The usefulness of visual rating of posterior atrophy in predicting rapid cognitive decline in Alzheimer disease: A preliminary study.

Abstract

BACKGROUND:

Approximately 10% to 30% of Alzheimer disease (AD) patients progress rapidly in severity and become more dependent on caregivers. Although several studies have investigated whether imaging biomarkers such as medial temporal atrophy (MTA) and posterior atrophy (PA) are useful for predicting the rapid progression of AD, their results have been inconsistent.

OBJECTIVE:

The study aims to investigate the association of visually rated MTA and PA with rapid disease progression in AD.

METHODS:

This was a retrospective cohort study of 159 AD patients who were initially diagnosed with mild AD and were followed for 1 year to determine whether they progressed rapidly (a decrease of three points or more on the Mini-Mental State Examination over 1 year). We used 5-point and 4-point visual rating scales to assess MTA and PA, respectively. MTA and PA scores for each patient were dichotomized as normal (without atrophy) or abnormal (atrophy). We performed a logistic regression analysis to determine the odds ratios (ORs) of MTA and PA for rapid disease progression with adjustment for covariates.

RESULTS:

Within the study population, 47 (29.6%) patients progressed rapidly. Visual assessment of the magnetic resonance imaging (MRI) scans revealed that 112 patients (70.4%) showed MTA, whereas 80 patients (50.3%) showed PA. The ORs with 95% confidence intervals for MTA and PA were 1.825 (0.819-4.070) and 2.844 (1.378-5.835), respectively. The association of visually assessed PA, but not MTA, with rapid progression was significant after adjustment for covariates.

CONCLUSION:

In patients with mild AD, visual assessment of PA exhibits independent predictive value for rapid disease progression.

• Authors: Jeewon Suh, Young Ho Park, Hang-Rai Kim, Jae-Won Jang, Min Ju Kang, Jimin Yang, Min Jae Baek, SangYun Kim
• Journal: International journal of geriatric psychiatry (Int J Geriatr Psychiatry) Vol. 34 Issue 4 Pg. 625-632 (04 2019) ISSN: 1099-1166 [Electronic] England
• PMID: 30714196 (Publication Type: Journal Article)
• Copyright: © 2019 John Wiley & Sons, Ltd.

Topics

• Aged
• Alzheimer Disease (diagnosis)
• Atrophy
• Cognitive Dysfunction (diagnosis)
• Female
• Humans
• Magnetic Resonance Imaging
• Male
• Middle Aged
• Retrospective Studies
• Temporal Lobe (diagnostic imaging)