The prognosis of mild cognitive impairment in the elderly

Wolf, Henrike; Grünwald, Martin; Ecke, Gustav Martin; Zedlick, Dyrk; Bettin, S.; Dannenberg, C.; Dietrich, Joachim; Eschrich, Klaus; Arendt, Thomas; Gertz, H.-J.

doi:10.1007/978-3-7091-7508-8_4

Cited by 100 publications

(77 citation statements)

References 58 publications

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“…Within our cognitive complaint cohort followed over 3 years, the conversion rate to senile dementia (18% incidence over 3 years) is much higher than that observed in the general population. Our results are in agreement with previous clinical observations of subclinical cognitive deficit, [7][8][9][10]19 which report conversion rates of 15 to 53% over a similar time period. MCI criteria as currently defined have not, however, adequately captured this prodromal group in the general population.…”

supporting

confidence: 93%

“…Previous clinical studies of MCI have suggested that subjects with MCI may have smaller medial temporal lobe volumes, [8][9][10][11] and that risk factors for progression from MCI to AD are higher age, the presence of the APOE ⑀4 allele, fine motor deficit, and lower premorbid IQ. 7,12 These factors are considered in the current general population validation study.…”

mentioning

confidence: 99%

“…The principal difference between MCI and AACD lies in the prerequisite that there be impairment in memory, but not in any other area of cognitive functioning. This point has already been the subject of much debate, as an increasing number of studies conclude that subjects with MCI, although having primarily memory complaints, also commonly show deficits on tasks of language, 12,20 orientation, 10 and praxis. 12,20 Although there is some evidence that a purely mnesic syndrome may exist within a clinical context, 7 this appears to be a rare occurrence when the full range of cognitive functions are examined.…”

mentioning

confidence: 99%

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Classification criteria for mild cognitive impairment

Ritchie¹,

Artéro²,

Touchon³

2001

Neurology

774

605

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Article abstract-Objective: To evaluate the predictive validity and temporal stability of diagnostic criteria for mild cognitive impairment (MCI). Background: MCI has been proposed as a nosologic entity referring to elderly persons with subclinical cognitive deficits due to incipient dementia. Classification criteria, which have been derived from small, selected clinical groups, are currently disputed, and have not yet been assessed within the general population. Methods: Subjects meeting current criteria for MCI and also age-associated cognitive decline (AACD-a similar concept that is assumed to be related to normal cognitive aging processes rather than incipient dementia) were identified within each of three waves of a longitudinal population study, which included a standardized neurologic examination. Results: In the general population, the prevalence of MCI was estimated to be 3.2% and AACD 19.3%. MCI was a poor predictor of dementia within a 3-year period, with an 11.1% conversion rate. Subjects with MCI also constituted an unstable group, with almost all subjects changing category each year. Discriminant function analysis failed to isolate a homogeneous clinical group. Subjects classified as AACD, contrary to the theoretical assumptions underlying the disorder, represented a more stable group, with a 28.6% conversion rate to dementia over 3 years (relative risk ϭ 21.2). Conclusion: MCI criteria perform poorly when applied to a representative population sample. The authors propose modifications to current diagnostic criteria to increase their capacity to detect incipient dementia.

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supporting

confidence: 93%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Classification criteria for mild cognitive impairment

Ritchie¹,

Artéro²,

Touchon³

2001

Neurology

774

605

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“…Against this, it is well known that not all patients with MCI deteriorate. In fact some patients appear to improve over time (22,23). For example, Wolf and colleagues (1998) were one of the first groups to show that over almost 3 years 19.5% of MCI sufferers had recovered and an additional 61% neither improved nor deteriorated (22).…”

Section: Introductionmentioning

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

1,302

912

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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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“…Only 20% of these patients will progress to dementia. 32 Motor skills decline can also be predictive. Subjects who later develop cognitive impairment have slower finger tapping, take longer to walk 30 feet, and have an inability to suppress the eye-blink response to sudden movement.…”

Section: Clinical Identification Of Early or Pre-alzheimer Diseasementioning

confidence: 99%