| Title | Age and diagnostic performance of Alzheimer disease CSF biomarkers. |
| Publication Type | Journal Article |
| Year of Publication | 2012 |
| Authors | Mattsson N, Rosén E, Hansson O, Andreasen N, Parnetti L, Jonsson M, Herukka S-K, van der Flier WM, Blankenstein MA, Ewers M, Rich K, Kaiser E, Verbeek MM, M Rikkert O, Tsolaki M, Mulugeta E, Aarsland D, Visser PJ, 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 | 2012 Feb 14 |
| ISSN | 1526-632X |
| Keywords | Adult, Aged, Aged, 80 and over, Aging, Alzheimer Disease, Biomarkers, Cognitive Dysfunction, Cohort Studies, Cross-Sectional Studies, Endpoint Determination, Female, Humans, Likelihood Functions, Longitudinal Studies, Male, Middle Aged, Models, Neurological, Predictive Value of Tests, Reproducibility of Results, ROC Curve, tau Proteins |
| 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 |
| Alternate Journal | Neurology |
| PubMed ID | 22302554 |
| PubMed Central ID | PMC3280049 |
| Grant List | P30 AG008051 / AG / NIA NIH HHS / United States R01 AG012101 / AG / NIA NIH HHS / United States R01 AG022374 / AG / NIA NIH HHS / United States |
Related Institute:
Brain Health Imaging Institute (BHII)