Hostname: page-component-586b7cd67f-dlnhk Total loading time: 0 Render date: 2024-11-25T08:11:32.242Z Has data issue: false hasContentIssue false
  • English
  • Français

Mild cognitive impairment as predictor for Alzheimer's disease in clinical practice: effect of age and diagnostic criteria

Published online by Cambridge University Press:  24 April 2007

P. J. Visser  and
F. R. J. Verhey
P. J. Visser*
Affiliation:
Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands Department of Neurology, VU University Medical Centre, Amsterdam, The Netherlands
F. R. J. Verhey
Affiliation:
Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands
*
*Address for correspondence: Dr P. J. Visser, Department of Psychiatry and Neuropsychology, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands. (Email: [email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

We investigated whether the predictive accuracy of mild cognitive impairment (MCI) for Alzheimer-type dementia (AD) in a clinical setting is dependent on age and the definition of MCI used.

Method

Non-demented subjects older than 40 (n=320) who attended a memory clinic of a university hospital were reassessed 5 years later for the presence of AD. MCI was diagnosed according to the criteria of amnestic MCI, mild functional impairment (MFI), ageing-associated cognitive decline (AACD), and age-associated memory impairment (AAMI). The main outcome measure was the area under the curve (AUC) of a receiver operating characteristic (ROC) curve. Analyses were conducted on the entire sample and on subgroups of subjects aged 40–54, 55–69 and 70–85 years.

Results

A diagnosis of AD at follow-up was made in 58 subjects. Four of them were in the 40–54 age group, 29 in the 55–69 age group and 25 in the 70–85 age group. The diagnostic accuracy in the entire sample was low to moderately high with AUCs ranging from 0.56 (AACD) to 0.75 (amnestic MCI). A good predictive accuracy with an AUC >0.80 was only observed in subjects aged 70–85 using the criteria of amnestic MCI (AUC=0.84).

Conclusions

The predictive accuracy of MCI for AD is dependent on age and the definition of MCI used. The predictive accuracy is good only for amnestic MCI in subjects 70–85 years. As subjects with prodromal AD are often younger than 70, the usefulness of MCI as predictor of AD in clinical practice is limited.

Keywords

Alzheimer's diseasediagnosislongitudinal studiesmild cognitive impairment
Type
Original Articles
Information
Psychological Medicine , Volume 38 , Issue 1 , January 2008 , pp. 113 - 122
Copyright
Copyright © Cambridge University Press 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

