Alzheimer's Disease Neuroimaging Initiative (ADNI)
Open accessAbstract
BACKGROUND: Neuroimaging measures and chemical biomarkers may be important indices of clinical progression in normal aging and mild cognitive impairment (MCI) and need to be evaluated longitudinally. OBJECTIVE: To characterize cross-sectionally and longitudinally clinical measures in normal controls, subjects with MCI, and subjects with mild Alzheimer disease (AD) to enable the assessment of the utility of neuroimaging and chemical biomarker measures. METHODS: A total of 819 subjects (229 cognitively normal, 398 with MCI, and 192 with AD) were enrolled at baseline and followed for 12 months using standard cognitive and functional measures typical of clinical trials. RESULTS: The subjects with MCI were more memory impaired than the cognitively normal subjects but not as impaired as the subjects with AD. Nonmemory cognitive measures were only minimally impaired in the subjects with MCI. The subjects with MCI progressed to dementia in 12 months at a rate of 16.5% per year. Approximately 50% of the subjects with MCI were on antidementia therapies. There was minimal movement on the Alzheimer's Disease Assessment Scale-Cognitive Subscale for the normal control subjects, slight movement for the subjects with MCI of 1.1, and a modest change for the subjects with AD of 4.3. Baseline CSF measures of Abeta-42 separated the 3 groups as expected and successfully predicted the 12-month change in cognitive measures. CONCLUSION: The Alzheimer's Disease Neuroimaging Initiative has successfully recruited cohorts of cognitively normal subjects, subjects with mild cognitive impairment (MCI), and subjects with Alzheimer disease with anticipated baseline characteristics. The 12-month progression rate of MCI was as predicted, and the CSF measures heralded progression of clinical measures over 12 months.
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Written from the paper’s full text.
TL;DR
This ADNI clinical characterization paper reports baseline and 12-month clinical, cognitive, and CSF biomarker data for 819 participants: 229 cognitively normal, 398 with MCI, and 192 with mild AD. It shows expected group differences at baseline, a 16.5% 12-month MCI-to-AD progression rate, and baseline CSF Aβ-42 predicting 12-month cognitive change in normal and MCI groups.
Key findings
- At baseline, ADAS-Cog total scores were 6.2 ± 2.9 in controls, 11.5 ± 4.4 in MCI, and 18.6 ± 6.3 in AD (p < 0.001); MCI subjects were most impaired on memory items and only mildly impaired in nonmemory domains.
- Over 12 months, 64 of 398 MCI subjects progressed to AD, a rate of 16.5% (95% CI 11.9%–20.5%); normal controls progressed to MCI at an estimated 1.4% (95% CI 0%–3.2%).
- ADAS-Cog 12-month change was −0.5 ± 3.0 in controls, 1.1 ± 4.4 in MCI, and 4.3 ± 6.6 in AD (p < 0.001).
- Baseline CSF Aβ-42 decreased across groups (controls 206 ± 5, MCI 164 ± 4, AD 143 ± 4 pg/mL; p < 0.001), and higher baseline Aβ-42 was associated with better ADAS-Cog performance and smaller 12-month change in normal subjects and MCI.
Methods
- Multicenter ADNI cohort of 819 subjects aged 55–90 enrolled at baseline and classified as cognitively normal, MCI, or mild AD using standard clinical, cognitive, and functional criteria; subjects were followed for 12 months with cognitive and functional measures, MRI/PET in subsets, and lumbar puncture in a minimum of 20% per site.
- Baseline group comparisons used nonparametric tests (Kruskal-Wallis) with Hochberg multiple comparisons and exact tests for proportions; 12-month change was summarized as conversion proportion, baseline-to-12-month mean or percent difference, and rate per year from mixed-effects regression models.
- Annual conversion rates were estimated using a hybrid interval-censored method; CSF Aβ-42 was related to diagnosis, ADAS-Cog performance, and 12-month ADAS-Cog change.
Limitations
- The paper states that a 12-month change period is not sufficient to draw conclusions about the likelihood of clinical change, and that the ADNI cohort likely does not represent “typical” community subjects because participants were more highly educated, mostly white, and had a high proportion of APOE4 carriers in the MCI and AD groups.
- The paper also states that the MCI criteria required a stringent degree of memory impairment, so these subjects were likely further along the clinical spectrum and more likely to progress than less-impaired MCI subjects.
- Evident from the text: CSF analyses were limited to subsets (baseline n = 114 controls, 199 MCI, 102 AD), and some subjects lacked 12-month follow-up diagnoses (17 controls and 41 MCI subjects), which limits interpretation of conversion and biomarker results.
Model-written summary. Check it against the paper before relying on it.
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Claims the paper makes
0 of 23 cited sources checked · 0 supported · 0 flagged
- Findingown data
Baseline CSF Aβ-42 successfully predicted 12-month change in cognitive measures.
“successfully predicted the 12-month change in cognitive measures.”
Quote in the paperSubstantial claim - Findingown data
The MCI group's 12-month change resembled the AD group for digit span, category fluency, and trail making.
“but they looked more like the AD group for change in digit span, category fluency, and trail making”
Quote in the paperNot a substantial claim - Findingown data
In the ADNI cohort, nonmemory cognitive measures were only minimally impaired in subjects with MCI.
“Nonmemory cognitive measures were only minimally impaired in the subjects with MCI.”
- Also stated in: § RESULTS Baseline characteristics. · hedged
“The neuropsychological battery indicated that, in general, subjects with MCI were more impaired than controls on the memory items and were only mildly impaired in nonmemory domains (table 3).”
