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Vol. 19, No. 2-3, 2005
Issue release date: February 2005
Section title: Original Research Article
Dement Geriatr Cogn Disord 2005;19:113–119
(DOI:10.1159/000082662)

Predictive Accuracy of MCI Subtypes for Alzheimer’s Disease and Vascular Dementia in Subjects with Mild Cognitive Impairment: A 2-Year Follow-Up Study

Rasquin S.M.C.a · Lodder J.b · Visser P.J.a · Lousberg R.a · Verhey F.R.J.a
Research Institute Brain and Behavior,aDepartment of Psychiatry and Neuropsychology, and bDepartment of Neurology, University of Maastricht/University Hospital Maastricht, Maastricht, The Netherlands
email Corresponding Author

Abstract

Aim: The aim of this study was to investigate the prognostic accuracy of different subtypes of mild cognitive impairment (MCI): amnestic MCI, multiple domain MCI, and single non-memory domain MCI, for the development of Alzheimer’s dementia (AD) and vascular dementia (VaD). Patients: Nondemented patients from a memory clinic cohort (n = 118), and a stroke cohort (n = 80, older than 55 years and with a cognitive impairment). Results: ‘Multiple domain MCI’ had the highest sensitivity for both AD (80.8%) and VaD (100%), and ‘amnestic MCI’ had the highest specificity (85.9% for AD, 100% for VaD). The positive predictive value was low for all subtypes (0.0–32.7%), whereas the negative predictive value was high (72.8–100%). Discussion: The subtype ‘multiple domain MCI’ has high sensitivity in identifying people at risk for developing AD or VaD. The predictive accuracy of the MCI subtypes was similar for both AD and VaD.

© 2005 S. Karger AG, Basel


  

Key Words

  • Mild cognitive impairment
  • Predementia stage
  • Vascular dementia
  • Alzheimer’s dementia
  • Diagnostic criteria

References

  1. Petersen RC, Doody R, Kurz A, et al: Current concepts in mild cognitive impairment. Arch Neurol 2001;58:1985–1992.
  2. Busse A, Bischkopf J, Riedel-Heller SG, Angermeyer MC: Subclassifications for mild cognitive impairment: Prevalence and predictive validity. Psychol Med 2003;33:1029–1038.
  3. DeCarli C: Mild cognitive impairment: Prevalence, prognosis, aetiology, and treatment. Lancet Neurol 2003;2:15–21.
  4. Petersen RC, Smith GE, Waring SC, et al: Mild cognitive impairment: Clinical characterization and outcome. Arch Neurol 1999;56:303–308.
  5. Ritchie K, Touchon J: Mild cognitive impairment: Conceptual basis and current nosological status. Lancet 2000;355:225–228.
  6. Visser PJ, Verhey FRJ, Ponds RWHM, Kester A, Jolles J: Distinction between preclinical Alzheimer’s disease and depression. J Am Geriatr Soc 2000;48:479–484.
  7. Rasquin SMC, Verhey FRJ, Lousberg R, Winkens I, Lodder J: Vascular cognitive disorders: Memory, mental speed and cognitive flexibility after stroke. J Neurol Sci 2002;203–204(C):115–119.
  8. Rasquin SMC, Lodder J, Ponds RWHM, Jolles J, Winkens I, Verhey FRJ: Cognitive functioning after stroke: A one-year follow-up study. Dement Geriatr Cogn Disord 2004;18:138–144.
  9. Rasquin SMC, Lodder J, Verhey FRJ: Predictors of reversible mild cognitive impairment after stroke: A two year follow-up study. J Neurol Scie 2004, in press.
  10. Hachinski VC, Lassen NA, Marshall J: Multi-infarct dementia: A cause of mental deterioration in the elderly. Lancet 1974;ii:207–210.
  11. Jolles J, Houx PJ, van Boxtel MPJ, Ponds RWHM: The Maastricht Aging Study: Determinants of Cognitive Aging. Maastricht, Neuropsych Publishers, 1995.
  12. Roman GC, et al: Vascular dementia: Diagnostic criteria for research studies. Report of the NINDS-AIREN International Workshop. Neurology 1993;43:250–260.
  13. Brand N, Jolles J: Learning and retrieval rate of words presented auditorily and visually. J Gen Psychol 1985;112:201–210.
  14. Houx PJ, Jolles J, Vreeling FW: Stroop interference: Aging effects assessed with the Stroop Color-Word Test. Exp Aging Res 1993;19:204–224.
  15. Vink M, Jolles J: A new version of the Trail-Making Test as an information processing task. J Clin Neuropsychol 1985;7:162.
  16. Reitan RM: Validity of the Trail Making Test as an indication of organic brain damage. Percept Motor Skills 1985;8:271–276.

