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Updated: Aug 9, 2026
A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment
Published on: January 11, 2020
The MCI study in Taiwan
Pei-Ning Wang1, Hsiu-Chih Liu, Ker-Neng Lin
1Neurological Institutes, Taipei Veterans General Hospital, Department of Neurology, National Yang-Ming University School of Medicine, Fu Jen Catholic University, Taipei, Taiwan.
Abstract:
Veterans General Hospital started study for mild cognitive impairment (MCI) since 1996. We used clinical dementia rating (CDR) of 0.5 to define our questionable dementia (QD) subjects. These QD subjects received annual neuropsychological assessment in 5-year follow-up period. Annual conversion rate, apolipoprotein E (ApoE) genotype and neuropsychological risk factors for QD were investigated. We found a 19.9% person-year conversion rate for these QD subjects. Both of the poor cognitive performance and ApoE epsilon4 allele were risk factors for progressing to dementia. Based on the results of this study and the progress in the concept of MCI, we added more complex verbal and visual memory tests as well as MRI-based volumetry measurement in our subsequent research. Peterson's amnestic MCI criteria were used to diagnose our MCI subjects. In the 3-year follow-up period, the conversional rate was 18.2% person-year for MCI subjects, similar to our previous finding in QD. We found hippocampal volume was positively associated with cognitive performance. ApoE genotype had effect on hippocampal volume. Subjects with lower cognitive performance and smaller hippocampi had higher risk converting to AD. With rapidly expanding research on dementia and MCI worldwide, we are looking forward to seeing the integration in neurobiology, neuroimaging, and neurobehavior fields to establish a multidisciplinary approach to MCI and dementia.
Insights
This study found that poor cognitive performance and the ApoE epsilon4 gene increase the risk of dementia in individuals with questionable dementia (QD). Smaller hippocampal volumes also elevate the risk of progressing to Alzheimer's disease (AD).
Area of Science:
- Neuroscience
- Gerontology
- Genetics
Background:
- Mild cognitive impairment (MCI) research is crucial for early dementia detection.
- Questionable dementia (QD) subjects, defined by a CDR of 0.5, were studied since 1996.
- Previous studies indicated a need for more comprehensive MCI assessment methods.
Purpose of the Study:
- To investigate the conversion rate, risk factors, and genetic predispositions in QD subjects.
- To explore the relationship between cognitive performance, hippocampal volume, and Alzheimer's disease (AD) progression.
- To integrate neuroimaging and genetic data for a multidisciplinary approach to MCI and dementia.
Main Methods:
- Longitudinal follow-up of QD subjects with annual neuropsychological assessments over 5 years.
- Analysis of apolipoprotein E (ApoE) genotype and neuropsychological risk factors.
- In subsequent research, Peterson's amnestic MCI criteria were used, including advanced memory tests and MRI-based volumetry.
Main Results:
- QD subjects showed a 19.9% person-year conversion rate to dementia.
- Poor cognitive performance and the ApoE epsilon4 allele were identified as significant risk factors for dementia progression.
- MCI subjects exhibited an 18.2% person-year conversion rate; hippocampal volume was positively associated with cognitive performance, and ApoE genotype influenced hippocampal size.
Conclusions:
- Cognitive decline and specific genetic factors (ApoE epsilon4) are key predictors of dementia.
- Reduced hippocampal volume, associated with lower cognitive function, increases the risk of conversion to AD.
- A multidisciplinary approach integrating neurobiology, neuroimaging, and neurobehavioral data is essential for advancing MCI and dementia research.