Prediction of the Risk of Conversion from Mild Cognitive Impairment to Alzheimer`S Disease Dementia

Abstract

Purpose:  Identification of individuals at high risk of progressive cognitive deterioration may be useful for prognosis and intervention. The present investigation addressed the development of an algorithm for predicting the risk of conversion from mild cognitive impairment (MCI) to Alzheimer’s disease (AD) based on clinical, sociodemographic and laboratory data over a three-year clinical follow-up. Methods: Thirty-eight elderly patients of both sexes, diagnosed with MCI, participated in the present study. A total of 72 variables including inflammatory, hemostatic and vascular parameters, in addition to clinical, sociodemographic and cognitive evolution data of the patients were used in the construction of an algorithm to estimate the probability of an individual evolving from MCI to AD within a three-year period. Results: Age, gender, peak of thrombin generation test in the presence of activated protein C (TG peak+aPC) and homocysteine were the variables found independently associated with the highest risk of conversion from MCI to AD, that is, male patients aged ≥ 80 years old,  TG peak+aPC ≥58nM and homocysteine levels ≥ 30 µmol/L. Conclusion: Based on the results presented here, we propose that elderly patients, mainly males, should have their serum homocysteine levels and hemostatic status constantly monitored and, in cases of hyperhomocysteinemia and hypercoagulability, control measures should be taken immediately, provided that these changes are potentially modifiable. We suggest that the adoption of measures to control these undesirable conditions may reduce the chances of patients evolving from MCI to AD.