Machine Learning Classification of Alzheimer's Disease Stages Using Cerebrospinal Fluid Biomarkers Alone

Early diagnosis of Alzheimer's disease is a challenge because the existing methodologies do not identify the patients in their preclinical stage, which can last up to a decade prior to the onset of clinical symptoms. Several research studies demonstrate the potential of cerebrospinal fluid biomarkers, amyloid beta 1-42, T-tau, and P-tau, in early diagnosis of Alzheimer's disease stages. In this work, we used machine learning models to classify different stages of Alzheimer's disease based on the cerebrospinal fluid biomarker levels alone. An electronic health record of patients from the National Alzheimer's Coordinating Centre database was analyzed and the patients were subdivided based on mini-mental state scores and clinical dementia ratings. Statistical and correlation analyses were performed to identify significant differences between the Alzheimer's stages. Afterward, machine learning classifiers including K-Nearest Neighbors, Ensemble Boosted Tree, Ensemble Bagged Tree, Support Vector Machine, Logistic Regression, and Naive Bayes classifiers were employed to classify the Alzheimer's disease stages. The results demonstrate that Ensemble Boosted Tree (84.4%) and Logistic Regression (73.4%) provide the highest accuracy for binary classification, while Ensemble Bagged Tree (75.4%) demonstrates better accuracy for multiclassification. The findings from this research are expected to help clinicians in making an informed decision regarding the early diagnosis of Alzheimer's from the cerebrospinal fluid biomarkers alone, monitoring of the disease progression, and implementation of appropriate intervention measures.