Prediction of Alzheimer's disease in mild cognitive impairment: A prospective study in Taiwan

Wang, P.N.; Lirng, J.F; Lin, K.N.; Chang, F.C.; Liu, H.C.

doi:10.1016/j.neurobiolaging.2005.10.002

« Previous Next »Neurobiology of Aging
Volume 27, Issue 12 , Pages 1797-1806, December 2006

Prediction of Alzheimer's disease in mild cognitive impairment: A prospective study in Taiwan

P.N. Wang
- Department of Neurology, National Yang-Ming University School of Medicine, Taiwan
- The Neurological Institute, Taipei Veterans General Hospital, Taipei 112, Taiwan
J.F Lirng
- Department of Radiology, National Yang-Ming University School of Medicine, Taiwan
- Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan
K.N. Lin
- Department of Neurology, National Yang-Ming University School of Medicine, Taiwan
- The Neurological Institute, Taipei Veterans General Hospital, Taipei 112, Taiwan
- Department of Psychology, Fu Jen Catholic University, Taipei County, Taiwan
F.C. Chang
- Department of Radiology, National Yang-Ming University School of Medicine, Taiwan
- Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan
H.C. Liu
- Department of Neurology, National Yang-Ming University School of Medicine, Taiwan
- The Neurological Institute, Taipei Veterans General Hospital, Taipei 112, Taiwan
- Corresponding author. Tel.: +886 2 2875 7492; fax: +886 2 2873 8696.

Received 20 March 2005; received in revised form 2 October 2005; accepted 5 October 2005. published online 30 November 2005.

Abstract

The relationship between apolipoprotein E (ApoE) and clinical manifestations of mild cognitive impairment (MCI) has not been investigated in non-Caucasian populations. This prospective study was conducted in an ethnic Chinese population to evaluate the correlations of ApoE genotype, cognitive performance, medial temporal structure volumes, and clinical outcome in amnestic MCI. Twenty normal elders, 58 MCI, and 20 mild Alzheimer's disease (AD) patients received neuropsychological, MRI, and ApoE genotype assessments at baseline. Patients with MCI had intermediate cognitive performance and hippocampal volumes between those in normal and AD groups. In each diagnostic group, ɛ4 carriers (E4+) consistently had smaller hippocampal volume than non-carriers (E4−) did. Nineteen MCI subjects (32.7%) converted to AD during the 3-year study period. Compared with MCI non-converters and E4− MCI converters, E4+ MCI converters had the smallest hippocampal volume. However, ɛ4 was not a predictor for AD. Both cognitive performance and hippocampal volume were predictive for progression to AD. However, stepwise Cox regression model integrating both neuropsychological and radiological variables showed that global cognitive performance was the only significant predictor for AD. A poor global cognitive score may be more crucial than a small hippocampal volume in the prediction of AD.

Keywords: Mild cognitive impairment, Hippocampus, MRI, Cognition, ApoE, Prediction, Dementia