    External Resources

  17. Luteijn F, van der Ploeg FAE: Manual Groninger Intelligence Test. Lisse, Swets & Zeitlinger, 1983.
  18. Folstein MF, Folstein SE, McHugh PR: ‘Mini-mental state’: A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12:189–198.
  19. Bowler JV, Hadar U, Wade JP: Cognition in stroke. Acta Neurol Scand 1994;90:424–429.
  20. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 4 ed. Washington, American Psychiatric Association, 1994.
  21. Teunisse S, Derix MM: Measurement of activities of daily living in patients with dementia living at home: Development of a questionnaire (in Dutch). Tijdschr Gerontol Geriatr 1991;22:53–59.
  22. Wentzel C, Rockwood K, MacKnight C, Hachinski V, et al: Progression of impairment in patients with vascular cognitive impairment without dementia. Neurology 2001;57:714–716.
  23. Ingles JL, Wentzel C, Fisk JD, Rockwood K: Neuropsychological predictors of incident dementia in patients with vascular cognitive impairment, without dementia. Stroke 2002;33:1999–2002.
  24. Tian J, Bucks RS, Haworth J, Wilcock G: Neuropsychological prediction of conversion to dementia from questionable dementia: Statistically significant but not yet clinically useful. J Neurol Neurosurg Psychiatry 2003;74:433–438.
  25. Ballard C, Stephens S, McLaren A, Wesnes K, Kenny R: Mild cognitive impairment and vascular cognitive impairment in stroke patients. Int Psychogeriatr 2003;15:123–126.
  26. Frisoni GB, Galluzi S, Bresciani L, Zanetti O, Geroldi L: Mild cognitive impairment with subcortical vascular features: Clinical characteristics and outcome. J Neurol 2002;249:1423–1432.
  27. Rockwood K, Wentzel C, Hachinski V, Hogan DB, et al: Prevalence and outcomes of vascular cognitive impairment. Vascular Cognitive Impairment Investigators of the Canadian Study of Health and Aging. Neurology 2000;54:447–451.
  28. Tham W, Auchus AP, Thong M, Go ML, Chang HM, et al: Progression of cognitive impairment after stroke: One year results from a longitudinal study of Singaporean stroke patients. J Neurol Sci 2002;203–204(C):49–52.
  29. Fisk JD, Merry HR, Rockwood K: Variations in case definition affect prevalence but not outcomes of mild cognitive impairment. Neurology 2003;61:1179–1184.

  

Author Contacts

Prof. Dr. F.R.J. Verhey
Department Psychiatry and Neuropsychology
PO Box 5800, NL–6202 MD Maastricht (The Netherlands)
Tel. +31 43 3877537, Fax +31 43 3875444
E-Mail F.Verhey@np.unimaas.nl

  

Article Information

Accepted: May 23, 2004
Published online: December 9, 2004
Number of Print Pages : 7
Number of Figures : 1, Number of Tables : 4, Number of References : 29

  

Publication Details

Dementia and Geriatric Cognitive Disorders

Vol. 19, No. 2-3, Year 2005 (Cover Date: Released February 2005)

