Conversion to Dementia among Two Groups with Cognitive Impairment
A Preliminary ReportLuis C.A. · Barker W.W. · Loewenstein D.A. · Crum T.A. · Rogaeva E. · Kawarai T. · St. George-Hyslop P. · Duara R.
Objective: To determine the conversion rates to dementia in patients diagnosed with mild cognitive impairment (MCI) thought to be caused by incipient Alzheimer’s disease (MCI-AD) or with MCI with features of vascular disease (MCI-Vas). Methods: On the basis of patient history, neurocognitive, neurological and MRI evaluation, 99 patients were diagnosed with MCI-AD and 35 with MCI-Vas. Conversion to dementia over an average of a 2.4 ± 1.8-year period was determined. Results: Over the follow-up period, 44% converted to dementia, 51.5% remained classified as MCI, and 4.5% were reclassified as cognitively normal. The conversion rate to dementia was significantly faster at 3 years for the MCI-AD (50.5%) than for the MCI-Vas group (25.7%). The neuropsychological test found to best differentiate converters from non-converters was the Fuld-OME, a measure of learning and recall. Age, education, gender or APOE ε4 allele frequency did not differentiate converters from non-converters. Conclusions: MCI-AD and MCI-Vas are clinically meaningful subtypes of MCI that may convert to dementia at different rates. Prospective studies on larger subsets of MCI patients are required to confirm these findings.
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