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Variation in Variables that Predict Progression from MCI to AD Dementia over Duration of Follow-up

Shanshan Li1, Ozioma Okonkwo2, Marilyn Albert3

  • 1Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.

American Journal of Alzheimer'S Disease (Columbia, Mo.)
|February 14, 2014
PubMed

Insights

Neuroimaging and cognitive tests can predict Alzheimer's disease progression in individuals with mild cognitive impairment (MCI). Volumetric MRI and cognitive assessments are key predictors, with cognitive measures remaining significant throughout the follow-up period.

Area of Science:

  • Neuroscience
  • Medical Imaging
  • Genetics

Background:

  • Mild cognitive impairment (MCI) is a transitional stage between normal aging and Alzheimer's disease (AD) dementia.
  • Accurate prediction of MCI to AD progression is crucial for timely intervention and clinical trial enrollment.
  • Identifying reliable biomarkers for predicting AD progression is an ongoing research priority.

Purpose of the Study:

  • To evaluate the predictive utility of neuroimaging, genetic, cerebrospinal fluid (CSF), and cognitive measures for MCI to AD dementia progression.
  • To assess the prognostic performance and stability of candidate biomarkers over time.

Main Methods:

  • Utilized data from 139 individuals with MCI in the Alzheimer's Disease Neuroimaging Initiative.
  • Employed Cox regression analyses and time-dependent receiver operating characteristic (ROC) methods.
  • Assessed predictors including volumetric MRI (brain, ventricular, hippocampal), APOE ε4 genotype, Aβ42, p-tau181, and cognitive tests (memory, language, executive function).

Main Results:

  • A multivariable Cox model identified seven key predictors of AD progression: brain volume, hippocampal volume, ventricular volume, APOE ε4, Aβ42, memory, and executive function.
  • The time-dependent ROC analysis showed a robust predictive model with an area under the curve ranging from 0.757 to 0.832 at 12 to 36 months.
  • While multiple measures predicted progression early, memory and executive function remained significant predictors at later time points (18 and 24 months).

Conclusions:

  • Baseline volumetric MRI and cognitive assessments are effective predictors of progression from MCI to AD.
  • Cognitive measures demonstrate sustained predictive power for AD progression, even late in the follow-up.
  • These findings can aid in selecting appropriate participants for Alzheimer's disease clinical trials.
Keywords:
Alzheimer's diseaseCox modelsMild cognitive impairmentROC analysismemory

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