Classification of Non-Demented Patients Attending a Memory Clinic using the New Diagnostic Criteria for Alzheimer's Disease with Disease-Related Biomarkers.

Ivanoiu, Adrian;Dricot, Laurence;Gilis, Nathalie;Grandin, Cécile;Hanseeuw, Bernard;et.al.
(2015) Journal of Alzheimer’s Disease — Vol. 43, n° 3, p. 835-847 (2015)

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Abstract
Background: New diagnostic criteria for predemential Alzheimer's disease (AD) advocate the use of biomarkers. However, the benefit of using biomarkers has not been clearly demonstrated in clinical practice. Objective: To investigate whether a combination of biomarkers may be helpful in classifying a population of non-demented patients attending a Memory Clinic. Methods: Sixty non-demented patients were compared with 31 healthy elderly subjects. All subjects underwent a neuropsychological examination, brain 3T magnetic resonance imaging, and [F18]-fluorodeoxyglucose and [F18]-flutemetamol positron emission tomography. According to their performance on memory, language, executive, and visuo-spatial domains, the patients were classified as mild cognitive impairment (amnestic, non-amnestic, single, or multiple domain) or subjective cognitive impairment. Patients were then classified according to the National Institute on Aging-Alzheimer's Association (NIA-AA) criteria, using the normalized mean hippocampal volume (Freesurfer), [F18]-FDG PALZAD, and [F18]-flutemetamol standard uptake value ratio (SUVr) (cut-off at the 10th percentile of controls). The standard of truth was the clinical status at study entry (patient versus control). Results: The sensitivity/specificity of the clinical classification was 65/84%. The NIA-AA criteria were applicable in 85% of patients and 87% of controls. For biomarkers the best sensitivity (72%) at a fixed specificity of 84% was achieved by a combination of the three biomarkers. The clinical diagnosis was reconsidered in more than one third of the patients (42%) as a result of including the biomarker results. Conclusions: Application of the new NIA-AA AD diagnostic criteria based on biomarkers in an unselected sample of non-demented patients attending a Memory Clinic was useful in allowing for a better classification of the subjects.
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Ivanoiu, A., Dricot, L., Gilis, N., Grandin, C., Lhommel, R., Quenon, L., & Hanseeuw, B. (2015). Classification of Non-Demented Patients Attending a Memory Clinic using the New Diagnostic Criteria for Alzheimer’s Disease with Disease-Related Biomarkers. Journal of Alzheimer’s Disease, 43(3), 835-847. https://doi.org/10.3233/JAD-140651 (Original work published 2015)