23931.

Mild cognitive impairment due to Alzheimer disease in the community

Ronald C Petersen  1 , Paul Aisen, Bradley F Boeve, Yonas E Geda, Robert J Ivnik, David S Knopman, Michelle Mielke, Vernon S Pankratz, Rosebud Roberts, Walter A Rocca, Stephen Weigand, Michael Weiner, Heather Wiste, Clifford R Jack Jr
Affiliations
Comparative Study

Mild cognitive impairment due to Alzheimer disease in the community

Ronald C Petersen et al. Ann Neurol. 2013 Aug.

Abstract

Objective: The newly proposed National Institute on Aging-Alzheimer's Association (NIA-AA) criteria for mild cognitive impairment (MCI) due to Alzheimer disease (AD) suggest a combination of clinical features and biomarker measures, but their performance in the community is not known.

Methods: The Mayo Clinic Study of Aging (MCSA) is a population-based longitudinal study of nondemented subjects in Olmsted County, Minnesota. A sample of 154 MCI subjects from the MCSA was compared to a sample of 58 amnestic MCI subjects from the Alzheimer's Disease Neuroimaging Initiative 1 (ADNI-1) to assess the applicability of the criteria in both settings and to assess their outcomes.

Results: Fourteen percent of MCSA and 16% of ADNI-1 of subjects were biomarker negative. In addition, 14% of MCSA and 12% of ADNI-1 subjects had evidence for amyloid deposition only, whereas 43% of MCSA and 55% of ADNI-1 subjects had evidence for amyloid deposition plus neurodegeneration (magnetic resonance imaging atrophy, fluorodeoxyglucose positron emission tomography hypometabolism, or both). However, a considerable number of subjects had biomarkers inconsistent with the proposed AD model; for example, 29% of MCSA subjects and 17% of ADNI-1 subjects had evidence for neurodegeneration without amyloid deposition. These subjects may not be on an AD pathway. Neurodegeneration appears to be a key factor in predicting progression relative to amyloid deposition alone.

Interpretation: The NIA-AA criteria apply to most MCI subjects in both the community and clinical trials settings; however, a sizeable proportion of subjects had conflicting biomarkers, which may be very important and need to be explored.

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Figures

Figure
Figure
Frequency of positive biomarkers in the Mayo Clinic Study of Aging (MCSA) and Alzheimer’s Disease Neuroimaging Initiative (ADNI).
See this image and copyright information in PMC

References

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