title: An analysis of systems of classifying mild cognitive impairment in older people.
abstract: OBJECTIVE
  Over the past two decades, a number of systems have been developed for the classification of cognitive and behavioural abnormalities in older people, in order that individuals at high risk of developing neurodegenerative disease, particularly Alzheimer's disease, may be identified well before the disease manifests clinically. This article critically examines the inclusion and exclusion criteria of a number of such classification systems, to determine the effect that variations in criterion may have on clinical, behavioural and neuroimaging outcomes reported from older people with mild cognitive impairment.
  
  
  METHODS
  Qualitative review of the literature describing systems of classifying mild cognitive impairment, and outcomes from clinical, behavioural, neuroimaging and genetic studies of older people with mild cognitive impairment.
  
  
  RESULTS
  The exclusion and inclusion criteria for these classification systems vary markedly, as do the design of studies upon which the validity of these systems has been assessed. Minor changes to individual exclusion/inclusion criterion may result in substantial changes to estimates of the prevalence and clinical outcome of mild cognitive impairment, while inadequate experimental design may act to confound the interpretation of results.
  
  
  CONCLUSIONS
  As a result of these factors, accurate and consistent estimates of the outcome of mild cognitive impairments in otherwise healthy older people are yet to be obtained. On the basis of this analysis of the literature, optimal criteria via which accurate classifications of mild cognitive impairment can be made in future are proposed.
authors.affiliation: Neuropsychology Laboratory, Mental Health Research Institute of Victoria, Locked Bag 11, Parkville, Victoria 3052, Australia. alex@neuro.mhri.edu.au
authors.forename: Alexander
authors.initials: A
authors.lastname: Collie
authors.forename: Paul
authors.initials: P
authors.lastname: Maruff
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000145:classification* / Q000175:diagnosis / Q000235:genetics / Q000523:psychology; D001057:Apolipoproteins E / Q000097:blood; D001921:Brain / Q000473:pathology; D003072:Cognition Disorders / Q000145:classification* / Q000175:diagnosis / Q000235:genetics / Q000523:psychology; D006801:Humans; D008279:Magnetic Resonance Imaging; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D011237:Predictive Value of Tests; D011594:Psychometrics; D015203:Reproducibility of Results
chemical_list: D001057:Apolipoproteins E