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P3‐211: Index for the Prediction of Incident Dementia: Three Years’ Follow‐Up Study
Author(s) -
Acosta-Castillo Gilberto Isaac,
Sosa-Ortiz Ana Luisa,
Borges Guilherme L.
Publication year - 2016
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.2016.06.1873
Subject(s) - dementia , medicine , gerontology , context (archaeology) , socioeconomic status , population , interquartile range , disease , environmental health , geography , archaeology
collected: age; sex; MMSE; neuropsychological evaluation including long term memory, executive functions, language and visuospatial abilities. Core biomarkers were collected following local practices: Scheltens’s visual assessment of medial temporal atrophy (MTA) on MR scan; visual assessment of hypometabolism/hypoperfusion on FDG-PET/SPECT brain scan; CSFAß1-42, tau and phospho-tau levels. At diagnostic workup completion, an estimate of confidence that cognitive complaints were due to AD was elicited from clinicians on a structured scale ranging from 0 to 100. Only cases with uncertain diagnoses (confidence between 15% and 85%) were retained for analysis. Generalized linear models were used to describe the relationship between the collected measures and the diagnostic confidence of AD. Results:Neuropsychological assessment was carried out in almost all cases (98% of the cases). Medial temporal atrophy ratings were done in 40% of cases, assessment of cortical hypometabolism/hypoperfusion in 34%, and CSF Aß and tau levels in 26%. The markers that better explained the variability of diagnostic confidence were CSF Aß142 level (R1⁄40.46) and hypometabolism/hypoperfusion (R1⁄40.45), followed by CSF tau level (R1⁄40.35), MTA assessment (R1⁄40.32) and. All figures were highly significant, at p<<0.001. The diagnostic confidence variability due to neuropsychological tests for different domains was lower: MMSE (R1⁄40.29); long term memory (R1⁄40.23); executive functions (R1⁄40.05); language (R1⁄40.02); visuospatial abilities (R1⁄40.04) even if significant (p<0.01). Conclusions: The use of core biomarkers in the clinical assessment of subjects with suspected AD and high diagnostic uncertainty is still limited. However, when assessed, these biomarkers show a higher impact on diagnostic confidence of AD than the most widespread clinical measures.