The prevalence and biomarkers’ characteristic of rapidly progressive Alzheimer’s disease from the Alzheimer’s Disease Neuroimaging Initiative database.

INTRODUCTION: The prevalence and detailed biomarkers’ characteristic of rapidly progressive Alzheimer’s disease (rpAD) remain incompletely understood.

RESULTS: The prevalence of rpAD was 17.6% in mild AD. Compared with non-rpAD, there were no differences in APOEε4/ε4, APOE ε3/ε4, and APOE ε2/ε4 genotype distribution, cerebrospinal fluid tau, phosphorylated tau (p-tau), amyloid-β, hippocampus volume, and amyloid deposition in rpAD. Yet, a lower p-tau/tau ratio was observed in rpAD (P = .04). rpAD showed region-specific hypometabolism ([18F]fluorodeoxyglucose-positron emission tomography [FDG-PET]) (P = .001). Receiver-operating characteristic analysis of FDG-PET demonstrated that left angular and left temporal cortices were the regions with higher area under the curve and predictive value for identifying clinical at-risk rpAD.