Alladi, S, Arnold, R, Mitchell, J, Nestor, PJ, Hodges, JR (2006). Mild cognitive impairment: applicability of research criteria in a memory clinic and characterization of cognitive profile. Psychological Medicine 36, 507–515.CrossRefGoogle Scholar
APA (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn. American Psychiatric Association: Washington, DC.Google Scholar
Blessed, G, Tomlinson, BE, Roth, M (1968). The association between quantitative measures of dementia and of senile changes in the cerebral grey matter of elderly subjects. British Journal of Psychiatry 114, 797–811.CrossRefGoogle ScholarPubMed
Bozoki, A, Giordani, B, Heidebrink, JL, Berent, S, Foster, NL (2001). Mild cognitive impairments predict dementia in nondemented elderly patients with memory loss. Archives of Neurology 58, 411–416.CrossRefGoogle ScholarPubMed
Brand, N, Jolles, J (1987). Information processing in depression and anxiety. Psychological Medicine 17, 145–153.CrossRefGoogle ScholarPubMed
Brandt, J, Spencer, M, Folstein, M (1988). The Telephone Interview for Cognitive Status. Neuropsychiatry, Neuropsychology and Behavioral Neurology 1, 111–117.Google Scholar
Busse, A, Bischkopf, J, Riedel-Heller, SG, Angermeyer, MC (2003 a). Mild cognitive impairment: prevalence and predictive validity according to current approaches. Acta Neurologica Scandinavica 108, 71–81.CrossRefGoogle ScholarPubMed
Busse, A, Bischkopf, J, Riedel-Heller, SG, Angermeyer, MC (2003 b). Mild cognitive impairment: prevalence and incidence according to different diagnostic criteria. Results of the Leipzig Longitudinal Study of the Aged (LEILA75+). British Journal of Psychiatry 182, 449–454.CrossRefGoogle ScholarPubMed
Busse, A, Bischkopf, J, Riedel-Heller, SG, Angermeyer, MC (2003 c). Subclassifications for mild cognitive impairment: prevalence and predictive validity. Psychological Medicine 33, 1029–1038.CrossRefGoogle ScholarPubMed
Crook, T, Bartus, RT, Ferris, SH, Whitehouse, P, Cohen, GD, Gershon, S (1986). Age-associated memory impairment: proposed criteria and measures of clinical change. Report of the National Institute of Mental Health work group. Developmental Neuropsychology 2, 261–276.CrossRefGoogle Scholar
Drzezga, A, Grimmer, T, Riemenschneider, M, Lautenschlager, N, Siebner, H, Alexopoulus, P, Minoshima, S, Schwaiger, M, Kurz, A (2005). Prediction of individual clinical outcome in MCI by means of genetic assessment and (18)F-FDG PET. Journal of Nuclear Medicine 46, 1625–1632.Google Scholar
Fisk, JD, Rockwood, K (2005). Outcomes of incident mild cognitive impairment in relation to case definition. Journal of Neurology, Neurosurgery and Psychiatry 76, 1175–1177.CrossRefGoogle ScholarPubMed
Folstein, MF, Folstein, SE, McHugh, PR (1975). ‘Mini-Mental State’: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research 12, 189–198.CrossRefGoogle Scholar
Geslani, DM, Tierney, MC, Herrmann, N, Szalai, JP (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
Goldman, WP, Morris, JC (2001). Evidence that age-associated memory impairment is not a normal variant of aging. Alzheimer Disease and Associated Disorders 15, 72–79.CrossRefGoogle Scholar
Grundman, M, Petersen, RC, Bennett, DA, Feldman, HH, Salloway, S, Visser, PJ, Thal, LJ, Schenk, D, Khachaturian, Z, Thies, W; for the Alzheimer's Association Research Roundtable (2006). Alzheimer's Association Research Roundtable meeting on mild cognitive impairment: what have we learned? Alzheimer's and Dementia 2, 393–414.CrossRefGoogle ScholarPubMed
Habbema, JDF, Eijkemans, R, Krijnen, P, Knottnerus, JA (2002). Analysis of data on the accuracy of diagnostic tests. In The Evidence Base of Clinical Diagnosis (ed. Knottnerus, J. A.), pp. 117–144. BMJ Books: London.Google Scholar
