Can clinical data predict progression to dementia in amnestic mild cognitive impairment?
BACKGROUND
To determine whether clinical data obtained by history and physical examination can predict eventual progression to dementia in a cohort of elderly people with mild cognitive impairment.


METHODS
A prospective, longitudinal study of a cohort of elderly subjects with amnestic Mild Cognitive Impairment (MCI). Ninety subjects meeting the criteria for amnestic MCI were recruited and followed annually for an average of 3.3 years. Main outcome measure was the development of dementia determined by clinical assessment with confirmatory neuropsychological evaluation.


RESULTS
Fifty patients (56%) developed dementia on follow-up. They were older, had lower Mini-mental status exam (MMSE) scores and a shorter duration of symptoms at the time of first assessment. Multivariate logistic regression analysis identified age at symptom onset as the only clinical parameter which distinguished the group that deteriorated to dementia from the group that did not. The odds ratio for age was 1.1 (confidence interval 1.04 - 1.18).


CONCLUSIONS
Patients presenting with amnestic MCI insufficient for the diagnosis of dementia are at high risk of developing dementia on follow-up. In our cohort, 56% were diagnosed with dementia over an average period of 5.9 years from symptom onset. The only clinical predictor for the eventual development of dementia was older age at symptom onset. Clinical features alone were insufficient to predict development of dementia.
Fellows
Lesley
L
Dept. of Neurology and Neurosurgery, Division of Clinical Epidemiology, McGill University Health Centre, Montreal, Quebec, Canada.
Bergman
Howard
H
Wolfson
Christina
C
Chertkow
Howard
H
D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis / Q000209:etiology; D000647:Amnesia / Q000150:complications*; D016009:Chi-Square Distribution; D003072:Cognition Disorders / Q000150:complications*; D015331:Cohort Studies; D003704:Dementia / Q000175:diagnosis* / Q000209:etiology; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D006801:Humans; D016015:Logistic Models; D008297:Male; D008609:Mental Status Schedule; D008959:Models, Neurological; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D012307:Risk Factors