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Does adding MRI and CSF-based biomarkers improve cognitive status classification based on cognitive performance

Mateo P Farina1,2, Joseph Saenz3, Eileen M Crimmins1

  • 1School of Gerontology, University of Southern California, Los Angeles, California, United States of America.

Plos One
|May 8, 2023
PubMed
Summary
This summary is machine-generated.

Adding MRI and CSF biomarkers slightly improved cognitive status classification accuracy in population studies. However, the modest gains may not justify the costs and invasiveness for widespread adoption in dementia research.

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Area of Science:

  • Neurology
  • Biomarkers
  • Population Health

Background:

  • Cognitive status classification is crucial for understanding dementia prevalence in population studies.
  • Concerns exist regarding the accuracy of cognitive assessments using questionnaires alone.
  • The utility of MRI and CSF biomarkers for improving classification in population settings remains unclear.

Purpose of the Study:

  • To evaluate if adding MRI and CSF biomarkers enhances cognitive status classification accuracy.
  • To compare the predictive performance of models using cognitive questionnaires versus those including biomarkers.
  • To assess the impact on prevalence estimates for different cognitive statuses.

Main Methods:

  • Utilized data from the Alzheimer's Disease Neuroimaging Initiative (ADNI).
  • Developed multinomial logistic regression models incorporating the Mini-Mental State Examination (MMSE) alone and with MRI/CSF biomarkers.
  • Compared predicted cognitive status prevalence with diagnosed prevalence.

Main Results:

  • The inclusion of MRI and CSF biomarkers resulted in a modest increase in explained variance (pseudo-R2 from .401 to .445).
  • A small improvement (3.1%) was observed in the predicted prevalence of cognitively normal individuals.
  • No significant improvement was found in the accurate prediction of dementia prevalence.

Conclusions:

  • While valuable in clinical research, MRI and CSF biomarkers did not substantially enhance cognitive status classification in this population-based study.
  • The cost, training, and invasiveness associated with biomarker collection may limit their adoption in large-scale surveys.
  • Current cognitive questionnaires, despite limitations, remain a primary tool for population-level dementia screening.