Alzheimer’s Disease: CSF Biomarker Predicts Preclinical Cognitive Decline

Argonde van Harten From the Alzheimer Center School for Mental Health and Neurosciences, Maastricht University Medical Center, Maastricht, the Netherlands. MedicalResearch.com Interview Invitation
Argonde van Harten
From the Alzheimer Center
School for Mental Health and Neurosciences, Maastricht University Medical Center, Maastricht, the Netherlands.
MedicalResearch.com: What are the main findings of the study?

Answer: We found cerebrospinal fluid biomarker evidence of preclinical Alzheimer’s disease (AD) predicted cognitive decline in patients with subjective complaints. These patients have cognitive complaints, but are cognitively normal at baseline. Preclinical AD predicted decline in memory performance, executive functions and global cognition over time. Most patients, however, had no evidence of preclinical AD and their cogntive functions generally remained stable over two years. Their memory performance improved.

MedicalResearch.com: Were any of the findings unexpected?

Answer: We expected preclinical Alzheimer’s disease would predict cognitive decline, but it was interesting to find this decline was not restricted to memory alone. In this study we looked at very subtle and very early cogntive decline, which has mostly not led to dementia yet. Knowing that executive functioning and global cognition also deteriorate this early in the clinical continuum of AD is very important.

MedicalResearch.com: What should clinicians and patients take away from your report

Answer: Clinicians should be aware “subjective complaints” is a heterogeneous entity and CSF biomarkers can help predict its cognitive outcome. For now, however, it is too early for implementation into clinical practice. We cannot give a patient with preclinical AD an individual prognosis yet. In future, however, our findings may be of use when designing intervention studies for preclinical AD or when making desisions concerning the nessecity of clinical follow-up.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Answer: Our results have to be validated in a larger cohort, especially containing more subjects with preclinical Alzheimer’s disease. Also, it would be good to find out what the influence of APOEe4 genotype is on the predictive value of preclinical Alzheimer’s disease.

Citation:

Preclinical AD predicts decline in memory and executive functions in subjective complaints

Argonde C. van Harten, MD, Lieke L. Smits, MSc, Charlotte E. Teunissen, PhD, Pieter J. Visser, MD, PhD, Teddy Koene, MSc, Marinus A. Blankenstein, PhD, Philip Scheltens, MD, PhD and Wiesje M. van der Flier, PhD

Published online before print September 18, 2013, doi: 10.1212/WNL.0b013e3182a8418b

Neurology 10.1212/WNL.0b013e3182a8418b