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Neurobiol Aging. 2007 Jul;28(7):1070-4. Epub 2006 Jun 19.

CSF biomarkers and medial temporal lobe atrophy predict dementia in mild cognitive impairment.

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1
Department of Neurology, Alzheimer Centre, VU Medical Center, MB Amsterdam, The Netherlands. femke.bouwman@vumc.nl <femke.bouwman@vumc.nl>

Abstract

OBJECTIVE:

To study CSF biomarkers, beta-amyloid(1-42) (Abeta(1-42)) and tau, and medial temporal lobe atrophy (MTA) on MRI in their ability to predict dementia in patients with mild cognitive impairment (MCI).

METHODS:

Fifty-nine MCI patients (49% male, mean age 69+/-8), follow-up 19 months, were included. Baseline CSF levels of Abeta(1-42), tau and MTA-score were dichotomized.

RESULTS:

Thirty-three (56%) of the MCI patients progressed to dementia, 30 of which had Alzheimer's disease. Lower CSF Abeta(1-42) level, higher CSF-tau and higher MTA-scores at baseline were found in progressed patients. Cox proportional hazards models revealed that abnormal CSF Abeta(1-42), CSF tau and MTA were significantly associated with dementia at follow-up (hazard ratio (95% confidence interval): 4.0 (1.3-12.1), 5.9 (1.6-21.7) and 2.1 (1.0-4.6)). A fourfold higher risk was found for patients with both abnormal CSF biomarkers and MTA compared to patients with either test abnormal. Ninety-four percent of patients with both abnormalities converted to dementia.

CONCLUSIONS:

These findings suggest an added value of CSF to MRI in the diagnostic work up of patients presenting at a memory clinic.

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