Alvarez-Sanchez Lourdes, Pereto Mar, Garcia-Valles Lorena, Balaguer Angel, Pena-Bautista Carmen, Ferre-Gonzalez Laura, Baquero Miguel, Pericas Consuelo Chafer
Alzheimer Disease Research Group, Instituto de Investigación Sanitaria La Fe, Valencia, Spain.
Division of Neurology, University and Polytechnic Hospital La Fe, Valencia, Spain.
Curr Neuropharmacol. 2025;23(5):602-611. doi: 10.2174/011570159X332930240925095423.
The heterogenicity in Alzheimer's Disease (AD) progression hinders individual prognosis. The present work is an observational 2-year longitudinal study in patients with mild cognitive impairment due to AD (n = 52, with positive CSF biomarkers). The aim of this study is to predict which patients are at risk of fast progression. For this, 3 neuropsychological tests based on different domains (clinical dementia, cognition, delayed memory) and the sum of them were used.
The tests were performed at diagnosis time (T1) and two years after the diagnosis time (T2). Then, the corresponding progression models were developed using each individual test and their sum as a variable response.
As a result, the model based on cognition status to predict fast decline (differences in the Z score (T2-T1) <1.5 were considered fast declining) provided satisfactory performance (AUC 0.74, 83.3% of sensibility and 70.2% of specificity); the models based on clinical dementia and delayed memory to predict fast declining showed low AUC and sensitivity. Nevertheless, the model based on the sum of the 3 tests showed the highest AUC (0.79), low sensitivity (63.6%), and high specificity.
The developed progression models could provide useful information to clinicians and AD patients regarding their fast/normal decline in general or specific domains.
阿尔茨海默病（AD）进展的异质性阻碍了个体预后。本研究是一项针对因AD导致轻度认知障碍患者（n = 52，脑脊液生物标志物呈阳性）的为期2年的观察性纵向研究。本研究的目的是预测哪些患者有快速进展的风险。为此，使用了基于不同领域（临床痴呆、认知、延迟记忆）的3项神经心理学测试及其总和。
测试在诊断时（T1）和诊断后两年（T2）进行。然后，使用每项单独测试及其总和作为变量响应来建立相应的进展模型。
结果显示，基于认知状态预测快速衰退（Z分数（T2 - T1）差异<1.5被认为是快速衰退）的模型表现令人满意（曲线下面积（AUC）为0.74，敏感性为83.3%，特异性为70.2%）；基于临床痴呆和延迟记忆预测快速衰退的模型显示出较低的AUC和敏感性。然而，基于3项测试总和的模型显示出最高的AUC（0.79）、较低的敏感性（63.6%）和较高的特异性。
所建立的进展模型可为临床医生和AD患者提供有关其在一般或特定领域快速/正常衰退的有用信息。