Quote in the paperNot a substantial claim - Also stated in: § RESULTS Baseline characteristics. · hedged
- Findingown data
Subjects with AD were impaired in virtually all cognitive areas tested.
“The sub-jects with AD were impaired in virtually all of the cognitive areas tested.”
Quote in the paperNot a substantial claim - Findingown data
Subjects with MCI gained most of their ADAS-Cog error points on memory items.
“These scores indicated, however, that the subjects with MCI gained most of their error points on memory items.”
Quote in the paperNot a substantial claim
- Findingown data
Baseline CSF Aβ-42 levels separated the three diagnostic groups.
“Baseline CSF measures of A-42 separated the 3 groups as expected”
Quote in the paperSubstantial claim - Findingown data
The next greatest area of impairment for subjects with MCI was executive function.
“The next greatest area of impairment for the subjects with MCI resulted from the executive function domain.”
Quote in the paperNot a substantial claim - Findingown data
Subjects with MCI in ADNI progressed to dementia over 12 months at a rate of 16.5% per year.
“The subjects with MCI progressed to dementia in 12 months at a rate of 16.5% per year.”
Quote in the paperNot a substantial claim - Findingown data
The subjects with mild AD showed a decline on most measures over 12 months.
“The subjects with MCI also remained relatively stable as a group, and the subjects with mild AD showed a decline on most of these measures.”
Quote in the paperNot a substantial claim - Findingown data
The interaction of Aβ-42 and time did not have a significant effect on ADAS-Cog scores in normal subjects.
“The interaction of A-42 and time also had a significant effect on ADAS-Cog scores in subjects with MCI ( p ϭ 0.00), but not in normal subjects.”
Quote in the paperNot a substantial claim - Findingown data
Higher baseline levels of Aβ-42 were associated with a smaller change over 12 months on the ADAS-Cog in subjects with MCI (r = -0.29; 95% CI -0.41 to -0.16).
“Similarly, the annual rate of change on the ADAS-Cog against A-42 at screening suggested that higher baseline levels of A-42 were associated with a smaller change over 12 months in the normal subjects (r ϭ Ϫ0.23; 95% CI Ϫ0.40 to Ϫ0.05) and in MCI (r ϭ Ϫ0.29; 95% CI Ϫ0.41 to Ϫ0.16).”
Quote in the paperNot a substantial claim - Findingown data
Lower CSF Aβ-42 level at baseline was associated with greater cognitive change over 12 months in both normal subjects and subjects with MCI.
“In addition, the lower the CSF A-42 level at baseline, the greater the cognitive change over 12 months in both the normal subjects and subjects with MCI, suggesting that baseline A levels might be used to stratify subjects' likelihood of progressing more rapidly.”
Quote in the paperSubstantial claim- Rests on an assumption: CSF Aβ-42 level is a valid biomarker of Alzheimer's disease pathology and progression.
- Findingreasoning
The memory performance of subjects with MCI was slightly better than that of subjects with mild AD by design.
“The summary of the baseline characteristics of the subjects indicated that the subjects with MCI were memory impaired compared to the normal controls and their memory performance was slightly better than that of the subjects with mild AD by design.”
Quote in the paperNot a substantial claim - Findingcitation
The subjects recruited for ADNI tend to be more highly educated.
“They tend to be more highly educated and the proportion of APOE4 carriers was quite high in the MCI and AD groups but is consistent with subjects recruited for clinical trials.25”
Quote in the paperNot a substantial claim - Findingown data
Among the 229 normal control subjects, 3 progressed to MCI over 12 months.
“Among the 229 subjects who were recruited in the normal control group, only 3 progressed to MCI over 12 months and none to AD; 17 did not have final diagnosis for 12-month follow-up.”
Quote in the paperNot a substantial claim - Findingnone given
The 12-month change data indicated little movement on many of the global scales.
“The 12-month change data indicated little movement on many of the global scales.”
Quote in the paperNot a substantial claim - Findingown data
Higher levels of Aβ-42 were associated with better performance on the ADAS-Cog in normal subjects (r = -0.21; 95% CI -0.38 to -0.03).
“Higher levels of A-42 were associated with better performance on the ADAS-Cog in normal subjects (r ϭ Ϫ0.21; 95% CI Ϫ0.38 to Ϫ0.03) and subjects with MCI (r ϭ Ϫ0.22; 95% CI Ϫ0.035 to Ϫ0.08).”
Quote in the paperNot a substantial claim - Findingown data
The estimated conversion rate for normal control subjects, allowing for interval-censored data, was 1.4% (95% CI 0%-3.2%).
“Allowing for interval-censored data, the estimated conversion rate was just 1.4% (95% confidence interval [CI] 0%-3.2%).”
Quote in the paperNot a substantial claim - Findingown data
Among the 229 normal control subjects, none progressed to AD over 12 months.
“Among the 229 subjects who were recruited in the normal control group, only 3 progressed to MCI over 12 months and none to AD; 17 did not have final diagnosis for 12-month follow-up.”
Quote in the paperNot a substantial claim - Findingown data
The control subjects essentially remained stable or improved slightly over 12 months.
“As would be expected, the control subjects essentially remained stable or improved slightly.”
Quote in the paperNot a substantial claim - Findingown data
Higher levels of Aβ-42 were associated with better performance on the ADAS-Cog in subjects with MCI (r = -0.22; 95% CI -0.035 to -0.08).
“Higher levels of A-42 were associated with better performance on the ADAS-Cog in normal subjects (r ϭ Ϫ0.21; 95% CI Ϫ0.38 to Ϫ0.03) and subjects with MCI (r ϭ Ϫ0.22; 95% CI Ϫ0.035 to Ϫ0.08).”
