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https://hdl.handle.net/2440/123433
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Type: | Journal article |
Title: | Predicting Alzheimer disease with β-amyloid imaging: results from the Australian imaging, biomarkers, and lifestyle study of ageing |
Other Titles: | Predicting Alzheimer disease with beta-amyloid imaging: results from the Australian imaging, biomarkers, and lifestyle study of ageing |
Author: | Rowe, C.C. Bourgeat, P. Ellis, K.A. Brown, B. Lim, Y.Y. Mulligan, R. Jones, G. Maruff, P. Woodward, M. Price, R. Robins, P. Tochon-Danguy, H. O'Keefe, G. Pike, K.E. Yates, P. Szoeke, C. Salvado, O. Macaulay, S.L. O'Meara, T. Head, R. et al. |
Citation: | Annals of Neurology, 2013; 74(6):905-913 |
Publisher: | Wiley |
Issue Date: | 2013 |
ISSN: | 0364-5134 1531-8249 |
Statement of Responsibility: | Christopher C. Rowe, Pierrick Bourgeat, Kathryn A. Ellis, Belinda Brown, Yen Ying Lim, Rachel Mulligan, Gareth Jones, Paul Maruff, Michael Woodward, Roger Price, Peter Robins, Henri Tochon-Danguy, Graeme O’Keefe, Kerryn E. Pike, Paul Yates, Cassandra Szoeke, Olivier Salvado, S. Lance Macaulay, Timothy O’Meara, Richard Head, Lynne Cobiac, Greg Savage, Ralph Martins, Colin L. Masters, David Ames, and Victor L. Villemagne |
Abstract: | Objective: Biomarkers for Alzheimer disease (AD) can detect the disease pathology in asymptomatic subjects and individuals with mild cognitive impairment (MCI), but their cognitive prognosis remains uncertain. We aimed to determine the prognostic value of β-amyloid imaging, alone and in combination with memory performance, hippocampal atrophy, and apolipoprotein E ε4 status in nondemented, older individuals. Methods: A total of 183 healthy individuals (age = 72.0 ± 7.26 years) and 87 participants with MCI (age = 73.7 ± 8.27) in the Australian Imaging, Biomarkers, and Lifestyle study of ageing were studied. Clinical reclassification was performed after 3 years, blind to biomarker findings. β-Amyloid imaging was considered positive if the (11) C-Pittsburgh compound B cortical to reference ratio was ≥1.5. Results: Thirteen percent of healthy persons progressed (15 to MCI, 8 to dementia), and 59% of the MCI cohort progressed to probable AD. Multivariate analysis showed β-amyloid imaging as the single variable most strongly associated with progression. Of combinations, subtle memory impairment (Z score = -0.5 to -1.5) with a positive amyloid scan was most strongly associated with progression in healthy individuals (odds ratio [OR] = 16, 95% confidence interval [CI] = 3.7-68; positive predictive value [PPV] = 50%, 95% CI = 19-81; negative predictive value [NPV] = 94%, 95% CI = 88-98). Almost all amnestic MCI subjects (Z score ≤ -1.5) with a positive amyloid scan developed AD (OR = ∞; PPV = 86%, 95% CI = 72-95; NPV = 100%, 95% CI = 80-100). Hippocampal atrophy and ε4 status did not add further predictive value. Interpretations: Subtle memory impairment with a positive β-amyloid scan identifies healthy individuals at high risk for MCI or AD. Clearly amnestic patients with a positive amyloid scan have prodromal AD and a poor prognosis for dementia within 3 years. |
Keywords: | Alzheimer Disease |
Rights: | © 2014 The Authors. Annals of Neurology published by Wiley Periodicals, Inc. on behalf of American Neurological Association. This is an open access article under the terms of the Creative Commons Attribution Non-Commercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
DOI: | 10.1002/ana.24040 |
Grant ID: | http://purl.org/au-research/grants/nhmrc/1011689 |
Published version: | http://dx.doi.org/10.1002/ana.24040 |
Appears in Collections: | Aurora harvest 4 Medicine publications |
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