Mild cognitive impairment due to Alzheimer disease in the community. Issue 2 (24th September 2013)

• Record Type: Journal Article
• Authors: Petersen, Ronald C.; Aisen, Paul; Boeve, Bradley F.; Geda, Yonas E.; Ivnik, Robert J.; Knopman, David S.; Mielke, Michelle; Pankratz, Vernon S.; Roberts, Rosebud; Rocca, Walter A.; Weigand, Stephen; Weiner, Michael; Wiste, Heather; Jack, Clifford R.
• Is Part Of: Annals of neurology. Volume 74:Issue 2(2013:Aug.)
• Page Start: 199
• Page End: 208
• Publication Date: 2013-09-24
• Subjects: Neurology -- Periodicals; Pediatric neurology -- Periodicals; Nervous system -- Surgery -- Periodicals; 616.8
• DOI: 10.1002/ana.23931
• Languages: English
• ISSNs: 0364-5134

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="ana23931-sec-0001" sec-type="section"> <title>Objective</title> <p>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.</p> </sec> <sec id="ana23931-sec-0002" sec-type="section"> <title>Methods</title> <p>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.</p> </sec> <sec id="ana23931-sec-0003" sec-type="section"> <title>Results</title> <p>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.</p> </sec> <sec id="ana23931-sec-0004" sec-type="section"> <title>Interpretation</title> <p>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. Ann Neurol 2013;74:199–208</p> </sec> </abstract>