Hostname: page-component-78c5997874-m6dg7 Total loading time: 0 Render date: 2024-11-16T18:25:33.021Z Has data issue: false hasContentIssue false
  • English
  • Français

High rate of conversion to Alzheimer's disease in a cohort of amnestic MCI patients

Published online by Cambridge University Press:  01 February 2008

Klaus Schmidtke  and
Sonja Hermeneit
Klaus Schmidtke*
Affiliation:
Center for Geriatric Medicine and Gerontology, University Hospital Freiburg, Germany, and German Dementia Competence Network
Sonja Hermeneit
Affiliation:
Center for Geriatric Medicine and Gerontology, University Hospital Freiburg, Germany, and German Dementia Competence Network
*
Correspondence should be addressed to: Prof. Dr. K. Schmidtke, Centre for Geriatric Medicine and Gerontology Freiburg, Lehener Str. 88, 79106 Freiburg, Germany. Phone +49 761 2707077; Fax: +49 761 2707077. Email: [email protected].
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: A large proportion of patients with amnestic mild cognitive impairment (MCI) progress to Alzheimer's disease (AD), but the rate of conversion is highly variable, depending on selection and inclusion criteria. In the present prospective study, amnestic MCI criteria were applied in order to enrich the study population with prodromal AD patients.

Methods: A composite CERAD word list learning z-score of −1 was applied as a cut-off for memory performance at baseline. Competing causes of memory impairment other than prodromal AD were actively excluded. A cohort of 88 amnestic MCI patients was included; 75 were available for follow-up.

Results: After a mean delay of 19 months, 44% were found to have converted to AD, corresponding to an annualized conversion rate of 28%. The rate of new diagnoses other than stable MCI or AD was 6%. Baseline neuropsychological variables were not instrumental to predict progression.

Conclusion: Amnestic MCI patients, as identified by the present set of criteria, carry a high risk of median-term progression to AD.

