Added Prognostic Value of Cerebrospinal Fluid Biomarkers in Predicting Decline in Memory Clinic Patients in a Prospective Cohort
| Autor: | Pieter Jelle Visser, Ron Handels, Johan L. Severens, Claire A. G. Wolfs, Bart Nm van Berckel, Frans R.J. Verhey, Jan Hoogmoed, Philip Scheltens, Willemijn J. Jansen, Marcel G. M. Olde Rikkert, Inez H.G.B. Ramakers, Albert F.G. Leentjens, Pauline Aalten, Machiel Smid, Femke H. Bouwman, Peter van Domburg, Stephanie J.B. Vos, Erik Hoff, Manuela A. Joore, Jurgen A.H.R. Claassen |
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| Přispěvatelé: | Neurology, Amsterdam Neuroscience - Neurodegeneration, Radiology and nuclear medicine, RS: CAPHRI School for Public Health and Primary Care, RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, Psychiatrie & Neuropsychologie, Health Services Research, MUMC+: KIO Kemta (9), RS: CAPHRI - R2 - Creating Value-Based Health Care, Promovendi MHN, MUMC+: MA Med Staf Spec Psychiatrie (9), Health Technology Assessment (HTA) |
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Male
Pathology medicine.medical_specialty Disease cerebrospinal fluid Cohort Studies 03 medical and health sciences 0302 clinical medicine Cerebrospinal fluid mild cognitive impairment Alzheimer Disease Reference Values Internal medicine medicine Dementia Humans Medical history 030212 general & internal medicine memory disorders Prospective cohort study Aged Aged 80 and over business.industry General Neuroscience Memory clinic Cognitive disorder Neuropsychology General Medicine Middle Aged Alzheimer's disease medicine.disease Psychiatry and Mental health Clinical Psychology sensitivity and specificity Female prognosis Geriatrics and Gerontology business Mental Status Schedule 030217 neurology & neurosurgery Biomarkers |
| Zdroj: | Journal of Alzheimer's Disease, 52(3), 875-885. IOS Press Handels, R L H, Joore, M A, Vos, S J B, Aalten, P, Ramakers, I H G B, Rikkert, M O, Scheltens, P, Jansen, W J, Visser, P-J, van Berckel, B M N, van Domburg, P, Smid, M, Hoff, E, Hoogmoed, J, Bouwman, F, Claassen, J, Leentjens, A F G, Wolfs, C A G, Severens, J L & Verhey, F R J 2016, ' Added Prognostic Value of Cerebrospinal Fluid Biomarkers in Predicting Decline in Memory Clinic Patients in a Prospective Cohort ', Journal of Alzheimer's Disease, vol. 52, no. 3, pp. 875-885 . https://doi.org/10.3233/JAD-151120 Journal of Alzheimers Disease, 52(3), 875-885. IOS Press BV |
| ISSN: | 1875-8908 1387-2877 |
| DOI: | 10.3233/JAD-151120 |
| Popis: | Background: Limited information is available on short-term prognosis of Alzheimer's disease (AD) biomarkers in cerebrospinal fluid (CSF) in addition to routine diagnostic workup. Objective: This study aims to investigate the added prognostic value of AD CSF biomarkers. Methods: In a prospective cohort study, clinical experts predicted cognitive and functional symptoms in 114 memory clinic patients by assessing comprehensive routine diagnostic test information (patient history, and physical, neurological, psychiatric, neuropsychological, and MRI examinations), without and with CSF biomarkers. The reference standard was the 'observed clinically relevant decline' using baseline and 1- and 2-year follow-up information. Results: Decline over a 2-year period was observed in 51% of all participants (3% in SMC, 48% in MCI, 90% in mild dementia). In the total sample, the accuracy of predicted decline did not differ significantly between routine assessment without (79% correctly predicted) and with (74% correctly predicted) CSF biomarkers. Subgroup analyses revealed 25 (83%) correct predictions in SMC, 30 (68%) in MCI, and 35 (88%) in dementia without the use of CSF; and 21 (70%), 27 (61%), and 36 (90%), respectively, with the use of CSF in addition to the routine assessment. Conclusion: AD CSF biomarkers did not increase accuracy of 2-year prognosis of cognitive and functional decline when added to routine diagnostic workup. This suggests that the standard diagnostic workup without CSF biomarkers allows fairly accurate predictions for the short-term course of symptoms. Routine AD biomarkers in CSF have limited prognostic value over 2 years in persons with a suspected cognitive disorder. |
| Databáze: | OpenAIRE |
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