A Case of Minimally Progressive Prodromal Alzheimer's Disease

Abstract

Prodromal Alzheimer's disease (AD) is a neurodegenerative condition typically progressing to dementia within 3 years. We describe a case of a mild cognitive impairment (MCI) patient with biomarker evidence for amyloidosis, tau, and neurodegeneration who had minimal changes in clinical phenotype during an 11-year period. AD biomarkers were obtained with cerebrospinal fluid analysis and amyloid PET imaging, both of which supported a biological diagnosis of AD. However, the patient's neuropsychological profile remained stable over 11 years except for mild memory-retrieval changes. This case provides evidence that MCI with supportive AD biomarkers may have an atypically minimal progression.

Keywords: Biomarkers; cognitive reserve; longitudinal progression; prodromal AD.

Fig. 1

Neuropsychological Test Performance by Cognitive Domain 2010–2021. *T-scores are standardized values calculated using normative data (i.e., mean, standard deviation) from test performance of healthy peers of similar age and/or education. Values <29 Impaired; 30–36 Borderline Impaired; 37–42 Low Average; 43–56 Average;>56 High Average or better. Scores shown here for each cognitive domain were obtained by averaging T-scores across individual tests. No clinically significant “outlier” values were identified during this process. Memory Recognition scores are not normally distributed.