Quote in the paperNot a substantial claim - Findingown data
There was no significant baseline Aβ-42 effect observed over 12 months in subjects with AD.
“There was no significant baseline A-42 effect observed over 12 months in the subjects with AD.”
Quote in the paperNot a substantial claim - Findingown data
Of the 192 subjects with AD, 2 reverted to MCI status at 12 months.
“Of the 192 subjects with AD, virtually all of them remained in that category, while 2 reverted to MCI status at 12 months.”
Quote in the paperNot a substantial claim - Findingown data
Baseline Aβ-42 levels decreased significantly across diagnostic categories: normal controls 206 ± 5; MCI 164 ± 4; AD 143 ± 4 (p < 0.001).
“Baseline A-42 levels decreased significantly across the diagnostic categories as follows (mean Ϯ SE): normal controls 206 Ϯ 5; MCI 164 Ϯ 4; AD 143 Ϯ 4 (p Ͻ 0.001).”
Quote in the paperSubstantial claim - Findingnone given
The variability among subjects increased across the three clinical groups from normal to MCI to AD.
“The variability among the subjects increased across the 3 clinical groups from normal to MCI to AD.”
Quote in the paperNot a substantial claim - Findingown data
The progression rate from MCI to AD at 12 months was 16.5% (95% CI 11.9%-20.5%).
“Among the 398 subjects with MCI at baseline, 64 progressed to AD at 12 months for a progression rate of 16.5% (95% CI 11.9%-20.5%).”
Quote in the paperNot a substantial claim - Findingown data
The subjects with MCI were memory impaired compared to the normal controls.
“The summary of the baseline characteristics of the subjects indicated that the subjects with MCI were memory impaired compared to the normal controls and their memory performance was slightly better than that of the subjects with mild AD by design.”
Quote in the paperNot a substantial claim - Findingown data
Among the 398 subjects with MCI at baseline, 8 reverted to a normal classification over 12 months.
“An additional 8 subjects with MCI reverted to a normal classification over that interval, and 41 did not have a follow-up diagnosis.”
Quote in the paperNot a substantial claim - Findingnone given
With respect to nonmemory domains, subjects with MCI were more similar to normal control subjects than to subjects with AD.
“With respect to nonmemory domains, the subjects with MCI were more similar to the normal control subjects than they were to the subjects with AD.”
Quote in the paperNot a substantial claim - Findingown data
Among the 398 subjects with MCI at baseline, 64 progressed to AD at 12 months.
“Among the 398 subjects with MCI at baseline, 64 progressed to AD at 12 months for a progression rate of 16.5% (95% CI 11.9%-20.5%).”
Quote in the paperNot a substantial claim - Findingown data
Higher baseline levels of Aβ-42 were associated with a smaller change over 12 months on the ADAS-Cog in normal subjects (r = -0.23; 95% CI -0.40 to -0.05).
“Similarly, the annual rate of change on the ADAS-Cog against A-42 at screening suggested that higher baseline levels of A-42 were associated with a smaller change over 12 months in the normal subjects (r ϭ Ϫ0.23; 95% CI Ϫ0.40 to Ϫ0.05) and in MCI (r ϭ Ϫ0.29; 95% CI Ϫ0.41 to Ϫ0.16).”
Quote in the paperNot a substantial claim - Findingown data
The interaction of Aβ-42 and time had a significant effect on ADAS-Cog scores in subjects with MCI (p = 0.00).
“The interaction of A-42 and time also had a significant effect on ADAS-Cog scores in subjects with MCI ( p ϭ 0.00), but not in normal subjects.”
Quote in the paperNot a substantial claim - Findingown data
The correlation between Aβ-42 and ADAS-Cog in AD was not significant.
“The correlation with the ADAS-Cog in AD was not significant.”
Quote in the paperNot a substantial claim - Findingown data
The subjects with MCI remained relatively stable as a group over 12 months.
“The subjects with MCI also remained relatively stable as a group, and the subjects with mild AD showed a decline on most of these measures.”
Quote in the paperNot a substantial claim - Findingown data
Among the 229 normal control subjects, 17 did not have a final diagnosis at 12-month follow-up.
“Among the 229 subjects who were recruited in the normal control group, only 3 progressed to MCI over 12 months and none to AD; 17 did not have final diagnosis for 12-month follow-up.”
Quote in the paperNot a substantial claim - Findingown data
There was considerable movement from the MCI group to the AD group over the 12 months at the progression rate of 16% per year as projected.
“However, there was considerable movement from the MCI group to the AD group over the 12 months at the progression rate of 16% per year as projected.”
Quote in the paperNot a substantial claim - Findingown data
Of the 192 subjects with AD, virtually all remained in the AD category at 12 months.
“Of the 192 subjects with AD, virtually all of them remained in that category, while 2 reverted to MCI status at 12 months.”
Quote in the paperNot a substantial claim - Findingown data
Subjects with AD had lower Aβ-42 levels.
“Correspondingly, the subjects with AD had lower A-42 levels.”
Quote in the paperSubstantial claim - Interpretationown data
The observed 12-month progression rate of MCI was as predicted.
“The 12-month progression rate of MCI was as predicted”
Quote in the paperSubstantial claim- Rests on an assumption: The expected 12-month progression rate for MCI was approximately 16.5% per year.
- Interpretationown data
ADNI successfully recruited cohorts of cognitively normal subjects, subjects with MCI, and subjects with AD with anticipated baseline characteristics.
