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Conversion to dementia among two groups with cognitive impairment. A preliminary report
Cheryl A Luis1, Warren W Barker, David A Loewenstein
1Wien Center for Alzheimer's Disease and Memory Disorders, Mount Sinai Medical Center, Miami, Fla. 33140, USA. cluis@msmc.com
Dementia and Geriatric Cognitive Disorders
|August 12, 2004
Summary
Patients with mild cognitive impairment due to Alzheimer's disease (MCI-AD) convert to dementia faster than those with vascular MCI (MCI-Vas). This highlights distinct progression rates for MCI subtypes.
Area of Science:
- Neurology
- Neuroscience
- Geriatrics
Background:
- Mild cognitive impairment (MCI) is a transitional stage between normal cognition and dementia.
- Differentiating subtypes of MCI, such as MCI due to incipient Alzheimer's disease (MCI-AD) and MCI with vascular features (MCI-Vas), is crucial for understanding disease progression.
Purpose of the Study:
- To compare the conversion rates to dementia in patients diagnosed with MCI-AD versus MCI-Vas.
- To identify clinical and neuropsychological factors associated with dementia conversion in MCI subtypes.
Main Methods:
- Ninety-nine patients with MCI-AD and 35 with MCI-Vas were diagnosed based on clinical history, neurocognitive, neurological, and MRI evaluations.
- Conversion to dementia was monitored over an average follow-up period of 2.4 years.
- The Fuld Object Memory Evaluation (Fuld-OME) was used to assess learning and recall.
Main Results:
- Overall, 44% of MCI patients converted to dementia within the follow-up period.
- The MCI-AD group showed a significantly faster conversion rate to dementia (50.5% at 3 years) compared to the MCI-Vas group (25.7% at 3 years).
- The Fuld-OME best differentiated converters from non-converters; age, education, gender, and APOE ε4 status did not.
Conclusions:
- MCI-AD and MCI-Vas represent clinically distinct subtypes of MCI with differing rates of progression to dementia.
- These findings underscore the importance of subtype classification in MCI management and prognosis.
- Larger prospective studies are needed to validate these results and further elucidate the natural history of MCI subtypes.