Luis Cheryl A, Abdullah Laila, Ait-Ghezala Ghania, Mouzon Benoit, Keegan Andrew P, Crawford Fiona, Mullan Michael
Roskamp Institute, 2040 Whitfield Avenue, Sarasota, FL 34243, USA.
Int J Alzheimers Dis. 2011;2011:786264. doi: 10.4061/2011/786264. Epub 2011 May 24.
We examined the usefulness of brief neuropsychological tests and serum Aβ as a predictive test for detecting MCI/AD in older adults. Serum Aβ levels were measured from 208 subjects who were cognitively normal at enrollment and blood draw. Twenty-eight of the subjects subsequently developed MCI (n = 18) or AD (n = 10) over the follow-up period. Baseline measures of global cognition, memory, language fluency, and serum Aβ(1-42) and the ratio of serum Aβ(1-42)/Aβ(1-40) were significant predictors for future MCI/AD using Cox regression with demographic variables, APOE ε4, vascular risk factors, and specific medication as covariates. An optimal sensitivity of 85.2% and specificity of 86.5% for predicting MCI/AD was achieved using ROC analyses. Brief neuropsychological tests and measurements of Aβ(1-42) obtained via blood warrants further study as a practical and cost effective method for wide-scale screening for identifying older adults who may be at-risk for pathological cognitive decline.
我们研究了简短神经心理测试和血清淀粉样蛋白β(Aβ)作为检测老年人轻度认知障碍(MCI)/阿尔茨海默病(AD)预测性测试的效用。对入组时认知正常且采血时认知正常的208名受试者测量血清Aβ水平。在随访期间,其中28名受试者随后发展为MCI(n = 18)或AD(n = 10)。使用Cox回归,将人口统计学变量、载脂蛋白E(APOE)ε4、血管危险因素和特定药物作为协变量,整体认知、记忆、语言流畅性的基线测量值以及血清Aβ(1-42)和血清Aβ(1-42)/Aβ(1-40)比值是未来发生MCI/AD的显著预测因素。通过ROC分析,预测MCI/AD的最佳灵敏度为85.2%,特异性为86.5%。作为一种用于大规模筛查以识别可能存在病理性认知衰退风险的老年人的实用且具有成本效益的方法,简短神经心理测试和通过血液获取的Aβ(1-42)测量值得进一步研究。