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P4‐061: LIFESTYLE FACTORS MAY DELAY THE AGE OF CLINICAL DIAGNOSIS OF ALZHEIMER'S DISEASE
Author(s) -
Yotter Rachel Aine,
Da Xiao,
Davatzikos Christos
Publication year - 2014
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2014.05.1576
Subject(s) - disease , apolipoprotein e , alzheimer's disease neuroimaging initiative , medicine , cognition , dementia , psychiatry
Cerebrospinal fluid (CSF) protein concentration (due to defects in the bloodbrain barrier), white cell count as well as intrathecal IgG syntesis are potential markers of such processes. The aim of this study was t o investigate whether an elevated CSF protein concentration,an elevated CSF white cell count or an increased IgG synthesis at baseline can predict clinical progression from Mild Cognitive Impairment (MCI) to AD. Furthermore, to investigate the potential role of these markers as risk factors for progression from MCI to AD, in comparison to Ab42, Tau and P-tau levels. Methods: Routine CSF parameters (white cell count and protein concentration) as well as CSFAb42, CSF-Total Tau, CSF-P-Tau and IgG index measured at baseline lumbar puncture, were retrospectively registered in a consecutive cohort referred for cognitive evaluation and diagnosed with MCI. Clinical progression was determined based on clinical history and cognitive tests (MMSE) administered at baseline and during follow-up. Results: Fifty-two MCI subjects (21 females, 31 males) were included, mean age 70.3 (range 56 to 80 years), mean MMSE score 27 (range 24 to 30). The patients had a mean follow-up period of 28.5 months (range 5 to 48). Twenty-seven patients remained stable during follow-up (non-progressive MCI), whereas twenty-five patients progressed from MCI to AD (progressive MCI). Neither CSF white cell count nor protein concentration differed significantly between the two groups. None of the patients had an elevated IgG index. No significant difference was found in CSF-Total Tau or CSF-Ab42 concentrations between the groups. The CSF-P-Tau mean concentration was significantly higher in the group of progressive MCI (p 1⁄4 0.04), although within laboratory reference range. Conclusions: In this retrospective study of CSF parameters as potential baseline predictors of clinical progression in MCI, we found only CSF-P-Tau to be a risk factor for progression. We found no association between CSF protein concentration, CSF white cell count or IgG synthesis and clinical progression of MCI.