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A 2-Year Follow-up Study

Barbara Borroni, MD; Francesca Colciaghi, PhD; Carlo Caltagirone, MD; Luca Rozzini, MD; Laura Broglio, MD; Flaminio Cattabeni, PhD; Monica Di Luca, PhD; Alessandro Padovani, MD, PhD

Arch Neurol. 2003;60:1740-1744.

Background  Alteration of the amyloid precursor protein (APP) forms ratio has been described in the platelets of patients with dementia of Alzheimer type (DAT) and in a subset of subjects with mild cognitive impairment (MCI).

Objective  To evaluate the potential role of the platelet APP forms ratio in predicting progression from MCI to DAT.

Design  Thirty subjects with MCI underwent a clinical and neuropsychological examination and a determination of the platelet APP forms ratio. Subjects were followed up periodically for 2 years, and the progression to dementia was evaluated.

Setting  Community population-based sample of patients admitted for memory complaints.

Results  Patients who progressed to DAT at the 2-year follow-up (n = 12) showed a significant decrease of baseline platelet APP forms ratio values (mean ± SD, 0.36 ± 0.28) compared with stable MCI subjects (mean ± SD, 0.73 ± 0.32) (P<.01) and patients who developed other types of dementia (mean ± SD, 0.83 ± 0.27) (P = .03). By fixing a cutoff score of 0.6, 10 (83%) of the 12 DAT patients showed baseline values below the cutoff, whereas 10 (71%) of 14 subjects who either developed non-Alzheimer–type dementia or maintained cognitive functions had values in the normal range.

Conclusion  Mild cognitive impairment is a major risk factor for DAT, and Alzheimer disease–related pathological changes can be identified in patients converting to DAT within a 2-year follow-up.

From the Department of Neurology, University of Brescia, Brescia (Drs Borroni, Rozzini, Broglio, and Padovani), the Institute of Pharmacological Sciences, Centre of Excellence for Neurodegenerative Disorders, University of Milan, Milan (Drs Colciaghi, Cattabeni, and Di Luca), and the Department of Neurology, University "Tor Vergata," Rome (Dr Caltagirone), Italy.

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