Two-Year Progression from Mild Cognitive Impairment to Dementia: To What Extent Do Different Definitions Agree?: CONVERSION TO DEMENTIA IN INDIVIDUALS WITH MCI (original) (raw)
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Mild cognitive impairment in the older population: Who is missed and does it matter?
International Journal of Geriatric Psychiatry, 2008
ObjectivesClassifications of mild cognitive impairment (MCI) vary in the precision of the defining criteria. Their value in clinical settings is different from population settings. This difference depending on setting is to be expected, but must be well understood if population screening for dementia and pre-dementia states is to be considered. Of importance is the impact of missed diagnosis. The magnitude of missed ‘at-risk’ cases in the application of different MCI criteria in the population is unknown.Classifications of mild cognitive impairment (MCI) vary in the precision of the defining criteria. Their value in clinical settings is different from population settings. This difference depending on setting is to be expected, but must be well understood if population screening for dementia and pre-dementia states is to be considered. Of importance is the impact of missed diagnosis. The magnitude of missed ‘at-risk’ cases in the application of different MCI criteria in the population is unknown.MethodsData were from the Medical Research Council Cognitive Function and Ageing Study, a large population based study of older aged individuals in the UK. Prevalence and two-year progression to dementia in individuals whose impairment failed to fulfil published criteria for MCI was evaluated.Data were from the Medical Research Council Cognitive Function and Ageing Study, a large population based study of older aged individuals in the UK. Prevalence and two-year progression to dementia in individuals whose impairment failed to fulfil published criteria for MCI was evaluated.ResultsPrevalence estimates of individuals not classified from current MCI definitions were extremely variable (range 2.5–41.0%). Rates of progression to dementia in these non-classified groups were also very variable (3.7–30.0%), reflecting heterogeneity in MCI classification requirements.Prevalence estimates of individuals not classified from current MCI definitions were extremely variable (range 2.5–41.0%). Rates of progression to dementia in these non-classified groups were also very variable (3.7–30.0%), reflecting heterogeneity in MCI classification requirements.ConclusionsNarrow definitions of MCI developed for clinical settings when applied in the population result in a large proportion of individuals who progress to dementia being excluded from MCI classifications. More broadly defined criteria would be better for selection of individuals at risk of dementia in population settings, but at the possibility of high false positive rates. While exclusion may be a good thing in the population since most people are presumably ‘normal’, over-inclusion is more likely to be harmful. Further work needs to investigate the best classification system for application in the population. Copyright © 2008 John Wiley & Sons, Ltd.Narrow definitions of MCI developed for clinical settings when applied in the population result in a large proportion of individuals who progress to dementia being excluded from MCI classifications. More broadly defined criteria would be better for selection of individuals at risk of dementia in population settings, but at the possibility of high false positive rates. While exclusion may be a good thing in the population since most people are presumably ‘normal’, over-inclusion is more likely to be harmful. Further work needs to investigate the best classification system for application in the population. Copyright © 2008 John Wiley & Sons, Ltd.
Progression from mild cognitive impairment to dementia: a 3-year longitudinal study
The Australian and New Zealand journal of psychiatry, 2014
To examine characteristics that predict the progression from mild cognitive impairment to dementia. Of 970 patients recruited from nine memory clinics around Australia, 185 had mild cognitive impairment diagnosed. Measures of cognitive ability, functional ability, and neuropsychiatric symptoms were completed at baseline and over 3 years of follow up. Over 3 years, 52 (28%) patients with mild cognitive impairment developed dementia. Older age, lower cognitive ability at baseline, and faster decline in cognitive ability over the first 6 months of follow up, but not depression, predicted progression to dementia. The findings confirm that simple clinical data such as age, cognitive ability at baseline, and rate of cognitive decline are important predictors of progression from mild cognitive impairment to dementia over 3 years.
Journal of Alzheimer's disease : JAD, 2013
The most recent studies about mild cognitive impairment (MCI) are focused on the search for factors that make patients more vulnerable to conversion to dementia, mainly Alzheimer's disease (AD). The aim of this study was to determine which neuropsychological test performances, including episodic memory profiles, and genetic risk factors (APOE ε4) better predict early conversion to dementia among the four MCI subtypes. Data from 550 MCI patients were analyzed for the purpose of this study and were classified according to Petersen's criteria (2004), and also taking into account the absence (probable MCI) or presence (possible MCI) of comorbidities…
Predicting outcome in mild cognitive impairment: 4-year follow-up study
The British Journal of Psychiatry, 2010
Background Cognitive impairment precedes the diagnosis of Alzheimer's disease. It is unclear which psychometric measures predict dementia, and what cut-off points should be used. Replicable cognitive measures to provide information about differential diagnosis and prognosis would be clinically useful. Aims In a prospective cohort study we investigated which measures distinguish between individuals with amnestic mild cognitive impairment (aMCI) that converts to dementia and those whose impairment does not, and which combination of measures best predicts the fate of people with aMCI. Method Forty-four participants with aMCI underwent extensive neuropsychological assessment at baseline and annually thereafter for an average of 4 years. Differences in baseline cognitive performance of participants who were converters and non-converters to clinically diagnosed dementia were analysed. Classification accuracy was estimated by sensitivity, specificity, positive and negative predictive v...