Abstract Details

Title Validation and Comparison of NIA-AA and IWG Diagnostic Criteria for Alzheimer's Disease in MCI Patients Coming from Three European Memory Clinics

Topic Aging and Dementia

Presentation(s) S24 - (-)

Poster/Presentation
Number 001

Objective

Background The availability of in vivo biomarkers of Alzheimer's Disease (AD) neuropathology has led to the development of new diagnostic criteria that reconceptualize AD as a disease featuring the combination of brain amyloidosis and neurodegeneration beyond a core of clinical symptoms.

Design/Methods Markers of amyloidosis (abnormal CSF Abeta42) and neurodegeneration (hippocampal atrophy, TP hypometabolism on FDG PET, and abnormal CSF tau) were measured in 73 MCI patients clinically followed for at least 1 year (mean of 28±17 months) to ascertain progression to AD. Positive (LR+) and negative likelihood ratios (LR-) of individual items of IWG and NIA-AA criteria were compared.

Results 29 MCI patients progressed to AD (pMCI) and 44 remained stable (sMCI). Among IWG criteria, positivity to any biomarker had lowest LR- (0.00), while positivity to FDGPET had highest LR+ (5.82) and low LR- (0.24) (IWG criteria). Among NIA-AA criteria, positivity to neurodegeneration (FDG-PET, MRI or CSF tau markers, irrespective of amyloidosis status) had lowest LR- (0.06), while positivity to AB42 and FDGPET or AB42 and hippocampal volume atrophy had highest LR+ (6.45 and 5.56).

Conclusions Markers of neurodegeneration are the strongest positive and negative predictors of short term incident dementia in MCI, irrespective of amyloidosis status. FDG-PET is the strongest individual positive predictive biomarker.

Authors/Disclosures
Giovanni B. Frisoni, MD (Alzheimer's Unit IRCCS) PRESENTER	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Philip Scheltens, MD, PhD, FAAN (Alzheimer Center Amsterdam University medical Center)	Dr. Scheltens has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for NOVO NOrdisk.
Michael Levy, MD, PhD, FAAN (Massachusetts General Hospital/Harvard Medical School)	Dr. Levy has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Mitsubishi Pharma. Dr. Levy has received personal compensation in the range of $500-$4,999 for serving as a Consultant for UCB Pharma. Dr. Levy has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi. Dr. Levy has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Levy has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon. Dr. Levy has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Levy has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier. Dr. Levy has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Various law firms. The institution of Dr. Levy has received research support from National Institutes Health.
Claudio Gasperini, MD	Dr. Gasperini has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Roche, Merck, Genzyme, Novartis,Bayer, Teva, Almirall.

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