Hachinski, VC, Iliff, LD, Zilhka, E, Du Boulay, GH, McAllister, VL, Marshall, J, Russell, RW, Symon, L (1975). Cerebral blood flow in dementia. Archives of Neurology 32, 632–637.CrossRefGoogle ScholarPubMed
Hamilton, M (1960). A rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry 23, 56–62.CrossRefGoogle ScholarPubMed
Hansson, O, Zetterberg, H, Buchhave, P, Londos, E, Blennow, K, Minthon, L (2006). Association between CSF biomarkers and incipient Alzheimer's disease in patients with mild cognitive impairment: a follow-up study. Lancet Neurology 5, 228–234.CrossRefGoogle ScholarPubMed
Hodges, JR, Erzinclioglu, S, Patterson, K (2006). Evolution of cognitive deficits and conversion to dementia in patients with mild cognitive impairment: a very-long-term follow-up study. Dementia and Geriatric Cognitive Disorders 21, 380–391.CrossRefGoogle ScholarPubMed
Jelic, V, Johansson, SE, Almkvist, O, Shigeta, M, Julin, P, Nordberg, A, Winblad, B, Wahlund, LO (2000). Quantitative electroencephalography in mild cognitive impairment: longitudinal changes and possible prediction of Alzheimer's disease. Neurobiology of Aging 21, 533–540.CrossRefGoogle ScholarPubMed
Kluger, A, Ferris, SH, Golomb, J, Mittelman, MS, Reisberg, B (1999). Neuropsychological prediction of decline to dementia in nondemented elderly. Journal of Geriatric Psychiatry and Neurology 12, 168–179.CrossRefGoogle ScholarPubMed
Levy, R (1994). Aging-associated cognitive decline. Working Party of the International Psychogeriatric Association in collaboration with the World Health Organization. International Psychogeriatrics 6, 63–68.Google ScholarPubMed
Lezak, M (1995). Neuropsychological Assessment, 3rd edn. Oxford University Press: New York.Google Scholar
Luis, CA, Barker, WW, Loewenstein, DA, Crum, TA, Rogaeva, E, Kawarai, T, St George-Hyslop, P, Duara, R (2004). Conversion to dementia among two groups with cognitive impairment. A preliminary report. Dementia and Geriatric Cognitive Disorders 18, 307–313.CrossRefGoogle ScholarPubMed
Luteyn, F, van der Ploeg, FAE (1983). The Groningen Intelligence Test [in Dutch]. Swets & Zeitlinger: Lisse, The Netherlands.Google Scholar
McKhann, G, Drachman, D, Folstein, M, Katzman, R, Price, D, Stadlan, EM (1984). Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work-Group under the auspices of the Department of Health and Human Services Task Force on Alzheimer's disease. Neurology 34, 939–944.CrossRefGoogle ScholarPubMed
Morris, JC, Storandt, M, Miller, JP, McKeel, DW, Price, JL, Rubin, EH, Berg, L (2001). Mild cognitive impairment represents early-stage Alzheimer disease. Archives of Neurology 58, 397–405.CrossRefGoogle ScholarPubMed
Neary, D, Snowden, JS, Gustafson, L, Passant, U, Stuss, D, Black, S, Freedman, M, Kertesz, A, Robert, PH, Albert, M, Boone, K, Miller, BL, Cummings, J, Benson, DF (1998). Frontotemporal lobar degeneration: a consensus on clinical diagnostic criteria. Neurology 51, 1546–1554.CrossRefGoogle ScholarPubMed
Petersen, RC, Smith, GE, Waring, SC, Ivnik, RJ, Tangalos, EG, Kokmen, E (1999). Mild cognitive impairment. Clinical characterization and outcome. Archives of Neurology 56, 303–308.CrossRefGoogle ScholarPubMed
Rasquin, SMC, Lodder, J, Visser, PJ, Lousberg, R, Verhey, FRJ (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
Raven, JC (1965). Guide to Using the Coloured Progressive Matrices. Lewis & Co: London.Google Scholar
Reisberg, B, Ferris, SH, De Leon, MJ, Crook, T (1982). The global deterioration scale for assessment of primary degenerative dementia. American Journal of Psychiatry 139, 1136–1139.Google ScholarPubMed
