Impairment of neocortical metabolism predicts progression in Alzheimer's disease

Progression rates of Alzheimer's disease (AD) vary considerably, and they a re particularly difficult to predict in patients with mild cognitive impair ment. We performed a prospective multicenter cohort study in 186 patients w ith possible or probable AD, mostly with presenile onset. In a cross-sectio nal analysis at entry, impairment of glucose metabolism in temporoparietal or frontal association areas measured with positron emission tomography was significantly associated with dementia severity, clinical classification a s possible versus probable AD, presence of multiple cognitive deficits and history of progression. A prospective longitudinal analysis showed a signif icant association between initial metabolic impairment and subsequent clini cal deterioration. In patients with mild cognitive deficits at entry, the r isk of deterioration was up to 4.7 times higher if the metabolism was sever ely impaired than with mild or absent metabolic impairment. Copyright (C) 1 999 S. Karger AG. Basel.