Predicting cognitive stage transition using plasma p‐tau181, the Centiloid scale, and other measures

Abstract

AbstractBackgroundA combination of plasma phospho‐tau (p‐tau), amyloid beta (Aβ)‐PET, brain magnetic resonance imaging, cognitive function tests, and other biomarkers might predict future cognitive decline. This study aimed to investigate the efficacy of combining these biomarkers in predicting future cognitive stage transitions within 3 years.MethodAll participants were from the validation cohort of the Korean Brain Aging Study for the Early Diagnosis and Prediction of Alzheimer’s Disease (KBASE‐V) study. Among the participants in the KBASE‐V study, 49 mild cognitive impairment (MCI) and 113 cognitively unimpaired (CU) participants with Aβ‐PET and brain imaging data were analyzed. Main outcome was cognitive stage transitions within 3 years. The best combination model that predicts cognitive stage transition was considered by significant change of area under the curve (AUC) and Akaike information criterion value.ResultWithin 3 years, 19.1% of the participants showed a cognitive stage transition. Older age, increased plasma p‐tau, Aβ‐PET positivity, and decreased semantic fluency were independently associated with cognitive stage transitions. Plasma p‐tau181 (AUC = 0.673) and the Centiloid scale (AUC = 0.769) alone predicted cognitive stage transition well and correlated with each other significantly. Combining age, p‐tau181, the Centiloid scale, semantic fluency, and hippocampal volume produced better accuracy (AUC = 0.879). In MCI participants, the model combining age, p‐tau181, and the Centiloid scale demonstrated the highest predictive value (AUC = 0.963).ConclusionPlasma p‐tau181 and Centiloid scale, in combination with other biomarkers, might have high predictive value in predicting future cognitive stage transition in non‐dementia patients.