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Amnestic mild cognitive impairment: diagnostic outcomes and clinical prediction over a two-year time period

H Randall Griffith1, Kelli L Netson, Lindy E Harrell

  • 1Department of Neurology, University of Alabama at Birmingham, 1216 Jefferson Tower, 625 19th Street South, Birmingham, AL, USA. rlgriffith@uabmc.edu

Journal of the International Neuropsychological Society : JINS
|April 1, 2006
PubMed

Insights

Neuropsychological tests can predict Alzheimer's disease (AD) progression in individuals with mild cognitive impairment (MCI). Specific scores on the Dementia Rating Scale and Wechsler Memory Scale accurately identify those at high risk for conversion to AD.

Area of Science:

  • Neurology
  • Neuropsychology
  • Gerontology

Background:

  • Amnestic mild cognitive impairment (MCI) is a known precursor to Alzheimer's disease (AD).
  • Accurately identifying MCI patients who will progress to AD is challenging but crucial for timely intervention.
  • Early detection of MCI conversion to AD aids in treatment planning and clinical trial recruitment.

Purpose of the Study:

  • To predict the conversion of mild cognitive impairment (MCI) to Alzheimer's disease (AD) within a two-year timeframe.
  • To evaluate the efficacy of baseline demographic and neuropsychological data in predicting MCI to AD conversion.
  • To establish specific neuropsychological test cutoff scores for identifying individuals at high risk for AD progression.

Main Methods:

  • A cohort of 49 MCI patients was analyzed using baseline demographic and neuropsychological data.
  • Stepwise discriminant function analysis was employed, focusing on Dementia Rating Scale (DRS) Initiation/Perseveration and Wechsler Memory Scale, third edition (WMS-III) Visual Reproduction Percent Retention scores.
  • Classification rates, sensitivity, and specificity were calculated to assess predictive accuracy.

Main Results:

  • The analysis correctly classified 85.7% of MCI patients as converters or non-converters to AD.
  • High sensitivity (76.9%) and specificity (88.9%) were achieved using DRS and WMS-III scores.
  • Specific cutoff scores (DRS < 37, WMS-III < 26%) demonstrated high accuracy in identifying AD converters (76.9% sensitivity, 91.7% specificity).
  • Demographic factors and vascular risk did not significantly improve predictive accuracy.

Conclusions:

  • Commonly administered neuropsychological tests can effectively identify MCI patients at risk for conversion to AD within 1-2 years.
  • These findings support the use of neuropsychological assessments for prognostic information and early treatment targeting in MCI.
  • The study highlights the potential of these methods for identifying suitable participants for Alzheimer's disease clinical trials.

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