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Neuropsychological Criteria for Mild Cognitive Impairment in the Framingham Heart Study's Old-Old
Christina G Wong1,2, Kelsey R Thomas1,2, Emily C Edmonds1,2
1Veteran Affairs San Diego Healthcare System, San Diego, California, USA.
Background/Aims:
Mild cognitive impairment (MCI) lacks a "gold standard" operational definition. The Jak/Bondi actuarial neuropsychological criteria for MCI are associated with improved diagnostic stability and prediction of progression to dementia compared to conventional MCI diagnostic approaches, although its utility in diagnosing MCI in old-old individuals (age 75+) is unknown. Therefore, we investigated the applicability of neuropsychological MCI criteria among old-old from the Framingham Heart Study.
Methods:
A total of 347 adults (ages 79-102) were classified as cognitively normal or MCI via Jak/Bondi and conventional Petersen/Winblad criteria, which differ on cutoffs for cognitive impairment and number of impaired scores required for a diagnosis. Cox models examined MCI status in predicting risk of progression to dementia.
Results:
MCI diagnosed by both the Jak/Bondi and Petersen/Winblad criteria was associated with incident dementia; however, when both criteria were included in the regression model together, only the Jak/Bondi criteria remained statistically significant. At follow-up, the Jak/Bondi criteria had a lower MCI-to-normal reversion rate than the Petersen/Winblad criteria.
Conclusions:
Our findings are consistent with previous research on the Jak/Bondi criteria and support the use of a comprehensive neuropsychological diagnostic approach for MCI among old-old individuals.
Insights
The Jak/Bondi criteria effectively diagnose mild cognitive impairment (MCI) in older adults, showing better diagnostic stability and prediction of dementia progression than conventional methods. This supports using comprehensive neuropsychological assessments for the old-old population.
Area of Science:
- Neuropsychology
- Gerontology
- Neurology
Background:
- Mild cognitive impairment (MCI) lacks a universally accepted definition.
- Existing diagnostic criteria for MCI have limitations, especially in older populations.
- The utility of the Jak/Bondi neuropsychological criteria in individuals aged 75 and older was previously unknown.
Purpose of the Study:
- To investigate the applicability of Jak/Bondi neuropsychological criteria for diagnosing MCI in old-old individuals (age 75+).
- To compare the diagnostic stability and predictive value of Jak/Bondi criteria against conventional Petersen/Winblad criteria in this age group.
Main Methods:
- 347 adults (ages 79-102) from the Framingham Heart Study were assessed.
- Participants were classified as cognitively normal or MCI using both Jak/Bondi and Petersen/Winblad criteria.
- Cox regression models analyzed MCI status in predicting dementia risk and reversion rates.
Main Results:
- MCI diagnosed by both criteria predicted incident dementia.
- When compared directly, only the Jak/Bondi criteria remained statistically significant in predicting dementia.
- The Jak/Bondi criteria demonstrated a lower rate of MCI-to-normal reversion compared to Petersen/Winblad criteria.
Conclusions:
- The Jak/Bondi criteria are effective for diagnosing MCI in old-old individuals.
- Findings support the use of comprehensive neuropsychological diagnostic approaches for MCI in this demographic.
- This study validates the Jak/Bondi criteria in a population aged 75 and older.