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Background:  Cerebrospinal fluid (CSF) biomarkers’ performance for predicting conversion from mild cognitive impairment (MCI) to Alzheimer’s disease (AD) is still suboptimal.   Objective:  By considering several confounding factors we aimed to identify in which situations these CSF biomarkers can be useful.   Data Sources:  A systematic review was conducted on MEDLINE, PreMedline, EMBASE, PsycInfo, CINAHL, Cochrane, and CRD (1990–2013).   Eligibility Criteria:  (1) Prospective studies of CSF biomarkers’ performance for predicting conversion from MCI to AD/dementia; (2) inclusion of Aβ42 and T-tau and/or p-tau. Several meta-analyses were performed.   Results:  Aβ42/p-tau ratio had high capacity to predict conversion to AD in MCI patients younger than 70 years. The p-tau had high capacity to identify MCI cases converting to AD in ≤24 months.   Conclusions:  Explaining how different confounding factors influence CSF biomarkers’ predictive performance is mandatory to elaborate a definitive map of situations, where these CSF biomarkers are useful both in clinics and research.

frontiers in aging neuroscience

Improving CSF Biomarkersâ€™ Performance for Predicting Progression from Mild Cognitive Impairment to Alzheimerâ€™s Disease by Considering Different Confounding Factors: A Meta-Analysis