“The Alzheimer's DiseaseNeuroimaging Initiative has successfully recruited cohorts of cognitively normal subjects, subjects with mild cognitive impairment (MCI), and subjects with Alzheimer disease with anticipated baseline characteristics.”
Quote in the paperSubstantial claim- Rests on an assumption: The baseline characteristics observed in the recruited cohorts matched the characteristics anticipated for normal, MCI, and AD cohorts.
- Interpretationown data
CSF measures heralded progression of clinical measures over 12 months.
“the CSF measures heralded progression of clinical measures over 12 months.”
Quote in the paperSubstantial claim - Interpretationcitation
The high proportion of APOE4 carriers in the MCI and AD groups is consistent with subjects recruited for clinical trials.
“They tend to be more highly educated and the proportion of APOE4 carriers was quite high in the MCI and AD groups but is consistent with subjects recruited for clinical trials.25”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [25]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Interpretationown data
Baseline Aβ levels might be used to stratify subjects' likelihood of progressing more rapidly.
“In addition, the lower the CSF A-42 level at baseline, the greater the cognitive change over 12 months in both the normal subjects and subjects with MCI, suggesting that baseline A levels might be used to stratify subjects' likelihood of progressing more rapidly.”
Quote in the paperSubstantial claim- Rests on an assumption: CSF Aβ-42 level is a valid biomarker of Alzheimer's disease pathology and progression.
- Interpretationreasoning
The MCI subjects recruited in ADNI were likely further down the clinical spectrum with respect to the underlying AD process, making them more likely to progress than subjects with less impairment in the MCI spectrum.
“As such, these subjects were likely further down the clinical spectrum with respect to the underlying AD process such that they would be more likely to progress than subjects with less impairment in the MCI spectrum.”
Quote in the paperSubstantial claim- Rests on an assumption: The MCI subjects have an underlying Alzheimer's disease process that drives clinical progression.
- Interpretationreasoning
The MCI group recruited in ADNI represents individuals in a transitional state between cognitive changes of normal aging and the clinical criteria for probable AD.
“As such, the MCI group recruited in this study represents individuals in a transitional state between cognitive changes of normal aging and clinical features and the clinical criteria for probable AD.”
Quote in the paperSubstantial claim - Premisecitation
Neuroimaging and chemical biomarkers may increase the ability to detect treatment effects in clinical trials.
“increase our ability to detect treatment effects in clinical trials.[6][7][8]”
Quote in the paperSubstantial claim0 of 3 sources checked- cites [6]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [7]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [8]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Interpretationcitation
ADNI was successful in recruiting a cohort of subjects that was very similar to those seen in MCI and mild AD clinical trials.
“ADNI was successful in recruiting a cohort of subjects that was very similar to those seen in MCI and mild AD clinical trials.[25][26][27]”
Quote in the paperSubstantial claim0 of 3 sources checked- cites [25]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [26]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [27]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Interpretationcitation
The three ADNI groups performed in a fashion similar to subjects recruited for typical clinical trials.
“As such, the baseline characteristics of the subjects indicated that the 3 groups were generally well educated, intelligent, and mostly white, and perform in a fashion similar to subjects recruited for typical clinical trials.[25][26][27][28]”
Quote in the paperSubstantial claim0 of 4 sources checked- cites [25]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [26]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [27]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [28]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Interpretationreasoning
The subjects recruited for ADNI likely do not represent 'typical' subjects in the community.
“The subjects recruited for ADNI likely do not represent”
Quote in the paperNot a substantial claim
- May combine two claims. 20
- Classified as probably not a substantial claim. 14
May combine two claims.
Findingown dataCDR sum of boxes did not change in normal controls (0.1) and increased by approximately 0.7 points in MCI and 1.5 points in AD (p<0.001).
“The CDR sum of the boxes essentially did not change in the normal control group (0.1) and increased by approximately 0.7 points in the subjects with MCI and 1.5 points in the subjects with AD ( p Ͻ 0.001).”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataIn the ADNI cohort, subjects with MCI were more memory impaired than cognitively normal subjects but less impaired than subjects with AD.
“The subjects with MCI were more memory impaired than the cognitively normal subjects but not as impaired as the subjects with AD.”
- Also stated in: § RESULTS Baseline characteristics. · hedged
“These scores indicated, however, that the subjects with MCI gained most of their error points on memory items.”
Quote in the paperNot a substantial claim- Also stated in: § RESULTS Baseline characteristics. · hedged
May combine two claims.
Findingown dataOver 12 months, the normal group stayed nearly the same and the AD group worsened significantly compared with normal controls.
“In general, the normal group stayed nearly the same, and the AD group worsened significantly compared to the normal controls.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataThe MCI group's 12-month change resembled normal controls for the clock test and global CDR.
“and more like the normal controls for the clock test and global CDR.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataMean baseline ADAS-Cog total was 6.2 in normal controls, 11.5 in MCI, and 18.7 in mild AD (p<0.001).
“Overall, subjects with MCI had a mean total Alzheimer's Disease Assessment Scale-Cognitive subscale (ADAS-Cog) score of 11.5, while the normal control subjects had a score of 6.2 and the subjects with mild AD had a score of 18.7 ( p Ͻ 0.001, table 3).”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Findingown dataAt baseline, cholinesterase inhibitor use was 0% in normal controls, 43.7% in MCI, and 84.9% in AD.
“cholinesterase inhibitors-normal controls 0%, subjects with MCI 43.7%, subjects with AD 84.9%”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataADNI enrolled 819 subjects at baseline: 229 cognitively normal, 398 with MCI, and 192 with mild AD.
