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Updated: Jul 29, 2026
A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment
Published on: January 11, 2020
Mild cognitive impairment etiologic subtyping using pragmatic and conventional criteria: preliminary experience in
R Valenti1, E Salvadori, A Poggesi
1Neuroscience Section, NEUROFARBA Department, University of Florence, Florence, Italy.
Background:
Mild cognitive impairment (MCI) is an abnormal condition defined by the presence of cognitive decline not severe enough to fit dementia criteria. According to Winblad et al.'s criteria, the clinical distinction of MCI subtypes (amnestic/non-amnestic, single/multiple domain) is based on the cognitive profiling (conventional diagnosis) and infers possible different MCI etiologies. MCI prodromic of vascular dementia (Vasc-MCI) is thought to be characterized by a multiple domain profile. In our outpatient clinic (the "Florence VAS-COG clinic"), the diagnosis of MCI and of its different subtypes (vascular, degenerative, mixed) is based on a comprehensive evaluation of clinical and neuroimaging features (pragmatic diagnosis).
Aims:
To compare the pragmatic and conventional diagnoses in terms of etiologic subtyping of MCI.
Methods:
We retrospectively assessed the agreement between the two diagnoses in 30 MCI patients. Agreement was considered present when degenerative MCI was of the amnestic type (single or multiple domain) and Vasc-MCI was of the multiple domain type (amnestic or non-amnestic MCI).
Results:
In 15/30 (50 %) patients, the diagnoses were in disagreement: 5/9 (56 %) patients diagnosed with a degenerative MCI type presented a non-amnestic cognitive profile (4 single domain and 1 multiple domain); 10/21 (48 %) Vasc-MCI were classified as non-amnestic single domain.
Conclusions:
The application of MCI etiologic subtyping using pragmatic or conventional diagnoses leads to different results. In our setting, not all the Vasc-MCI patients have a multiple domain profile. Our preliminary study suggests that the cognitive profile of Vasc-MCI is more heterogeneous than previously suggested.
Insights
Comparing diagnostic methods for mild cognitive impairment (MCI) subtypes revealed discrepancies. Not all vascular MCI patients exhibit a multiple domain profile, suggesting greater heterogeneity in Vasc-MCI cognitive presentation.
Area of Science:
- Neurology
- Cognitive Science
Background:
- Mild cognitive impairment (MCI) involves cognitive decline not meeting dementia criteria.
- Subtyping MCI (amnestic/non-amnestic, single/multiple domain) aids in understanding etiologies.
- Vascular MCI (Vasc-MCI) is often presumed to have a multiple domain profile.
Purpose of the Study:
- To compare etiologic subtyping of MCI using pragmatic (clinic-based) versus conventional (cognitive profiling) diagnostic approaches.
- To evaluate the agreement between pragmatic and conventional MCI diagnoses.
Main Methods:
- Retrospective analysis of 30 MCI patients.
- Assessed agreement based on specific subtype criteria for degenerative MCI and Vasc-MCI.
Main Results:
- Disagreement between diagnostic methods occurred in 50% of patients (15/30).
- A significant proportion of degenerative MCI patients showed non-amnestic profiles (56%).
- Nearly half of Vasc-MCI cases were classified as non-amnestic single domain.
Conclusions:
- MCI etiologic subtyping yields different outcomes depending on the diagnostic approach (pragmatic vs. conventional).
- The study challenges the assumption that all Vasc-MCI patients present with a multiple domain profile.
- Vasc-MCI may exhibit a more heterogeneous cognitive profile than previously recognized.
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