Journal Editor: V. Chan-Palay, New York, N.Y.
ISSN: 1420–8008 (print), 1421–9824 (Online)

For additional information: http://www.karger.com/dem


Copyright / Drug Dosage / Disclaimer

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

Abstract

Aim: The aim of this study was to investigate the prognostic accuracy of different subtypes of mild cognitive impairment (MCI): amnestic MCI, multiple domain MCI, and single non-memory domain MCI, for the development of Alzheimer’s dementia (AD) and vascular dementia (VaD). Patients: Nondemented patients from a memory clinic cohort (n = 118), and a stroke cohort (n = 80, older than 55 years and with a cognitive impairment). Results: ‘Multiple domain MCI’ had the highest sensitivity for both AD (80.8%) and VaD (100%), and ‘amnestic MCI’ had the highest specificity (85.9% for AD, 100% for VaD). The positive predictive value was low for all subtypes (0.0–32.7%), whereas the negative predictive value was high (72.8–100%). Discussion: The subtype ‘multiple domain MCI’ has high sensitivity in identifying people at risk for developing AD or VaD. The predictive accuracy of the MCI subtypes was similar for both AD and VaD.

© 2005 S. Karger AG, Basel


  

Author Contacts

Prof. Dr. F.R.J. Verhey
Department Psychiatry and Neuropsychology
PO Box 5800, NL–6202 MD Maastricht (The Netherlands)
Tel. +31 43 3877537, Fax +31 43 3875444
E-Mail F.Verhey@np.unimaas.nl

  

Article Information

Accepted: May 23, 2004
Published online: December 9, 2004
Number of Print Pages : 7
Number of Figures : 1, Number of Tables : 4, Number of References : 29

  

Publication Details

Dementia and Geriatric Cognitive Disorders

Vol. 19, No. 2-3, Year 2005 (Cover Date: Released February 2005)

Journal Editor: V. Chan-Palay, New York, N.Y.
ISSN: 1420–8008 (print), 1421–9824 (Online)

For additional information: http://www.karger.com/dem


Article / Publication Details

First-Page Preview
Abstract of Original Research Article

Received: 5/23/2004
Published online: 2/11/2005
Issue release date: February 2005

Number of Print Pages: 7
Number of Figures: 1
Number of Tables: 4

ISSN: 1420-8008 (Print)
eISSN: 1421-9824 (Online)

