簡単な嗅覚・記憶検査で、高額な脳画像検査と同程度に効果的にアルツハイマー病を予測できる可能性(Simple Smell and Memory Tests Could Predict Alzheimer’s as Effectively as Costly Brain Imaging)

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2024-10-11 コロンビア大学

コロンビア大学の研究により、簡単な嗅覚テストと短い記憶テストを組み合わせることで、コストの高い脳画像診断と同じ精度で認知機能の低下やアルツハイマー病のリスクを予測できることが示されました。この方法は、医療現場で早期診断に役立つと期待され、より手軽で低コストな代替手段となります。研究では647名を対象に行われ、嗅覚と記憶のテストが有効な予測手段として確認されました。

<関連情報>

MCSAコホートにおける認知機能低下および認知症の予測における、簡単な嗅覚および認知機能評価と神経画像バイオマーカーの比較 Comparison of brief olfactory and cognitive assessments to neuroimaging biomarkers in the prediction of cognitive decline and dementia in the MCSA cohort

Davangere P. Devanand, Seonjoo Lee, José A. Luchsinger, David Knopman, Maria Vassilaki, Jeffrey N. Motter
Alzheimer’s & Dementia  Published: 10 October 2024
DOI:https://doi.org/10.1002/alz.14261

簡単な嗅覚・記憶検査で、高額な脳画像検査と同程度に効果的にアルツハイマー病を予測できる可能性(Simple Smell and Memory Tests Could Predict Alzheimer’s as Effectively as Costly Brain Imaging)

Abstract

INTRODUCTION
We evaluated impaired odor identification and global cognition as simple, cost-effective alternatives to neuroimaging biomarkers to predict cognitive decline and dementia in the Mayo Clinic Study of Aging.

METHODS
Six hundred forty-seven participants (mean 8.1, standard deviation 3.4 years’ follow-up) had the following baseline procedures: modified Blessed Information Memory Concentration Test (BIMCT), 12-item Brief Smell Identification Test (BSIT), structural brain magnetic resonance imaging (MRI), and positron emission tomography (PET) imaging with 11C-Pittsburgh compound B (11C-PiB) and fluorodeoxyglucose (FDG; subset).

RESULTS
Cognitive decline developed in 102 participants and dementia in 34 participants. In survival analyses, PiB PET showed robust prediction for cognitive decline. Impaired BSIT, impaired BIMCT, MRI, and FDG measures were also significant predictors. The combination of demographics + BSIT + BIMCT showed strong predictive utility (C-index 0.81), similar to demographics + PiB PET (C-index 0.80). Similar but stronger results were obtained for prediction of dementia.

DISCUSSION
Impairment in both odor identification test and global cognition was comparable to PiB PET for predicting cognitive decline and dementia.

Highlights

  • In 647 participants in the population-based Mayo Clinic Study of Aging, several clinical markers and biomarkers each predicted cognitive decline or dementia during an average 8 years of follow-up.
  • The combination of the demographic variables of age, sex, and education with a brief odor identification test (BSIT) and a global cognitive test (Blessed Information Memory Concentration Test) showed strong predictive utility (C-index 0.81) for cognitive decline that was similar to the demographic variables combined with Pittsburgh Compound B amyloid imaging (C-index 0.80).
  • Combining a brief odor identification test with a brief cognitive test needs consideration as a simple, cost-effective option in the clinical assessment of individuals at risk of cognitive decline and dementia, as well as a potential tool to identify individuals who may benefit from disease-modifying treatments and to screen participants for prevention trials.
医療・健康
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