Luísa Alves1, Sandra Cardoso2, Dina Silva2,3, Tiago Mendes2,4, João Marôco5, Joana Nogueira6,7, Marisa Lima6,7, Miguel Tábuas-Pereira6,7, Inês Baldeiras6,7, Isabel Santana6,7, Alexandre de Mendonça2, Manuela Guerreiro2. 1. Chronic Diseases Research Centre, NOVA Medical School, NOVA University of Lisbon, Portugal. 2. Faculty of Medicine, University of Lisbon, Portugal. 3. Cognitive Neuroscience Research Group, Department of Psychology and Educational Sciences and Center for Biomedical Research (CBMR), Universidade do Algarve, Faro, Portugal. 4. Psychiatry and Mental Health Department, Santa Maria Hospital, Lisbon, Portugal. 5. Instituto Superior de Psicologia Aplicada, Lisbon, Portugal. 6. Neurology Department, Centro Hospitalar e Universitário de Coimbra, Portugal. 7. Faculdade de Medicina da Universidade de Coimbra, Portugal.
Abstract
INTRODUCTION: Patients diagnosed with amnestic mild cognitive impairment (aMCI) are at high risk of progressing to dementia. It became possible, through the use of biomarkers, to diagnose those patients with aMCI who have Alzheimer's disease. However, it is presently unfeasible that all patients undergo biomarker testing. Since neuropsychological testing is required to make a formal diagnosis of aMCI, it would be interesting if it could be used to predict the amyloid status of patients with aMCI. METHODS: Participants with aMCI, known amyloid status (Aβ+ or Aβ-) and a comprehensive neuropsychological evaluation, were selected from the Cognitive Complaints Cohort database for this study. Neuropsychological tests were compared in Aβ+ and Aβ- aMCI patients. A binary logistic regression analysis was conducted to model the probability of being amyloid positive. RESULTS: Of the 216 aMCI patients studied, 117 were Aβ+ and 99 were Aβ-. Aβ+ aMCI patients performed worse on several memory tests, namely Word Total Recall, Logical Memory Immediate and Delayed Free Recall, and Verbal Paired Associate Learning, as well as on Trail Making Test B, an executive function test. In a binary logistic regression model, only Logical Memory Delayed Free Recall retained significance, so that for each additional score point in this test, the probability of being amyloid positive decreased by 30.6%. The resulting model correctly classified 64.6% of the aMCI cases regarding their amyloid status. CONCLUSIONS: The neuropsychological assessment remains an essential step to diagnose and characterize patients with aMCI; however, neuropsychological tests have limited value to distinguish the aMCI patients who have amyloid pathology from those who might suffer from other clinical conditions.
INTRODUCTION:Patients diagnosed with amnestic mild cognitive impairment (aMCI) are at high risk of progressing to dementia. It became possible, through the use of biomarkers, to diagnose those patients with aMCI who have Alzheimer's disease. However, it is presently unfeasible that all patients undergo biomarker testing. Since neuropsychological testing is required to make a formal diagnosis of aMCI, it would be interesting if it could be used to predict the amyloid status of patients with aMCI. METHODS:Participants with aMCI, known amyloid status (Aβ+ or Aβ-) and a comprehensive neuropsychological evaluation, were selected from the Cognitive Complaints Cohort database for this study. Neuropsychological tests were compared in Aβ+ and Aβ- aMCIpatients. A binary logistic regression analysis was conducted to model the probability of being amyloid positive. RESULTS: Of the 216 aMCIpatients studied, 117 were Aβ+ and 99 were Aβ-. Aβ+ aMCIpatients performed worse on several memory tests, namely Word Total Recall, Logical Memory Immediate and Delayed Free Recall, and Verbal Paired Associate Learning, as well as on Trail Making Test B, an executive function test. In a binary logistic regression model, only Logical Memory Delayed Free Recall retained significance, so that for each additional score point in this test, the probability of being amyloid positive decreased by 30.6%. The resulting model correctly classified 64.6% of the aMCI cases regarding their amyloid status. CONCLUSIONS: The neuropsychological assessment remains an essential step to diagnose and characterize patients with aMCI; however, neuropsychological tests have limited value to distinguish the aMCIpatients who have amyloid pathology from those who might suffer from other clinical conditions.
Authors: Eliane Correa Miotto; Sonia Maria Dozzi Brucki; Carlos T Cerqueira; Paulo R Bazán; Geise Aline de Almeida Silva; Maria da Graça M Martin; Paula Squarzoni da Silveira; Daniele de Paula Faria; Artur Martins Coutinho; Carlos Alberto Buchpiguel; Geraldo Busatto Filho; Ricardo Nitrini Journal: J Alzheimers Dis Date: 2022 Impact factor: 4.160