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Mild cognitive impairment: long-term course of four clinical subtypes.

Abstract

OBJECTIVE

To empirically validate the expanded concept of mild cognitive impairment (MCI), which differentiates between four clinical subtypes-amnestic MCI-single domain, amnestic MCI-multiple domains, nonamnestic MCI-single domain, and nonamnestic MCI-multiple domains-and to examine the prevalence, course, and outcome of these four clinical MCI subtypes.

METHODS

We studied a community sample of 980 dementia-free individuals aged 75 years or older who participated in the Leipzig Longitudinal Study of the Aged (LEILA 75+). All participants were examined by neuropsychological testing based on 6 years of observation. The diagnoses of the four clinical MCI subtypes were made according to the original and to slightly modified criteria by Petersen et al. (2001) (both with a cutoff of 1.0 SD and with a cutoff of 1.5 SD). The complete range of outcome types (dementia, death, improvement, stable diagnosis, unstable diagnosis) was described for all subtypes. The relative predictive power of stable MCI for dementia onset was determined.

RESULTS

MCI-single domain is more frequent than MCI-multiple domains, and the nonamnestic MCI type is as frequent as the amnestic MCI type. The "MCI modified, 1.0 SD" criteria have the highest relative predictive power for the development of dementia (sensitivity = 74%, specificity = 73%). Alzheimer disease (AD) was the most common type of dementia at follow-up in all but one MCI subtype. Participants with nonamnestic MCI-multiple domains were more likely to progress to a non-AD dementia.

CONCLUSIONS

It has been assumed that each MCI subtype is associated with an increased risk for a particular type of dementia. We can only partially agree with this.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Department of Psychiatry, University of Leipzig, Leipzig, Germany.

    , , ,

    Source

    Neurology 67:12 2006 Dec 26 pg 2176-85

    MeSH

    Aged
    Aged, 80 and over
    Cognition Disorders
    Comorbidity
    Dementia
    Female
    Germany
    Humans
    Longitudinal Studies
    Male
    Memory Disorders
    Neurodegenerative Diseases
    Outcome Assessment (Health Care)
    Prevalence
    Risk Assessment
    Risk Factors

    Pub Type(s)

    Journal Article
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    17190940

    Citation

    Busse, A, et al. "Mild Cognitive Impairment: Long-term Course of Four Clinical Subtypes." Neurology, vol. 67, no. 12, 2006, pp. 2176-85.
    Busse A, Hensel A, Gühne U, et al. Mild cognitive impairment: long-term course of four clinical subtypes. Neurology. 2006;67(12):2176-85.
    Busse, A., Hensel, A., Gühne, U., Angermeyer, M. C., & Riedel-Heller, S. G. (2006). Mild cognitive impairment: long-term course of four clinical subtypes. Neurology, 67(12), pp. 2176-85.
    Busse A, et al. Mild Cognitive Impairment: Long-term Course of Four Clinical Subtypes. Neurology. 2006 Dec 26;67(12):2176-85. PubMed PMID: 17190940.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Mild cognitive impairment: long-term course of four clinical subtypes. AU - Busse,A, AU - Hensel,A, AU - Gühne,U, AU - Angermeyer,M C, AU - Riedel-Heller,S G, PY - 2006/12/28/pubmed PY - 2007/1/17/medline PY - 2006/12/28/entrez SP - 2176 EP - 85 JF - Neurology JO - Neurology VL - 67 IS - 12 N2 - OBJECTIVE: To empirically validate the expanded concept of mild cognitive impairment (MCI), which differentiates between four clinical subtypes-amnestic MCI-single domain, amnestic MCI-multiple domains, nonamnestic MCI-single domain, and nonamnestic MCI-multiple domains-and to examine the prevalence, course, and outcome of these four clinical MCI subtypes. METHODS: We studied a community sample of 980 dementia-free individuals aged 75 years or older who participated in the Leipzig Longitudinal Study of the Aged (LEILA 75+). All participants were examined by neuropsychological testing based on 6 years of observation. The diagnoses of the four clinical MCI subtypes were made according to the original and to slightly modified criteria by Petersen et al. (2001) (both with a cutoff of 1.0 SD and with a cutoff of 1.5 SD). The complete range of outcome types (dementia, death, improvement, stable diagnosis, unstable diagnosis) was described for all subtypes. The relative predictive power of stable MCI for dementia onset was determined. RESULTS: MCI-single domain is more frequent than MCI-multiple domains, and the nonamnestic MCI type is as frequent as the amnestic MCI type. The "MCI modified, 1.0 SD" criteria have the highest relative predictive power for the development of dementia (sensitivity = 74%, specificity = 73%). Alzheimer disease (AD) was the most common type of dementia at follow-up in all but one MCI subtype. Participants with nonamnestic MCI-multiple domains were more likely to progress to a non-AD dementia. CONCLUSIONS: It has been assumed that each MCI subtype is associated with an increased risk for a particular type of dementia. We can only partially agree with this. SN - 1526-632X UR - https://www.unboundmedicine.com/medline/citation/17190940/Mild_cognitive_impairment:_long_term_course_of_four_clinical_subtypes_ L2 - http://www.neurology.org/cgi/pmidlookup?view=long&pmid=17190940 DB - PRIME DP - Unbound Medicine ER -