Department of Neurology, School of Medicine, Affiliated ZhongDa Hospital, Southeast University, Nanjing, China.
Institute of Neuropsychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.
CNS Neurosci Ther. 2020 Jul;26(7):720-729. doi: 10.1111/cns.13371. Epub 2020 Apr 3.
Both amnestic mild cognitive impairment (aMCI) and remitted late-onset depression (rLOD) confer a high risk of developing Alzheimer's disease (AD). This study aims to determine whether the Characterizing AD Risk Events (CARE) index model can effectively predict conversion in individuals at high risk for AD development either in an independent aMCI population or in an rLOD population.
The CARE index model was constructed based on the event-based probabilistic framework fusion of AD biomarkers to differentiate individuals progressing to AD from cognitively stable individuals in the aMCI population (27 stable subjects, 6 progressive subjects) and rLOD population (29 stable subjects, 10 progressive subjects) during the follow-up period.
AD diagnoses were predicted in the aMCI population with a balanced accuracy of 80.6%, a sensitivity of 83.3%, and a specificity of 77.8%. They were also predicted in the rLOD population with a balanced accuracy of 74.5%, a sensitivity of 80.0%, and a specificity of 69.0%. In addition, the CARE index scores were observed to be negatively correlated with the composite Z scores for episodic memory (R = .17, P < .001) at baseline in the combined high-risk population (N = 72).
The CARE index model can be used for the prediction of conversion to AD in both aMCI and rLOD populations effectively. Additionally, it can be used to monitor the disease severity of patients.
遗忘型轻度认知障碍(aMCI)和缓解型晚发性抑郁(rLOD)均使发生阿尔茨海默病(AD)的风险增加。本研究旨在确定基于 AD 生物标志物事件基础概率框架融合的特征 AD 风险事件(CARE)指数模型是否可以有效地预测 AD 发展高危个体在 aMCI 人群或 rLOD 人群中的转化。
CARE 指数模型是基于 AD 生物标志物的事件基础概率框架融合构建的,用于区分认知稳定的个体和向 AD 进展的个体。该模型在 aMCI 人群(27 名稳定受试者,6 名进展受试者)和 rLOD 人群(29 名稳定受试者,10 名进展受试者)随访期间,将向 AD 进展的个体与认知稳定的个体进行区分。
在 aMCI 人群中,AD 诊断的预测准确率为 80.6%,敏感度为 83.3%,特异性为 77.8%。在 rLOD 人群中,AD 诊断的预测准确率为 74.5%,敏感度为 80.0%,特异性为 69.0%。此外,在合并的高危人群(N=72)中,CARE 指数评分与基线时情景记忆复合 Z 评分呈负相关(R=.17,P<0.001)。
CARE 指数模型可有效用于预测 aMCI 和 rLOD 人群向 AD 的转化,也可用于监测患者的疾病严重程度。