Neuroscience
Predictive value of APOE-ε4 allele for progression from MCI to AD-type dementia: A meta-analysis
Journal of Neurology Neurosurgery and Psychiatry. 2011 Oct; 82(10): 1149-1156.
Elias-Sonnenschein LS, Viechtbauer W, Ramakers IH, Verhey FR, Visser PJ
Abstract
BACKGROUND: The identification of subjects with mild cognitive impairment (MCI) at high risk for Alzheimer's disease (AD) is important for prognosis and early intervention. The APOE-ε4 allele is the strongest known genetic risk factor for AD. The authors performed a meta-analysis to establish the predictive accuracy of the APOE-ε4 allele for progression from MCI to AD-type dementia.
METHODS: The authors included 35 prospective cohort studies of subjects with MCI, including 6095 subjects, of whom 1236 progressed to AD-type dementia after 2.9 years of follow-up. Pooled estimates of the OR, sensitivity, specificity, positive and negative predictive values (PPV and NPV), and positive and negative likelihood ratios (LR+ and LR-) were obtained using random-effects models.
RESULTS: The OR for subjects with MCI who are carriers of APOE-ε4 allele to progress to AD-type dementia was 2.29 (95% CI 1.88 to 2.80), the sensitivity was 0.53 (95% CI 0.46 to 0.61), the specificity was 0.67 (95% CI 0.62 to 0.71), the PPV was 0.57 (95% CI 0.48 to 0.66), the NPV was 0.75 (95% CI 0.70 to 0.80), the LR+ was 1.60 (95% CI 1.48 to 1.72), and the LR- was 0.75 (95% CI 0.67 to 0.82). Meta-regression showed that sensitivity, specificity and NPV were dependent on age, APOE-ε4 allele background prevalence or follow-up length.
CONCLUSIONS: The APOE-ε4 allele is associated with a moderately increased risk for progression from MCI to AD-type dementia. The low sensitivity and PPV makes genotyping of limited value for predicting AD-type dementia in clinical practice. For trials aiming to prevent progression from MCI to AD-type dementia, APOE genotyping may be useful in selecting subjects with a higher risk for progression to AD-type dementia.
PMID: 21493755 [PubMed - indexed for MEDLINE]
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Neuroscience
Neuropsychology Abstract of the Day: MCI
Predictive value of APOE-ε4 allele for progression from MCI to AD-type dementia: A meta-analysis
Journal of Neurology Neurosurgery and Psychiatry. 2011 Oct; 82(10): 1149-1156.
Elias-Sonnenschein LS, Viechtbauer W, Ramakers IH, Verhey FR, Visser PJ
Abstract
BACKGROUND: The identification of subjects with mild cognitive impairment (MCI) at high risk for Alzheimer's disease (AD) is important for prognosis and early intervention. The APOE-ε4 allele is the strongest known genetic risk factor for AD. The authors performed a meta-analysis to establish the predictive accuracy of the APOE-ε4 allele for progression from MCI to AD-type dementia.
METHODS: The authors included 35 prospective cohort studies of subjects with MCI, including 6095 subjects, of whom 1236 progressed to AD-type dementia after 2.9 years of follow-up. Pooled estimates of the OR, sensitivity, specificity, positive and negative predictive values (PPV and NPV), and positive and negative likelihood ratios (LR+ and LR-) were obtained using random-effects models.
RESULTS: The OR for subjects with MCI who are carriers of APOE-ε4 allele to progress to AD-type dementia was 2.29 (95% CI 1.88 to 2.80), the sensitivity was 0.53 (95% CI 0.46 to 0.61), the specificity was 0.67 (95% CI 0.62 to 0.71), the PPV was 0.57 (95% CI 0.48 to 0.66), the NPV was 0.75 (95% CI 0.70 to 0.80), the LR+ was 1.60 (95% CI 1.48 to 1.72), and the LR- was 0.75 (95% CI 0.67 to 0.82). Meta-regression showed that sensitivity, specificity and NPV were dependent on age, APOE-ε4 allele background prevalence or follow-up length.
CONCLUSIONS: The APOE-ε4 allele is associated with a moderately increased risk for progression from MCI to AD-type dementia. The low sensitivity and PPV makes genotyping of limited value for predicting AD-type dementia in clinical practice. For trials aiming to prevent progression from MCI to AD-type dementia, APOE genotyping may be useful in selecting subjects with a higher risk for progression to AD-type dementia.
PMID: 21493755 [PubMed - indexed for MEDLINE]
- Neuropsychology Abstract Of The Day: Amnestic Mild Cognitive Impairment (amci)
Outcome of Mild Cognitive Impairment Comparing Early Memory Profiles. American Journal of Geriatric Psychiatry. 2011 Sep 19; Authors: Gómez-Tortosa E, Mahillo-Fernández I, Guerrero R, Montoya J, Alonso A, Sainz MJ Abstract BACKGROUND:: Finding variables...
- Neuropsychology Abstract Of The Day: Alzheimer's, Mci, & Csf Markers
Mattsson N, Zetterberg H, Hansson O, Andreasen N, Parnetti L, Jonsson M, Herukka SK, van der Flier WM, Blankenstein MA, Ewers M, Rich K, Kaiser E, Verbeek M, Tsolaki M, Mulugeta E, Rosén E, Aarsland D, Visser PJ, Schröder J, Marcusson J, de Leon M,...
- Neuropsychology Abstract Of The Day: Donepezil, Mci, And Ad
Lu PH, Edland SD, Teng E, Tingus K, Petersen RC, Cummings JL & Alzheimer's Disease Cooperative Study Group. (2009) Donepezil delays progression to AD in MCI subjects with depressive symptoms. Neurology, 72(24):, 2115-2121. Departments of Neurology,...
- Neuropsychology Abstract Of The Day: Cognitive Function In 95-year-olds
Börjesson-Hanson A, Gustafson D, & Skoog I. Five-year mortality in relation to dementia and cognitive function in 95-year-olds. Neurology. 2007 Nov 27; 69(22): 2069-2075. Neuropsychiatric Epidemiology Unit, Psychiatry Section, Institute of Neuroscience...
- Apoe (apolipoprotein E) Impact On Memory In Healthy Older Adults
The following study (see press release below and obtain the free full-text content of the research paper at full text) has received a good deal of media attention over the past couple of days. Date: January 23, 2005 Contact: Public Affairs Office...