Reitan, R (1958). Validity of the Trail Making Test as an indication of organic brain damage. Perceptual and Motor Skills 8, 271–276.CrossRefGoogle Scholar
Ritchie, K, Artero, S, Touchon, J (2001). Classification criteria for mild cognitive impairment: a population-based validation study. Neurology 56, 37–42.CrossRefGoogle ScholarPubMed
Roman, GC, Tatemichi, TK, Erkinjuntti, T, Cummings, JL, Masdeu, JC, Garcia, JH, Amaducci, L, Orgogozo, J-M, Brun, A, Hofman, A, Moody, DM, O'Brien, MD, Yamaguchi, T, Grafman, J, Drayer, BP, Bennett, DA, Fisher, M, Ogata, J, Kokmen, E, Bermejo, F, Wolf, PA, Gorelick, PB, Bick, KL, Pajeau, AK, Bell, MA, Decarli, C, Culebras, A, Korczyn, AD, Bogousslavsky, J, Hartmann, A, Scheinberg, P (1993). Vascular dementia: diagnostic criteria for research studies. Report of the NINDS-AIREN International Workshop. Neurology 43, 250–260.CrossRefGoogle ScholarPubMed
Solfrizzi, V, Panza, F, Colacicco, AM, D'Introno, A, Capurso, C, Torres, F, Grigoletto, F, Maggi, S, Del Parigi, A, Reiman, EM, Caselli, RJ, Scafato, E, Farchi, G, Capurso, A (2004). Vascular risk factors, incidence of MCI, and rates of progression to dementia. Neurology 63, 1882–1891.CrossRefGoogle ScholarPubMed
Stinissen, J, Willems, PJ, Coetsier, P, Hulsman, WLL (1970). Dutch Adaptation of the Wechsler Adult Intelligence Scale (WAIS) [in Dutch]. Swets & Zeitlinger: Lisse, The Netherlands.Google Scholar
Stokholm, J, Jakobsen, O, Czarna, JM, Mortensen, HV, Waldemar, G (2005). Years of severe and isolated amnesia can precede the development of dementia in early-onset Alzheimer's disease. Neurocase 11, 48–55.CrossRefGoogle ScholarPubMed
Storandt, M, Grant, EA, Miller, JP, Morris, JC (2006). Longitudinal course and neuropathologic outcomes in original vs revised MCI and in pre-MCI. Neurology 67, 467–473.CrossRefGoogle ScholarPubMed
Stroop, J (1935). Studies of interference in serial verbal reactions. Journal of Experimental Psychology 18, 643–662.CrossRefGoogle Scholar
van Boxtel, MPJ, Buntinx, F, Houx, PJ, Metsemakers, JFM, Knottnerus, A, Jolles, J (1998). The relation between morbidity and cognitive performance in a normal aging population. Journal of Gerontology: Medical Sciences 53A, M146–M154.Google Scholar
Verhey, FRJ, Jolles, J, Ponds, RWHM, Rozendaal, N, Plugge, L, de Vet, HCW, Vreeling, FW, van de Lugt, PJM (1993). Diagnosing dementia: a comparison between a monodisciplinary and multidisciplinary approach. Journal of Neuropsychiatry and Clinical Neurosciences 5, 78–85.Google ScholarPubMed
Visser, PJ, Kester, A, Jolles, J, Verhey, F (2006). Ten-year risk of dementia in subjects with mild cognitive impairment. Neurology 67, 1201–1207.CrossRefGoogle ScholarPubMed
Visser, PJ, Scheltens, P, Verhey, FR (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, PJ, Verhey, FRJ, Ponds, RWHM, Kester, A, Jolles, J (2000). Distinction between preclinical dementia and depression. Journal of the American Geriatrics Society 48, 479–484.CrossRefGoogle Scholar
Visser, PJ, Verhey, FRJ, Scheltens, P, Cruts, M, Ponds, RWHM, Hofman, PAM, Van Broeckhoven, CM, Jolles, J (2002). Diagnostic accuracy of the Preclinical AD Scale (PAS) in cognitively mildly impaired subjects. Journal of Neurology 249, 312–319.CrossRefGoogle ScholarPubMed
Winblad, B, Palmer, K, Kivipelto, M, Jelic, V, Fratiglioni, L, Wahlund, LO, Nordberg, A, Backman, L, Albert, M, Almkvist, O, Arai, H, Basun, H, Blennow, K, de Leon, M, DeCarli, C, Erkinjuntti, T, Giacobini, E, Graff, C, Hardy, J, Jack, C, Jorm, A, Ritchie, K, van Duijn, C, Visser, P, Petersen, RC (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