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Age and diagnostic performance of Alzheimer disease CSF biomarkers

2012; Lippincott Williams & Wilkins; Volume: 78; Issue: 7 Linguagem: Inglês

10.1212/wnl.0b013e3182477eed

1526-632X

Niklas Mattsson, Eric Rosen, Oskar Hansson, Nancy C. Andreasen, Lucilla Parnetti, Michael Jonsson, Sanna-Kaisa Herukka, Wiesje M. van der Flier, Marinus A. Blankenstein, Michael Ewers, Kenneth Rich, Elmar Kaiser, Marcel M. Verbeek, Marcel G. M. Olde Rikkert, Magda Tsolaki, E. Mulugeta, Dag Aarsland, Pieter Jelle Visser, J. Schröder, Jan Marcusson, Mony J. de Leon, Harald Hampel, Philip Scheltens, Anders Wallin, Maria Eriksdotter, Lennart Minthon, Bengt Winblad, Kaj Blennow, Henrik Zetterberg,

Neuroinflammation and Neurodegeneration Mechanisms

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.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.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.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.