Keywords

amnestic MCIAlzheimer's diseasedementia
Type
Research Article
Information
International Psychogeriatrics , Volume 20 , Issue 1 , February 2008 , pp. 96 - 108
Copyright
Copyright © International Psychogeriatric Association 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bowen, J., Teri, L., Kukull, W., McCormick, W., McCurry, S. M. and Larson, E. B. 1997. Progression to dementia in patients with isolated memory loss. Lancet, 349, 763–765.CrossRefGoogle ScholarPubMed
Bruscoli, M. and Lovestone, S. 2004. Is MCI really just early dementia? A systematic review of conversion studies. International Psychogeriatrics, 16, 129–140.CrossRefGoogle ScholarPubMed
Busse, A., Bischkopf, J., Riedel-Heller, S. G. and Angermeyer, M. C. 2003. Subclassifications for mild cognitive impairment: prevalence and predictive validity. Psychological Medicine, 33, 1029–1038.CrossRefGoogle ScholarPubMed
Chertkow, H. 2002. Mild cognitive impairment. Current Opinion in Neurology, 15, 401–407.CrossRefGoogle ScholarPubMed
Feldman, H. et al. 2004. Behavioral symptoms in mild cognitive impairment. Neurology, 62, 1199–1201.CrossRefGoogle ScholarPubMed
Flicker, C., Ferris, S. H. and Reisberg, B. 1991. Mild cognitive impairment in the elderly: predictors of dementia. Neurology, 41, 1006–1009.CrossRefGoogle ScholarPubMed
Galvin, J. E. et al. 2005. Predictors of preclinical Alzheimer's disease and dementia. Archives of Neurology, 62, 758–765.CrossRefGoogle Scholar
Geslani, D. M., Tierney, M. C., Herrmann, N. and Szalai, J. P. 2005. Mild cognitive impairment: an operational definition and its conversion rate to Alzheimer's disease. Dementia and Geriatric Cognitive Disorders, 19, 383–389.CrossRefGoogle ScholarPubMed
Goldstein, H. R. and Gold, M. 2004. Galantamine in the treatment of patients with mild cognitive impairment: baseline demographics and psychometric testing results. Neurobiology of Aging, 25 (suppl. 2), S472–S473.CrossRefGoogle Scholar
Jelic, V., Kivipelto, M. and Winblad, B. 2006. Clinical trials in mild cognitive impairment: lessons for the future. Journal of Neurology, Neurosurgery, and Psychiatry, 77, 429–436.CrossRefGoogle ScholarPubMed
McKhann, G. et al. 1984. Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ARDRA work group under the auspices of Department of Health and Human Service Task Force on Alzheimer's Disease. Neurology, 34, 939–944.CrossRefGoogle Scholar
McKeith, I. et al. 2004. Dementia with Lewy bodies. Lancet Neurology, 3, 19–28.CrossRefGoogle ScholarPubMed
Morris, J. C. 1993. The Clinical Dementia Rating (CDR): current version and scoring rules. Neurology, 43, 2412–2414.CrossRefGoogle ScholarPubMed
Nordlund, A., Rolstad, S., Hellstrom, P., Sjogren, M., Hansen, S. and Wallin, A. 2005. The Göteborg MCI study: mild cognitive impairment is a heterogeneous condition. Journal of Neurology, Neurosurgery, and Psychiatry, 76, 1485–1490.CrossRefGoogle ScholarPubMed
Petersen, R. C. and Morris, J. C. 2005. Mild cognitive impairment as a clinical entity and treatment target. Archives of Neurology, 62, 1160–1163.CrossRefGoogle ScholarPubMed
Petersen, R. C., Smith, G. E., Waring, A. C., Ivnik, R. J., Tangalos, E. G. and Kokmen, E. 1999. Mild cognitive impairment: clinical characterization and outcome. Archives of Neurology, 56, 303–308.CrossRefGoogle ScholarPubMed
Petersen, R. C., Stevens, J. C., Ganguli, M., Tangalos, E. G., Cummings, J. L. and DeKosky, S. T. 2001a. Practice parameter: early detection of dementia. Mild cognitive impairment (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology, 56, 1133–1142.CrossRefGoogle Scholar
Petersen, R. C. et al. 2001b. Current concepts in mild cognitive impairment. Archives of Neurology, 58, 1985–1992.CrossRefGoogle ScholarPubMed
Petersen, R. C. et al. 2005. Vitamin E and donezepil for the treatment of mild cognitive impairment. New England Journal of Medicine, 352, 2439–2441.CrossRefGoogle Scholar
Rasquin, S. M. C., Lodder, J., Visser, P. J., Lousberg, R. and Verhay, F. R. J. 2005. Predictive accuracy of MCI subtypes for Alzheimer's disease and vascular dementia in subjects with mild cognitive impairment: a 2-year follow-up study. Dementia and Geriatric Cognitive Disorders, 19, 113–119.CrossRefGoogle ScholarPubMed
Ritchie, K., Artero, S. and Touchon, J. 2001. Classification criteria for mild cognitive impairment: a population-based validation study. Neurology, 56, 37–42.CrossRefGoogle ScholarPubMed
Satzger, W. et al. 2001. Zur praktischen Anwendung der CERAD-Testbatterie als neuropsychologisches Defizitscreening. Nervenarzt, 72, 196–203.CrossRefGoogle Scholar
Schmidtke, K. and Hüll, M. 2002. Neuropsychological differentiation of small vessel disease, Alzheimer's disease and mixed dementia. Journal of the Neurological Sciences, 9, 419–429.Google Scholar
Schmidtke, K. and Olbrich, S. 2007. The Clock Reading Test – validation of an instrument for the diagnosis of dementia and disorders of visuo-spatial cognition. International Psychogeriatrics, 19, 307–321.CrossRefGoogle ScholarPubMed
Shulman, K. I. 2000. Clock-drawing: is it the ideal cognitive screening test? International Journal of Geriatric Psychiatry, 15, 548–561.3.0.CO;2-U>CrossRefGoogle ScholarPubMed
Tierney, M. C. et al. 1999. Do depressive symptoms in memory-impaired elders predict probable Alzheimer's disease? Aging and Mental Health, 3, 88–93.CrossRefGoogle Scholar
Visser, P. J., Scheltens, P. and Verhey, F. R. J. 2005. Do MCI criteria in drug trials accurately identify subjects with predementia Alzheimer's disease? Journal of Neurology, Neurosurgery, and Psychiatry, 76, 1348–1354.CrossRefGoogle ScholarPubMed
Visser, P. J., Kester, A., Jolles, J. and Verhey, F. 2006. Ten-year risk of dementia in subjects with mild cognitive impairment. Neurology, 67, 1201–1207.CrossRefGoogle ScholarPubMed
Winblad, B. et al. 2004. Mild cognitive impairment – beyond controversies, towards a consensus. Report of the International Working Group on Mild Cognitive Impairment. Journal of Internal Medicine, 256, 240–246.CrossRefGoogle Scholar