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Vol. 18, No. 3-4, 2004
Issue release date: October 2004
Dement Geriatr Cogn Disord 2004;18:307–313

Conversion to Dementia among Two Groups with Cognitive Impairment

A Preliminary Report

Luis C.A. · Barker W.W. · Loewenstein D.A. · Crum T.A. · Rogaeva E. · Kawarai T. · St. George-Hyslop P. · Duara R.
aWien Center for Alzheimer’s Disease and Memory Disorders, Mount Sinai Medical Center, Departments of bPsychiatry and Behavioral Sciences and cMedicine, University of Miami School of Medicine, Miami, Fla., USA; dDepartment of Medicine and Physiology, Center for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Canada

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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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  1. Brookmeyer R, Gray S, Kawas C: Projections of Alzheimer’s disease in the United States and the public health impact of delaying disease onset. Am J Public Health 1998;88:1337–1342.
  2. Flicker C, Ferris S, Reisberg B: Mild cognitive impairment in the elderly: Predictors of dementia. Neurology 1991;41:1006–1009.
  3. Albert MS, Moss MB, Tanzi R, Jones K: Preclinical prediction of AD using neuropsychological tests. J Int Neuropsychol Soc 2001;7:631–639.
  4. Perry RJ, Hodges HR: Fate of patients with questionable (very mild) Alzheimer’s disease: Longitudinal profiles of individual subjects’ decline. Dement Geriatr Cogn Disord 2000;11:342–349.
  5. Hughes TA, Ross HF, Musa S, Bhattacherjee S, Nathan RN, Mindham RH, Spokes EG: A 10-year study of the incidence of and factors predicting dementia in Parkinson’s disease. Neurology 2000;54:1596–1603.
  6. Marquis S, Moore MM, Howieson DB, et al: Independent predictors of cognitive decline in healthy elderly persons. Arch Neurol 2002;59:601–606.
  7. Waite LM, Broe GA, Grayson DA, Creasey H: Preclinical syndromes predict dementia: The Sidney older person study. Neurol Neurosurg Psychiatry 2001;71:296–302.
  8. Small GW, La Rue A, Komo S, Kaplan A, Mandelkern M: Predictors of cognitive change in middle-aged and older adults with memory loss. Am J Psychiatry 1995;152:1757–1764.
  9. Kuller LH, Lopez OL, Newman A, et al: Risk factors for dementia in the cardiovascular health cognition study. Neuroepidemiology 2003;22:13–22.
  10. Riemenschneider M, Lautenschlager N, Wagenpfeil S, Diehl J, Drzezga A, Kurz A: Cerebrospinal fluid tau and beta-amyloid 42 proteins identify Alzheimer’s disease in subjects with mild cognitive impairment. Arch Neurol 2002;59:1729–1734.
  11. Petersen RC: Normal aging, mild cognitive impairment, and early Alzheimer’s disease. Neurologist 1995;1:326–344.