“A total of 819 subjects were recruited and received a baseline evaluation as part of the ADNI study.”
- Also stated in: § RESULTS Baseline characteristics. · plain
“There were 229 normal control subjects, 398 subjects with MCI, and 192 subjects with mild AD enrolled.”
Quote in the paperNot a substantial claim- Also stated in: § RESULTS Baseline characteristics. · plain
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Findingown dataEstimated premorbid verbal IQ was high: almost 120 in normal controls, 116 in MCI, and 114 in AD.
“The estimated premorbid verbal IQ of these subjects was quite high, at almost 120 for the normal control subjects, 116 for the subjects with MCI, and 114 for the subjects with AD.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataExcept for the Hachinski Scale and Geriatric Depression Scale, mean screening measure scores differed significantly among the three groups (p<0.001), with normal controls best, AD worst, and MCI intermediate.
“In all cases except the Hachinski Scale and Geriatric Depression Scale, the mean scores for the 3 groups differed significantly at p Ͻ 0.001, with normal controls performing best, subjects with AD worst, and subjects with MCI in the middle.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataThe MCI group was more variable in 12-month change; in most cases they worsened more than normal controls but not as much as the AD group.
“The MCI group was more variable; in most cases they worsened more than the normal group but not as much as the AD group”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataApproximately 50% of ADNI subjects with MCI were on antidementia therapies at baseline.
“Approximately 50% of the subjects with MCI were on antidementia therapies.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Findingown dataMost subjects were white, and this was approximately equivalent across groups.
“Most of the subjects in the study were white, and this was approximately equivalent across the groups.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataOver 12 months, ADAS-Cog change was minimal in normal controls, slight in MCI (1.1 points), and modest in AD (4.3 points).
“There was minimal movement on the Alzheimer's Disease Assessment Scale-Cognitive Subscale for the normal control subjects, slight movement for the subjects with MCI of 1.1, and a modest change for the subjects with AD of 4.3.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataMean age was approximately 75 years and was equivalent across the three diagnostic groups.
“As shown in table 2, the mean age of the 3 groups was equivalent at approximately 75 years.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataThe MCI group had more men than women (64.6% men vs 35.4% women).
“there were more men than women in the MCI group (64.6% men vs 35.4% women).”
Quote in the paperNot a substantial claimMay combine two claims.
Findingnone givenThere was somewhat less variability on the global measures, while some individual neuropsychological tests such as the AVLT showed considerable variability among subjects despite relatively modest mean group changes.
“There was somewhat less variability on the global measures, while some of the individual neuropsychological tests such as the AVLT showed considerable variability among the subjects despite relatively modest mean group changes.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataCSF Aβ-42 levels at baseline were correlated with clinical diagnoses, performance on the ADAS-Cog, and changes in performance on the ADAS-Cog over 1 year.
“CSF A-42 levels were assessed at baseline and were correlated with clinical diagnoses, performance on the ADAS-Cog, and changes in performance on the ADAS-Cog over 1 year (table 3).”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataDelayed recall improved by 5.3% in normal controls and declined by 4.8% in MCI and 7.2% in AD over 12 months.
“Delayed recall improved by 5.3% in the normal control group and declined by 4.8% in the subjects with MCI and 7.2% in the subjects with AD.”
Quote in the paperNot a substantial claimMay combine two claims.
FindingcitationThe baseline characteristics of the three ADNI groups indicated that they were generally well educated, intelligent, and mostly white.
“As such, the baseline characteristics of the subjects indicated that the 3 groups were generally well educated, intelligent, and mostly white, and perform in a fashion similar to subjects recruited for typical clinical trials.[25][26][27][28]”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataThe CSF Aβ-42 data correlated with the diagnostic groups in the expected fashion, with levels being lower in subjects with MCI than in normal subjects.
“The CSF A-42 data correlated with the diagnostic groups in the expected fashion with levels being lower in the subjects with MCI than in the normal subjects.”
Quote in the paperNot a substantial claim- Rests on an assumption: CSF Aβ-42 level is a valid biomarker of Alzheimer's disease pathology and progression.
Probably not a substantial claim: may not pass S3 (load-bearing).
FindingcitationThe proportion of APOE4 carriers was quite high in the MCI and AD groups.
“They tend to be more highly educated and the proportion of APOE4 carriers was quite high in the MCI and AD groups but is consistent with subjects recruited for clinical trials.25”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataAVLT learning showed virtually no change over 12 months in normal controls, decreased by 1.3 items in MCI, and decreased by 3.7 items in AD.
“On the memory measures such as the AVLT, there was virtually no change across 12 months in learning in the normal control group with a decreased learning of 1.3 items in the subjects with MCI and 3.7 fewer items learned in the AD group.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataAmong the 398 subjects with MCI at baseline, 41 did not have a follow-up diagnosis.
“An additional 8 subjects with MCI reverted to a normal classification over that interval, and 41 did not have a follow-up diagnosis.”
Quote in the paperNot a substantial claimMay combine two claims.
PremisecitationNeuroimaging and chemical biomarkers may allow detection of the neurodegenerative process at an earlier point in the spectrum.
“may allow detection of the neurodegenerative process at an earlier point in the spectrum”
Quote in the paperSubstantial claim0 of 3 sources checked- cites [6]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [7]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [8]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenModels were validated both graphically and analytically.
“All hypothesis tests were 2-sided at level 0.05, and models were validated both graphically and analytically.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim.
PremisecitationAD is a slowly evolving process that likely begins years to decades before clinical symptoms are manifest.
