Diagnostic and Prognostic Value of the Combination of Two Measures of Verbal Memory in Mild Cognitive Impairment due to Alzheimer's Disease

作者：Sala Isabel; Illan Gala Ignacio; Alcolea Daniel; Belen Sanchez Saudinos Ma; Andres Salgado Sergio; Morenas Rodriguez Estrella; Subirana Andrea; Videla Laura; Clarimon Jordi; Carmona Iragui Maria; Ribosa Nogue Roser; Blesa Rafael; Fortea Juan; Lleo Alberto^*

来源：Journal of Alzheimer's Disease, 2017, 58(3): 909-918.

DOI：10.3233/JAD-170073

• Alzheimer's disease
• biomarkers
• cerebrospinal fluid
• episodic memory
• mild cognitive impairment
• mild neurocognitive disorder
• neuropsychological test

Background: Episodic memory impairment is the core feature of typical Alzheimer's disease.
Objective: To evaluate the performance of two commonly used verbal memory tests to detect mild cognitive impairment due to Alzheimer's disease (MCI-AD) and to predict progression to Alzheimer's disease dementia (AD-d).
Methods: Prospective study of MCI patients in a tertiary memory disorder unit. Patients underwent an extensive neuropsychological battery including two tests of declarative verbal memory: The Free and Cued Selective Reminding Test (FCSRT) and the word list learning task from the Consortium to Establish a Registry for Alzheimer's disease (CERAD-WL). Cerebrospinal fluid (CSF) was obtained from all patients and MCI-AD was defined by means of the t-Tau/A beta(1-42) ratio. Logistic regression analyses tested whether the combination of FCSRT and CERAD-WL measures significantly improved the prediction of MCI-AD. Progression to AD-d was analyzed in a Cox regression model.
Results: A total of 202 MCI patients with a mean follow-up of 34.2 +/- 24.2 months were included and 98 (48.5%) met the criteria for MCI-AD. The combination of FCSRT and CERAD-WL measures improved MCI-AD classification accuracy based on CSF biomarkers. Both tests yielded similar global predictive values (59.9-65.3% and 59.4-62.8% for FCSRT and CERAD-WL, respectively). MCI-AD patients with deficits in both FCSRT and CERAD-WL had a faster progression to AD-d than patients with deficits in only one test.
Conclusions: The combination of FCSRT and CERAD-WL improves the classification of MCI-AD and defines different prognostic profiles. These findings have important implications for clinical practice and the design of clinical trials.

• 出版日期2017