Department of Neurology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA.
Department of Statistics, University of Connecticut, Storrs, CT, USA.
J Alzheimers Dis. 2021;80(1):175-183. doi: 10.3233/JAD-200980.
The ultimate validation of a clinical marker for Alzheimer's disease (AD) is its association with AD neuropathology.
To identify clinical measures that predict pathology, we evaluated the relationships of the picture version of the Free and Cued Selective Reminding Test (pFCSRT + IR), the Mini-Mental State Exam (MMSE), and the Clinical Dementia Rating scale Sum of Boxes (CDR-SB) to Braak stage.
315 cases from the clinicopathologic series at the Knight Alzheimer's Disease Research Center were classified according to Braak stage. Boxplots of each predictor were compared to identify the earliest stage at which decline was observed and ordinal logistic regression was used to predict Braak stage.
Looking at the assessment closest to death, free recall scores were lower in individuals at Braak stage III versus Braak stages 0 and I (combined) while MMSE and CDR scores for individuals did not differ from Braak stages 0/I until Braak stage IV. The sum of free recall and total recall scores independently predicted Braak stage and had higher predictive validity than MMSE and CDR-SB in models including all three.
pFCSRT + IR scores may be more sensitive to early pathological changes than either the CDR-SB or the MMSE.
阿尔茨海默病（AD）临床标志物的最终验证与其与 AD 病理学的关联有关。
为了确定可预测病理学的临床指标，我们评估了自由和线索选择性提醒测试（pFCSRT + IR）、简易精神状态检查（MMSE）和临床痴呆评定量表总分（CDR-SB）与 Braak 分期的关系。
根据 Braak 分期，对 Knight 阿尔茨海默病研究中心临床病理系列中的 315 例病例进行分类。通过箱线图比较每个预测因子，以确定最早观察到下降的阶段，并使用有序逻辑回归预测 Braak 分期。
从最接近死亡的评估来看，Braak 分期 III 期的个体自由回忆分数低于 Braak 分期 0 和 I 期（合并），而 MMSE 和 CDR 评分在个体中直到 Braak 分期 IV 期才与 Braak 分期 0/I 期不同。自由回忆和总回忆得分之和独立地预测了 Braak 分期，并且在包括所有三个预测因子的模型中，其预测有效性高于 MMSE 和 CDR-SB。
pFCSRT + IR 评分可能比 CDR-SB 或 MMSE 更能敏感地反映早期病理变化。