“Most investigators believe that Alzheimer disease (AD) is a slowly evolving process that likely begins years to decades before the clinical symptoms are manifest.1”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [1]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Classified as probably not a substantial claim.
Study design and conductnone givenA 12-month change period is not a sufficient amount of time to draw conclusions regarding the likelihood of clinical change.
“A 12month change period is not a sufficient amount of time to draw conclusions regarding the likelihood of clinical change.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationMCI has been a target for clinical trials.
“has been a target for clinical trials.[2][3][4][5]”
Quote in the paperNot a substantial claim0 of 4 sources checked- cites [2]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [3]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [4]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [5]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).
Study design and conductreasoningThe diagnostic conversions over the 12-month period must be viewed with some caution.
“The diagnostic conversions over the 12-month period must be viewed with some caution.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S2 (checkable).
InterpretationreasoningThis stratification might be a useful technique to reduce the numbers of subjects used in clinical trials to detect a clinical effect of therapeutic interventions.
“This might be a useful technique to reduce the numbers of subjects used in clinical trials to detect a clinical effect of therapeutic interventions.”
Quote in the paperNot a substantial claim- Rests on an assumption: CSF Aβ-42 level is a valid biomarker of Alzheimer's disease pathology and progression.
Classified as probably not a substantial claim.
PremisecitationMCI represents an attempt to characterize subjects at an early clinical phase.
“Mild cognitive impairment (MCI) represents an attempt to characterize subjects at an early clinical phase”
Quote in the paperSubstantial claim0 of 4 sources checked- cites [2]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [3]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [4]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [5]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
The paper relies on this without support.
The expected 12-month progression rate for MCI was approximately 16.5% per year.
“The 12-month progression rate of MCI was as predicted”
“The subjects with MCI progressed to dementia in 12 months at a rate of 16.5% per year.”
The paper relies on this without support.
The baseline characteristics observed in the recruited cohorts matched the characteristics anticipated for normal, MCI, and AD cohorts.
“The Alzheimer's DiseaseNeuroimaging Initiative has successfully recruited cohorts of cognitively normal subjects, subjects with mild cognitive impairment (MCI), and subjects with Alzheimer disease with anticipated baseline characteristics.”
The paper relies on this without support.
The MCI subjects have an underlying Alzheimer's disease process that drives clinical progression.
“As such, these subjects were likely further down the clinical spectrum with respect to the underlying AD process such that they would be more likely to progress than subjects with less impairment in the MCI spectrum.”
The paper relies on this without support.
CSF Aβ-42 level is a valid biomarker of Alzheimer's disease pathology and progression.
“The CSF A-42 data correlated with the diagnostic groups in the expected fashion with levels being lower in the subjects with MCI than in the normal subjects.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The vast majority of data from PET and CSF are from selected participants recruited through tertiary care dementia centers.
“Another issue is that the vast majority of data from PET and CSF are from selected participants recruited through tertiary care dementia centers [176].”
From NIA‐AA Research Framework: Toward a biological definition of Alzheimer's disease (2018) · cites this paper as [176]
The Subject selection section reports that ADNI collected PET and CSF data, and the Discussion says its deliberately selected cohort was unlikely to represent typical community participants. The paper does not establish that the vast majority of PET and CSF data overall came from such participants, or that they were recruited through tertiary care dementia centers. Page numbers were not available in our copy. (LLM, conf=0.84)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
One-year MCI progressor counts disagree
MajorThe results state that 64 subjects with MCI progressed to AD at 12 months, but table 5 labels 69 subjects as progressors at one year.
“Among the 398 subjects with MCI at baseline, 64 progressed to AD at 12 months”
“Table 5 Baseline measures on subjects according to progression status at 1 year Assortment variable Nonprogressors, mean ؎ SD (n ؍ 329) Progressors, mean ؎ SD (n ؍ 69)”
Baseline ADAS-Cog score for AD differs from table 3
MinorThe text gives the mild-AD group's baseline ADAS-Cog score as 18.7, whereas table 3 gives 18.6.
“the subjects with mild AD had a score of 18.7”
“ADAS-Cog total 6.2 Ϯ 2.9 11.5 Ϯ 4.4 18.1 18.6 Ϯ 6.3 14.0 Ͻ0.001 a, b, c”
Reported correlation falls outside its confidence interval
MinorFor subjects with MCI, the reported correlation of −0.22 lies outside the stated 95% confidence interval, whose endpoints are −0.035 and −0.08.
“subjects with MCI (r ϭ Ϫ0.22; 95% CI Ϫ0.035 to Ϫ0.08)”
“95% CI Ϫ0.035 to Ϫ0.08”
Geriatric Depression Scale significance is described incorrectly
MinorThe text exempts the Geriatric Depression Scale from measures differing at p < 0.001, but table 3 reports p < 0.001 for that scale.
“In all cases except the Hachinski Scale and Geriatric Depression Scale, the mean scores for the 3 groups differed significantly at p Ͻ 0.001”
“GDS Score 0.8 Ϯ 1.1 1.6 Ϯ 1.4 7.3 1.7 Ϯ 1.4 0.6 Ͻ0.001 a, b”
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Self-citationFunctional brain architecture is associated with the rate of tau accumulation in Alzheimer’s disease
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“AD dementia diagnosis was accomplished according to standard clinical criteria as described previously ( 58 ).”
