Minor Neuropsychological Deficits Indicate Risk for Progression to Alzheimer Disease

For patients with subjective cognitive decline, those with minor neuropsychological deficits have increased cognitive decline, risk for progression to MCI

By Elana Gotkine HealthDay Reporter

FRIDAY, Oct. 13, 2023 (HealthDay News) — For patients with subjective cognitive decline (SCD), minor neuropsychological deficits (MNPD) are associated with Alzheimer disease-related clinical progression, according to a study published online Oct. 11 in Neurology.

Melina Stark, from the German Center for Neurodegenerative Diseases in TÃ¼bingen, and colleagues compared cerebrospinal fluid (CSF) amyloid-Î² (AÎ²)42/AÎ²40, phosphorylated tau (p-tau₁₈₁), total tau, and AÎ²42/p-tau₁₈₁ levels, longitudinal cognitive composite trajectories, and risk for clinical progression to incident mild cognitive impairment (MCI) among patients with SCD with and without MNPD. The analysis included 672 patients: 384 with SCD without MNPD, 55 with SCD with MNPD, and 215 healthy controls.

The researchers found that compared with SCD patients without MNPD, those with MNPD had significantly more abnormal CSF biomarker levels, increased cognitive decline, and increased risk for progression to incident MCI (hazard ratio, 4.07). For progression of SCD to MCI within three years, MNPD had a positive predictive value of 57.0 percent and a negative predictive value of 86.0 percent. Compared with healthy controls without MNPD, SCD patients without MNPD had increased cognitive decline and a higher risk for incident MCI, but these groups had no significant difference in the Alzheimer disease biomarker levels.

“Testing for these deficits in people with self-reported decline could help identify people at a higher risk for progressing to mild cognitive impairment,” coauthor Michael Wagner, M.D., also from the German Center for Neurodegenerative Diseases, said in a statement.

Several authors disclosed ties to the pharmaceutical industry.