Outcomes of incident mild cognitive impairment in relation to case definition

Fisk, John D.; Rockwood, Kenneth

doi:10.1136/jnnp.2004.053751

Cited by 48 publications

(33 citation statements)

References 19 publications

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“…Although the definition of MCI has evolved considerably over time, MCI has generally been conceptualized as a transitional stage between normal aging and dementia. Individuals with MCI have an increased risk of future dementia, although it is not clear that all individuals with MCI will progress to dementia (Fisk and Rockwood 2005). As originally proposed by Petersen et al (1999), MCI was characterized primarily as an amnestic disorder that represented a borderland between normal aging and AD.…”

Section: Cognitive Discrepancy Studiesmentioning

confidence: 97%

Neuropsychological Contributions to the Early Identification of Alzheimer’s Disease

et al. 2008

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A wealth of evidence demonstrates that a prodromal period of Alzheimer's disease (AD) exists for some years prior to the appearance of significant cognitive and functional declines required for the clinical diagnosis. This prodromal period of decline is characterized by a number of different neuropsychological and brain changes, and reliable identification of individuals prior to the development of significant clinical symptoms remains a top priority of research. In this review we provide an overview of those neuropsychological changes. In particular, we examine specific domains of cognition that appear to be negatively affected during the prodromal period of AD, and we review newer analytic strategies designed to examine cognitive asymmetries or discrepancies between higher-order cognitive functions versus fundamental skills. Finally, we provide a critical examination of the clinical concept of Mild Cognitive Impairment and offer suggestions for an increased focus on the impact of cerebrovascular disease (CVD) and CVD risk during the prodromal period of AD.

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Section: Cognitive Discrepancy Studiesmentioning

confidence: 97%

Neuropsychological Contributions to the Early Identification of Alzheimer’s Disease

et al. 2008

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“…Several groups reported findings in multiple publications, particularly those from large databases such as the CSHA. Where possible we excluded studies reporting subsamples and included only the main analysis (13,(32)(33)(34)(35). We included data from randomized trials but only using placebo data as this was considered more representative of the natural history of MCI.…”

Section: Excluded Studiesmentioning

confidence: 99%

Rate of progression of mild cognitive impairment to dementia – meta‐analysis of 41 robust inception cohort studies

Mitchell

Shiri-Feshki

2009

Acta Psychiatr Scand

1,357

967

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Objective: To quantify the risk of developing dementia in those with mild cognitive impairment (MCI).Method: Meta‐analysis of inception cohort studies.Results: Forty‐one robust cohort studies were identified. To avoid heterogeneity clinical studies, population studies and clinical trials were analysed separately. Using Mayo defined MCI at baseline and adjusting for sample size, the cumulative proportion who progressed to dementia, to Alzheimer’s disease (AD) and to vascular dementia (VaD) was 39.2%, 33.6% and 6.2%, respectively in specialist settings and 21.9%, 28.9% and 5.2%, respectively in population studies. The adjusted annual conversion rate (ACR) from Mayo defined MCI to dementia, AD and VaD was 9.6%, 8.1% and 1.9%, respectively in specialist clinical settings and 4.9%, 6.8% and 1.6% in community studies. Figures from non‐Mayo defined MCI and clinical trials are also reported.Conclusion: The ACR is approximately 5–10% and most people with MCI will not progress to dementia even after 10 years of follow‐up.

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“…In fact, some individuals with MCI appear to recover with time. Fisk and Rockwood [7] found that 20-30% of individuals with MCI and objective memory impairment showed no cognitive impairment at follow-up 5 years later. These results have led some researchers to suggest that MCI represents a heterogeneous disorder with multiple possible outcomes [8][9][10] .…”

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confidence: 99%

Functional Abilities in Older Adults with Mild Cognitive Impairment

et al. 2009

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Background: A classification scheme and general set of criteria for diagnosing mild cognitive impairment (MCI) were recently proposed by a multidisciplinary group of experts who met at an international symposium on MCI. One of the proposed criteria included preserved basic activities of daily living and minimal impairment in complex instrumental activities of daily living (IADLs). Objective: To investigate whether older adults with MCI classified according to the subtypes identified by the Working Group (i.e. amnestic, single non-memory domain, and multiple domain with or without a memory component) differed from cognitively intact older adults on a variety of measures indexing IADLs and to examine how well measures of IADL predict concurrent MCI status. Methods: Two hundred and fifty community-dwelling older adults, ranging in age from 66 to 92, completed self-report measures of IADLs (Lawton and Brody IADL Scale, Scales of Independent Behaviour-Revised – SIB-R) and a measure of everyday problem solving indexing IADLs (Everyday Problems Test – EPT). Ratings of participants’ IADL functioning were also obtained from informants (e.g. spouse, adult child and friend). Results: Older adults with multiple-domain MCI demonstrated poorer IADL functioning than older adults with no cognitive impairment on the EPT and the SIB-R (both self- and informant-report versions). The multiple-domain MCI participants also demonstrated poorer IADLs than MCI participants with impairments in a single cognitive domain on the self-reported SIB-R and EPT. The single-domain MCI groups demonstrated poorer IADLs than older adults without cognitive impairment on the informant-reported SIB-R and EPT. No significant group differences were found on the Lawton and Brody IADL Scale. Using the EPT and SIB-R as predictors in a multinomial regression analysis, MCI group status was reliably predicted, but the classification rate was poor. Conclusion: Individuals with MCI demonstrated poorer IADL functioning compared to cognitively intact older adults. However, the changes in IADL functioning observed in MCI may be too subtle to be detected by certain measures, such as the Lawton and Brody IADL Scale.

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Outcomes of incident mild cognitive impairment in relation to case definition

Cited by 48 publications

References 19 publications

Neuropsychological Contributions to the Early Identification of Alzheimer’s Disease

Neuropsychological Contributions to the Early Identification of Alzheimer’s Disease

Rate of progression of mild cognitive impairment to dementia – meta‐analysis of 41 robust inception cohort studies

Functional Abilities in Older Adults with Mild Cognitive Impairment

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