Self-citationMoscoso, A., Grothe, M. J., Ashton, N. J., Karikari, T. K., Lantero‐Rodriguez, J., Snellman, A., Suárez‐Calvet, M., Blennow, K., Zetterberg, H., Schöll, M., et al. (2021) · JAMA Neurology · doi:10.1001/jamaneurol.2020.4986 · Cited by 310 · see citing works
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Update on the biomarker core of the Alzheimer's Disease Neuroimaging Initiative subjects
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Self-citationEANM procedure guidelines for brain PET imaging using [18F]FDG, version 3
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Going Deep in Medical Image Analysis: Concepts, Methods, Challenges, and Future Directions
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Self-citationMulti-Method Analysis of MRI Images in Early Diagnostics of Alzheimer's Disease
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Longitudinal MRI atrophy biomarkers: Relationship to conversion in the ADNI cohort
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“Given the unknown impact of having an (cid:1) 2 (cid:1) 4 genotype (i.e., possessing a potential protective allele [ (cid:1) 2] and a risk allele [ (cid:1) 4] for AD), we chose to run analyses both including and excluding the (cid:1) 2 (cid:1) 4 participants ( n (cid:1) 13; 3 AD, 7 MCI-S, 3 HC).”
Self-citationLi, Y., El Habib Daho, M., Conze, P.-H., Zeghlache, R., Le Boité, H., Tadayoni, R., Cochener, B., Lamard, M., & Quellec, G. (2024) · Computers in Biology and Medicine · doi:10.1016/j.compbiomed.2024.108635 · Cited by 274 · see citing works
“…stages: ADNI 1 included 400 subjects diagnosed with mild cognitive impairment (MCI), 200 subjects with early AD, and 200 elderly control subjects (Petersen et al., 2010); ADNI 2 added new participant groups: 150 elderly controls, 100 EMCI subjects, 150 late mild cognitive impairment (LMCI)…”
BackgroundGraph-Based Deep Learning for Medical Diagnosis and Analysis: Past, Present and Future
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“EF Four studies reported level-change associations for a measure of GM and EF: in a large sample of healthy controls of the Alzheimer’s disease and neuroimaging initiative (ADNI; n = 379), baseline hippocampal volume was positively related to changes in EF over 4 years (Hohman et al., 2017), suggesting that older adul…”
BackgroundSubjective Cognitive Complaints Contribute to Misdiagnosis of Mild Cognitive Impairment
Edmonds, E. C., Delano-Wood, L., Galasko, D. R., Salmon, D. P., & Bondi, M. W. (2014) · Journal of the International Neuropsychological Society · doi:10.1017/s135561771400068x · Cited by 249 · see citing works
“diagnosed with MCI based on conventional diagnostic criteria adapted for ADNI (Petersen &Morris, 2005; Petersen et al., 2010).”
A Comprehensive Genetic Association Study of Alzheimer Disease in African Americans
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“closer to an AD diagnosis) compared with other studies (Petersen et al., 2009).”
Genome-wide association study of Alzheimer's disease
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Staging <b>β</b> -Amyloid Pathology With Amyloid Positron Emission Tomography
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Why do so many clinical trials of therapies for Alzheimer's disease fail?
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Plasma multianalyte profiling in mild cognitive impairment and Alzheimer disease
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Self-citationFunctional connectivity associated with tau levels in ageing, Alzheimer’s, and small vessel disease
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Impact of the Alzheimer's Disease Neuroimaging Initiative, 2004 to 2014
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Female advantage in verbal memory
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Manifold Learning of Brain MRIs by Deep Learning
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Self-citationManagement of mild cognitive impairment (MCI): The need for national and international guidelines
Kasper, S. F., Bancher, C., Eckert, A., Förstl, H., Frölich, L., Hort, J., Korczyn, A. D., Kressig, R. W., Levin, O. S., & Palomo, M. S. M. (2020) · The World Journal of Biological Psychiatry · doi:10.1080/15622975.2019.1696473 · Cited by 241 · see citing works
“…with MCI who tend to remain stable (i.e. do not develop dementia) (Ganguli et al. 2011), and a proportion of patients may even revert to normal (2% (Petersen et al. 2010) to 31% (Palmer et al. 2010) depending on the MCI criteria used and design of the study); reverse conversions occur mainly in…”
BackgroundTime course of phosphorylated-tau181 in blood across the Alzheimer’s disease spectrum
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“ADNI inclusion criteria for the diagnostic cohorts have been described in detail elsewhere (Petersen et al. , 2010).”
