Neuropsychological criteria for mild cognitive impairment (MCI) more accurately predict progression to Alzheimer’s disease (AD) and are more strongly associated with AD biomarkers and neuroimaging profiles than ADNI criteria. However, research to date has been conducted in relatively healthy samples with few comorbidities. Given that history of traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD) are risk factors for AD and common in Veterans, we compared neuropsychological, typical (Petersen/Winblad), and ADNI criteria for MCI in Vietnam-era Veterans with histories of TBI or PTSD.

267 Veterans (mean age = 69.8) from the DOD-ADNI study were evaluated for MCI using neuropsychological, typical, and ADNI criteria. Linear regressions adjusting for age and education assessed associations between MCI status and AD biomarker levels (cerebrospinal fluid [CSF] p-tau181, t-tau, and Aβ42) by diagnostic criteria. Logistic regressions adjusting for age and education assessed the effects of TBI severity and PTSD symptom severity simultaneously on MCI classification by each criteria.

Agreement between criteria was poor. Neuropsychological criteria identified more Veterans with MCI than typical or ADNI criteria, and were associated with higher CSF p-tau181 and t-tau. Typical and ADNI criteria were not associated with CSF biomarkers. PTSD symptom severity predicted MCI diagnosis by neuropsychological and ADNI criteria. History of moderate/severe TBI predicted MCI by typical and ADNI criteria.

MCI diagnosis using sensitive neuropsychological criteria is more strongly associated with AD biomarkers than conventional diagnostic methods. MCI diagnostics in Veterans would benefit from incorporation of comprehensive neuropsychological methods and consideration of the impact of PTSD.

与 ADNI 标准相比，轻度认知障碍 (MCI) 的神经心理学标准能够更准确地预测阿尔茨海默病 (AD) 的进展，并且与 AD 生物标志物和神经影像学特征的相关性更强。然而，迄今为止的研究是在相对健康的样本中进行的，几乎没有合并症。鉴于创伤性脑损伤 (TBI) 和创伤后应激障碍 (PTSD) 病史是 AD 的危险因素并且在退伍军人中很常见，我们比较了越战时期退伍军人 MCI 的神经心理学、典型 (Petersen/Winblad) 和 ADNI 标准有 TBI 或 PTSD 病史。

使用神经心理学、典型和 ADNI 标准对来自 DOD-ADNI 研究的 267 名退伍军人（平均年龄 = 69.8）进行了 MCI 评估。根据年龄和教育程度进行调整的线性回归根据诊断标准评估了 MCI 状态与 AD 生物标志物水平（脑脊液 [CSF] p -tau 181、t -tau 和 A β 42）之间的关联。根据年龄和教育程度进行逻辑回归调整，同时评估 TBI 严重程度和 PTSD 症状严重程度对每个标准的 MCI 分类的影响。

标准之间的一致性较差。神经心理学标准比典型标准或 ADNI 标准识别出更多患有 MCI 的退伍军人，并且与较高的 CSF p -tau 181和t -tau相关。典型标准和 ADNI 标准与 CSF 生物标志物无关。PTSD 症状严重程度可通过神经心理学和 ADNI 标准预测 MCI 诊断。中度/重度 TBI 病史可通过典型和 ADNI 标准预测 MCI。

与传统诊断方法相比，使用敏感神经心理学标准的 MCI 诊断与 AD 生物标志物的相关性更强。退伍军人的 MCI 诊断将受益于综合神经心理学方法的结合以及对 PTSD 影响的考虑。