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The study by Riemenschneider et al¹ suggests that markers of Alzheimer disease (AD) can be detected when patients are in the mild cognitive impairment (MCI) stage and that these markers are associated with the progression of cognitive symptoms. We wish to place the results of their study in a clinical context to imply that the detection of the biological "fingerprint" of AD in patients with MCI might be sufficiently accurate for clinical decisions.

The authors studied 28 patients with MCI using cerebrospinal fluid (CSF) assays of tau protein, a marker of neuronal and axonal damage that follows neurofibrillary tangle deposition. They found that CSF tau protein levels were elevated and that -amyloid 42 (A42) protein levels were decreased in the 16 subjects who had progressive cognitive deterioration during the following 18 months (10 satisfying and 6 not satisfying AD criteria) compared with those who did not progress or who . . . [Full Text of this Article]

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