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Research paper
Risk factors for predicting progression from mild cognitive impairment to Alzheimer’s disease: a systematic review and meta-analysis of cohort studies
  1. Jie-Qiong Li1,
  2. Lan Tan1,2,3,
  3. Hui-Fu Wang2,
  4. Meng-Shan Tan3,
  5. Lin Tan3,
  6. Wei Xu1,
  7. Qing-Fei Zhao1,
  8. Jun Wang1,
  9. Teng Jiang2,
  10. Jin-Tai Yu1,2,3,4
  1. 1Department of Neurology, Qingdao Municipal Hospital, School of Medicine, Qingdao University, Qingdao, China
  2. 2Department of Neurology, Qingdao Municipal Hospital, Nanjing Medical University, Qingdao, China
  3. 3College of Medicine and Pharmaceutics, Ocean University of China, Qingdao, China
  4. 4Department of Neurology, Memory and Aging Center, University of California, San Francisco, California, USA
  1. Correspondence to Dr Jin-Tai Yu, Department of Neurology, Memory and Aging Center, University of California, 675 Nelson Rising Lane, Suite 190, Box 1207, San Francisco, CA 94158, USA; yu-jintai{at}163.com

Abstract

Objective We sought to identify the risk factors for predicting the progression from mild cognitive impairment (MCI) to Alzheimer’s disease (AD).

Methods We searched 6 electronic databases for cohort studies published from January 1966 to March 2015. Eligible studies were required to be relevant to the subject and provide sufficient data for our needs.

Results 60 cohort studies with 14 821 participants from 16 countries were included in the meta-analysis. The strongest positive associations between risk factors and the progression from MCI to AD were found for abnormal cerebrospinal fluid (CSF), phosphorylated τ (p-τ) (relative risk (RR)=2.43, 95% CI=1.70 to 3.48), abnormal CSF τ/Aβ1–42 (RR=3.77, 95% CI=2.34 to 6.09), hippocampal atrophy (RR=2.59, 95% CI=1.95 to 3.44), medial temporal lobe atrophy (RR=2.11, 95% CI=1.70 to 2.63) and entorhinal atrophy (RR=2.03, 95% CI=1.57 to 2.62). Further positive associations were found for the presence of apolipoprotein E (APOE)ε4ε4 and at least 1 APOEε4 allele, CSF total-τ (t-τ), white matter hyperintensity volume, depression, diabetes, hypertension, older age, female gender, lower mini-mental state examination (MMSE) score and higher AD assessment scale cognitive subscale (ADAS-cog) score. Negative associations were found for high body mass index (RR=0.85, 95% CI=0.76 to 0.96) and higher auditory verbal learning test delay score (RR=0.86, 95% CI=0.77 to 0.96).

Conclusions Patients with MCI with APOEε4, abnormal CSF τ level, hippocampal and medial temporal lobe atrophy, entorhinal atrophy, depression, diabetes, hypertension, older age, female gender, lower MMSE score and higher ADAS-cog score, had a high risk for the progression to AD.

  • ALZHEIMER'S DISEASE
  • META-ANALYSIS
  • SYSTEMATIC REVIEWS

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