    External Resources

  12. Graham J, Rockwood K, Beattie BL, et al: Prevalence and severity of cognitive impairment with and without dementia in an elderly population. Lancet 1997;349:1793–1796.
  13. Petersen RC, Smith GE, Waring SC, Ivnik RJ, Tangalos E, Kokmen E: Mild cognitive impairment: Clinical characterization and outcome. Arch Neurol 1999;56:303–308.
  14. Daly E, Zaitchik D, Copeland M, Schmahmann J, Gunther J, Albert M: Predicting conversion of Alzheimer’s disease using standard clinical information. Arch Neurol 2000;57:675–680.
  15. Rockwood K, Wentzel C, Hachinski V, Hogan DB, MacKnight C, McDowell I: Prevalence and outcomes of vascular cognitive impairment. Vascular Cognitive Impairment Investigators of the Canadian Study of Health and Aging. Neurology 2000;54:447–451.
  16. Kluger A, Ferris SH, Golomb J, Mittleman MS, Reisberg B: Neuropsychological prediction of decline to dementia in nondemented elderly. J Geriatr Psychiatry Neurol 1999;12:168–179.
  17. Morris JC, Storandt M, Miller JP, et al: Mild cognitive impairment represents early-stage Alzheimer disease. Archives of Neurology 2001;58:397–405.
  18. Tuokko H, Frerichs R, Graham J, et al: Five-year follow-up of cognitive impairment with no dementia. Arch Neurol 2003;60:577–582.
  19. Petersen RC, Stevens JC, Ganguli M, Tangalos EG, Cummings JL, DeKosky ST: 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. 2001;56:1133–1142.
  20. Petersen RC: Mild cognitive impairment: Transition between aging and Alzheimer’s disease. Neurologia 2000;15:93–101.
  21. Celsis P: Age-related cognitive decline, mild cognitive impairment or preclinical Alzheimer’s disease? Ann Med 2000;32:6–14.
  22. Petersen RC, Doody R, Kurz A, et al: Current concepts in mild cognitive impairment. Arch Neurol 2001;58:1985–1992.
  23. Petersen RC, Morris JC: Clinical features; in Petersen RC (ed): Mild Cognitive Impairment: Aging to Alzheimer’s Disease. New York, Oxford University Press, 2003, pp 15–39.
  24. Wentzel C, Rockwood K, MacKnight C, et al: Progression of impairment in patients with vascular cognitive impairment without dementia. Neurology 2001;57:714–716.
  25. Kivipelto M, Helkala EL, Laakso MP, et al: Midlife vascular risk factors and AD in later life: Longitudinal, population-based study. BMJ 2001;322:1447–1451.
  26. Rockwood K, Brown M, Merry H, Sketris I, Fisk J: Societal costs of vascular cognitive impairment in older adults. Stroke 2002;33:1605–1609.
  27. Hughes RA, Berg L, Danziger WL, Coben LA, Martin RL: A new clinical scale for the staging of dementia. Br J Psychol 1982;140:556–572.
  28. Loewenstein DA, Barker W, Harwood D, et al: Utility of a modified mini-mental state examination with extended delayed recall in screening for mild cognitive impairment and dementia among community dwelling elders. Int J Geriatr Psychiatry 2000;15:434–440.
  29. Goodglass H, Kaplan E: The Assessment of Aphasia and Related Disorders, ed 2. Philadelphia, Lea and Febiger, 1983.
  30. Battersby WS, Bender MB, Pollack M, Kahn RL: Unilateral ‘spatial agnosia’ (‘inattention’) in patients with cerebral lesions. Brain 1956;79:68–93.
  31. McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM: Clinical diagnosis of Alzheimer’s disease: Report of the NINCDS-ADRDA workgroup under the auspices of Department of Health and Human Services Task Force on Alzheimer’s Disease. Neurology 1984;34:939–944.
  32. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, ed 3, revised. Washington, APA, 1987.
  33. Tsuda T, Lopez R, Rogaeva EA, et al: Are the associations between Alzheimer’s disease and polymorphisms in the apolipoprotein E and apolipoprotein CII genes due to linkage disequilibrium? Ann Neurol 1994;35:97–100.
  34. SAS Institute Inc.: SAS/STAT User’s Guide, Version 6, ed 4.Cary, SAS Institute Inc., 1989, vol 2, p. 846.
  35. Loewenstein DA, Arguelles T, Acevedo A, et al: The utility of a modified object memory test in distinguishing between different age groups of Alzheimer’s disease patients and normal controls. J Ment Health Aging 2001;7:317–324.
  36. Wechsler D: Wechsler Memory Scale, revised. San Antonio, Psychological Corporation, 1987.
  37. Wechsler D: Wechsler Adult Intelligence Scale. New York, Psychological Corporation, 1981.
  38. Bowen J, Teri L, Kukull W, McCormick W, McCurry SM, Larson EB: Progression to dementia in patients with isolated memory loss. Lancet 1997;349:764–765.
  39. Tierney M, Szalai J, Snow W, et al: Prediction of probable Alzheimer’s disease in memory-impaired patients: A prospective longitudinal study. Neurology 1996;46:661–665.
  40. Smith GE, Petersen R, Parisi J, et al: Definition, course, and outcome of mild cognitive impairment. Aging Neuropsychol Cogn 1996;3:141–147.

    External Resources

  41. Schneider JA, Wilson RS, Cochrane EJ, et al: Relation of cerebral infarctions to dementia and cognitive function in older persons. Neurology 2003;60:1082–1088.
  42. Smith CD, Snowdon DA, Wang H, Markesbery WR: White matter volumes and periventricular white matter hyperintensities in aging and dementia. Neurology 2000;54:838–842.
  43. Ritchie K, Artero S, Touchon J: Classification criteria for mild cognitive impairment: A population-based validation study. Neurology 2001;56:37–42.
  44. Larrieu S, Letenneur L, Orgogozo JM, et al: Incidence and outcome of mild cognitive impairment in a population-based prospective cohort. Neurology 2002;59:1594–1599.
  45. Petersen RC, Smith G, Ivnik R, et al: Apolipoprotein E status as a predictor of the development of Alzheimer’s disease in memory-impaired individuals. JAMA 1995;273:1274–1278.
  46. Harwood DG, Barker WW, Loewenstein DA, et al: A cross-ethnic analysis of risk factors for AD in white Hispanics and white non-Hispanics. Neurology 1999;52:551–556.
  47. Duara R, Barker WW, Lopez-Alberola R, et al: Alzheimer’s disease: Interaction of apolipoprotein E genotype, family history of dementia, gender, education, ethnicity, and age of onset. Neurology 1996;46:1575–1579.

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