Multimodal prediction of dementia with up to 10 years follow up: the Gothenburg MCI study.
BACKGROUND
Neuropsychological tests, CSF Aβ42, T-tau, P-tau181, hippocampal volume, and white matter lesions have been shown to predict conversion to dementia in patients with mild cognitive impairment (MCI).


OBJECTIVE
To examine the predictive value of combinations of these markers and to examine if the absence of pathological markers provides a lasting reduction of conversion rates.


METHODS
The Gothenburg MCI study is a clinically based study. Seventy-three MCI patients were included in the present sub-study and followed for a maximum of ten years. Thirty-four patients converted to dementia (18 to AD) and 39 remained stable. At inclusion, patients were classified into positive or negative risk groups according to results from neuropsychological testing (Rey auditory verbal learning test, Boston naming test, Trail making test B), CSF biomarkers (amyloid β42, T-tau, and P-tau181), and MRI scans (hippocampal volume, white matter lesions).


RESULTS
Trail making test B (TMT-B) was the best single predictor for the prediction of dementia (AUC 0.89, HR 25), and T-tau was the best predictor of AD (AUC 0.97, HR 41). The combination of hippocampal volume and TMT-B was the best combination for the prediction of dementia (HR 25), and the combination of hippocampal volume and T-tau was the best combination for the prediction of AD (HR 37).


CONCLUSION
Neuropsychological tests, CSF markers, and hippocampal volume predicted conversion from MCI to AD and general dementia. The absence of pathological markers provided a long-time protection from dementia.
['Eckerström|Carl|C|', 'Olsson|Erik|E|', 'Klasson|Niklas|N|', 'Berge|Josef|J|', 'Nordlund|Arto|A|', 'Bjerke|Maria|M|', 'Wallin|Anders|A|']
D000368:Aged D000544:Alzheimer Disease D016229:Amyloid beta-Peptides D019540:Area Under Curve D060825:Cognitive Dysfunction D003704:Dementia D018450:Disease Progression D005260:Female D006624:Hippocampus D006801:Humans D008137:Longitudinal Studies D008279:Magnetic Resonance Imaging D008297:Male D008609:Mental Status Schedule D008875:Middle Aged D009483:Neuropsychological Tests D011237:Predictive Value of Tests D016875:tau Proteins
dementia neuropsychological test mild cognitive impairment Cerebrospinal fluid magnetic resonance imaging