Identifying individuals with high risk of Alzheimer’s disease using polygenic risk scores
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Genetic Variation and Neuroimaging Measures in Alzheimer Disease
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Nho, K., Kueider-Paisley, A., Ahmad, S., MahmoudianDehkordi, S., Arnold, M., Risacher, S. L., Louie, G., Blach, C., Baillie, R., Han, X., et al. (2019) · JAMA Network Open · doi:10.1001/jamanetworkopen.2019.7978 · Cited by 227 · see citing works
Self-citationDeep multimodal fusion of image and non-image data in disease diagnosis and prognosis: a review
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BrainGB: A Benchmark for Brain Network Analysis with Graph Neural Networks
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Lifespan Changes of the Human Brain In Alzheimer’s Disease
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Better verbal memory in women than men in MCI despite similar levels of hippocampal atrophy
Sundermann, E. E., Biegon, A. R., Rubin, L. H., Lipton, R. B., Mowrey, W. B., Landau, S. M., Maki, P. M., Initiative, A. D. N., Initiative, A. D. N., Weiner, M. W., et al. (2016) · Neurology · doi:10.1212/wnl.0000000000002570 · Cited by 207 · see citing works
Self-citationKim, S., Swaminathan, S., Shen, L., Risacher, S. L., Nho, K., Foroud, T., Shaw, L. M., Trojanowski, J. Q., Potkin, S. G., Huentelman, M. J., et al. (2011) · Neurology · doi:10.1212/wnl.0b013e318204a397 · Cited by 206 · see citing works
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Fractionating verbal episodic memory in Alzheimer's disease
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Hippocampal sclerosis of aging, a prevalent and high-morbidity brain disease
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Generalizable deep learning model for early Alzheimer’s disease detection from structural MRIs
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Estimating long‐term multivariate progression from short‐term data
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Self-citationRegional Aβ-tau interactions promote onset and acceleration of Alzheimer’s disease tau spreading
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Subtle Cognitive Decline and Biomarker Staging in Preclinical Alzheimer’s Disease
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Evidence for benefit of statins to modify cognitive decline and risk in Alzheimer’s disease
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Longitudinal Change of Biomarkers in Cognitive Decline
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Reversion From Mild Cognitive Impairment to Normal Cognition
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Validation of Plasma Amyloid-β 42/40 for Detecting Alzheimer Disease Amyloid Plaques
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Self-citationAPOE effect on Alzheimer's disease biomarkers in older adults with significant memory concern
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- Authors
- Petersen, R. C., Aisen, P. S., Beckett, L. A., Donohue, M. C., Gamst, A. C., Harvey, D. J., Jack, C. R., Jagust, W. J., Shaw, L. M., Toga, A. W., Trojanowski, J. Q., & Weiner, M. W.
- Affiliations
- Mayo Clinic (US)
- ORCID
- Venue
- Neurology
- Published
- 2010-01-19
- Volume
- 74
- Issue
- 3
- Pages
- 201-209
- ISSN
- 0028-3878 (ISSN-L)
- 1526-632X
- PMC
- PMC2809036
- OpenAlex
- W2122328291
- Cited by
- 2,572
- References
- 27
- Citations by year
- 2026: 312 · 2025: 391 · 2024: 327 · 2023: 254 · 2022: 233 · 2021: 209 · 2020: 182 · 2019: 121 · 2018: 85 · 2017: 67 · 2016: 71 · 2015: 66 · 2014: 45 · 2013: 63 · 2012: 59
- FWCI
- 26.56
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Neurology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (submittedVersion)
- PubMed Central (submittedVersion)
- Funders
- Alzheimer's Disease Neuroimaging Initiative (AG024904)
- National Institutes of Health (5r01ag027984-03, 5r01ag030048-05, n01mh22005-16-0-1, 5r01dk075128-05, 5u01ag006786-38, 5r01mh083552-05, 5r01ca104573-05, 5p30ag010124-30, 5p01ag009215-20, 5r01ag011378-25, 5p41rr023953-04, 5u01ag024904-10, 5u01ag029213-05, 5r01ag016381-08, 5r01eb006266-04, 5r01ag010897-27, AG024904, 5p01ag019724-23, 5p30ca093373-23, 5p50ag016574-20)
- National Institute on Aging (AG027984, U01-AG-024904, R01AG11378, P30AG010129, U19 AG010483, U01‐AG10483, R01-AG030048, P50‐AG16574, P01 & AG019724, U01AG06786, P50-AG23501, RC1AG035427, AG 010483, R01AG031224, AG031224, P01 AG 17586-10, 1 U01 AG024904, AG 024904, UO1AG029213-01, P30AG036468, 2 P50 AG016570, 1 U01 AG 024904-05, P30 AG 10124-18, R01 AG031252, P01AG017586, U01AG010483, 1 U01 AG24904, 1P01 AG-19724-07, R01AG027859, P50AG023501, AG027859, P01 AG012435, AG-11378, 2P50AG005133, RC2AG036535, P01-AG19724, P01 AG 09215-20, R01-AG 10897, 2P30AG10129, R01 AG029672, R01 AG16381)
- National Heart, Lung, and Blood Institute (HL-095089, R01HL095089)
- National Institute of Mental Health (U01MH083506, MH 22005, MH062512, MH083506, R01MH079752, R01MH069433, MH083552, MH079752, R01 MH069259, 5 R01 MH071940, MH069433, R01MH072641, P30MH062512)
- National Institute on Drug Abuse (1 R01 DA017830)
- National Cancer Institute (2 P30 CA93373, CA104573)
- National Institute of Diabetes and Digestive and Kidney Diseases (DK075128)
- National Institute of Neurological Disorders and Stroke (1 R01 NS050792, RL1NS062412, P50NS053488, 1 R01 NS049194, RC2NS069368, R01NS031966)
- National Institute of Biomedical Imaging and Bioengineering (1 U54 EB05149, 1 R01 EB 006266-01, U54EB005149, P01EB001955, 5R01EB002138-07)
- U.S. National Library of Medicine (2 R01LM005639)
- National Center for Research Resources (5 P41 RR013642, P41 RR-023953, U24RR021760, U54RR021813, R24 RR021382, R24 RR021992, KL2RR024144)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD050735, 1R01 HD053893-01)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cancer-related cognitive impairment studies
- Keywords
- Alzheimer's disease, mild cognitive impairment, neuroimaging biomarkers, cerebrospinal fluid biomarkers, amyloid-beta 42, longitudinal cognitive change, normal aging, memory impairment, ADAS-Cog
- MeSH terms
- Aged, Aged, 80 and over, Alzheimer Disease, Cross-Sectional Studies, Diagnostic Imaging, Female, Follow-Up Studies, Humans, Longitudinal Studies, Male, Middle Aged, Biomarkers
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-18.
Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-18.
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