For additional information: http://www.karger.com/DEM


Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

References

  1. Petersen RC, Doody R, Kurz A, et al: Current concepts in mild cognitive impairment. Arch Neurol 2001;58:1985–1992.
  2. Busse A, Bischkopf J, Riedel-Heller SG, Angermeyer MC: Subclassifications for mild cognitive impairment: Prevalence and predictive validity. Psychol Med 2003;33:1029–1038.
  3. DeCarli C: Mild cognitive impairment: Prevalence, prognosis, aetiology, and treatment. Lancet Neurol 2003;2:15–21.
  4. Petersen RC, Smith GE, Waring SC, et al: Mild cognitive impairment: Clinical characterization and outcome. Arch Neurol 1999;56:303–308.
  5. Ritchie K, Touchon J: Mild cognitive impairment: Conceptual basis and current nosological status. Lancet 2000;355:225–228.
  6. Visser PJ, Verhey FRJ, Ponds RWHM, Kester A, Jolles J: Distinction between preclinical Alzheimer’s disease and depression. J Am Geriatr Soc 2000;48:479–484.
  7. Rasquin SMC, Verhey FRJ, Lousberg R, Winkens I, Lodder J: Vascular cognitive disorders: Memory, mental speed and cognitive flexibility after stroke. J Neurol Sci 2002;203–204(C):115–119.
  8. Rasquin SMC, Lodder J, Ponds RWHM, Jolles J, Winkens I, Verhey FRJ: Cognitive functioning after stroke: A one-year follow-up study. Dement Geriatr Cogn Disord 2004;18:138–144.
  9. Rasquin SMC, Lodder J, Verhey FRJ: Predictors of reversible mild cognitive impairment after stroke: A two year follow-up study. J Neurol Scie 2004, in press.
  10. Hachinski VC, Lassen NA, Marshall J: Multi-infarct dementia: A cause of mental deterioration in the elderly. Lancet 1974;ii:207–210.
  11. Jolles J, Houx PJ, van Boxtel MPJ, Ponds RWHM: The Maastricht Aging Study: Determinants of Cognitive Aging. Maastricht, Neuropsych Publishers, 1995.
  12. Roman GC, et al: Vascular dementia: Diagnostic criteria for research studies. Report of the NINDS-AIREN International Workshop. Neurology 1993;43:250–260.
  13. Brand N, Jolles J: Learning and retrieval rate of words presented auditorily and visually. J Gen Psychol 1985;112:201–210.
  14. Houx PJ, Jolles J, Vreeling FW: Stroop interference: Aging effects assessed with the Stroop Color-Word Test. Exp Aging Res 1993;19:204–224.
  15. Vink M, Jolles J: A new version of the Trail-Making Test as an information processing task. J Clin Neuropsychol 1985;7:162.
  16. Reitan RM: Validity of the Trail Making Test as an indication of organic brain damage. Percept Motor Skills 1985;8:271–276.

    External Resources

  17. Luteijn F, van der Ploeg FAE: Manual Groninger Intelligence Test. Lisse, Swets & Zeitlinger, 1983.
  18. Folstein MF, Folstein SE, McHugh PR: ‘Mini-mental state’: A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12:189–198.
  19. Bowler JV, Hadar U, Wade JP: Cognition in stroke. Acta Neurol Scand 1994;90:424–429.
  20. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 4 ed. Washington, American Psychiatric Association, 1994.
  21. Teunisse S, Derix MM: Measurement of activities of daily living in patients with dementia living at home: Development of a questionnaire (in Dutch). Tijdschr Gerontol Geriatr 1991;22:53–59.
  22. Wentzel C, Rockwood K, MacKnight C, Hachinski V, et al: Progression of impairment in patients with vascular cognitive impairment without dementia. Neurology 2001;57:714–716.
  23. Ingles JL, Wentzel C, Fisk JD, Rockwood K: Neuropsychological predictors of incident dementia in patients with vascular cognitive impairment, without dementia. Stroke 2002;33:1999–2002.
  24. Tian J, Bucks RS, Haworth J, Wilcock G: Neuropsychological prediction of conversion to dementia from questionable dementia: Statistically significant but not yet clinically useful. J Neurol Neurosurg Psychiatry 2003;74:433–438.
  25. Ballard C, Stephens S, McLaren A, Wesnes K, Kenny R: Mild cognitive impairment and vascular cognitive impairment in stroke patients. Int Psychogeriatr 2003;15:123–126.
  26. Frisoni GB, Galluzi S, Bresciani L, Zanetti O, Geroldi L: Mild cognitive impairment with subcortical vascular features: Clinical characteristics and outcome. J Neurol 2002;249:1423–1432.
  27. Rockwood K, Wentzel C, Hachinski V, Hogan DB, et al: Prevalence and outcomes of vascular cognitive impairment. Vascular Cognitive Impairment Investigators of the Canadian Study of Health and Aging. Neurology 2000;54:447–451.
  28. Tham W, Auchus AP, Thong M, Go ML, Chang HM, et al: Progression of cognitive impairment after stroke: One year results from a longitudinal study of Singaporean stroke patients. J Neurol Sci 2002;203–204(C):49–52.
  29. Fisk JD, Merry HR, Rockwood K: Variations in case definition affect prevalence but not outcomes of mild cognitive impairment. Neurology 2003;61:1179–1184.