Publication Type Academic Article
Authors Mattsson N, Rosén E, Hansson O, Andreasen N, Parnetti L, Jonsson M, Herukka S, van der Flier W, Blankenstein M, Ewers M, Rich K, Kaiser E, Verbeek M, Olde Rikkert M, Tsolaki M, Mulugeta E, Aarsland D, Visser P, Schröder J, Marcusson J, de Leon M, Hampel H, Scheltens P, Wallin A, Eriksdotter-Jönhagen M, Minthon L, Winblad B, Blennow K, Zetterberg H
Journal Neurology
Volume 78
Issue 7
Pagination 468-76
Date Published 02/01/2012
ISSN 1526-632X
Keywords Aging, Alzheimer Disease
Abstract OBJECTIVES: Core CSF changes in Alzheimer disease (AD) are decreased amyloid β(1-42), increased total tau, and increased phospho-tau, probably indicating amyloid plaque accumulation, axonal degeneration, and tangle pathology, respectively. These biomarkers identify AD already at the predementia stage, but their diagnostic performance might be affected by age-dependent increase of AD-type brain pathology in cognitively unaffected elderly. METHODS: We investigated effects of age on the diagnostic performance of CSF biomarkers in a uniquely large multicenter study population, including a cross-sectional cohort of 529 patients with AD dementia (median age 71, range 43-89 years) and 304 controls (67, 44-91 years), and a longitudinal cohort of 750 subjects without dementia with mild cognitive impairment (69, 43-89 years) followed for at least 2 years, or until dementia diagnosis. RESULTS: The specificities for subjects without AD and the areas under the receiver operating characteristics curves decreased with age. However, the positive predictive value for a combination of biomarkers remained stable, while the negative predictive value decreased only slightly in old subjects, as an effect of the high AD prevalence in older ages. CONCLUSION: Although the diagnostic accuracies for AD decreased with age, the predictive values for a combination of biomarkers remained essentially stable. The findings highlight biomarker variability across ages, but support the use of CSF biomarkers for AD even in older populations.
DOI 10.1212/WNL.0b013e3182477eed
PubMed ID 22302554
PubMed Central ID PMC3280049
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