title: Neuropsychological predictors of conversion from mild cognitive impairment to Alzheimer's disease.
abstract: The construct of mild cognitive impairment (MCI) has been proposed to identify patients at risk of developing Alzheimer's disease (AD) in the pre-clinical stage. Although subjects with MCI have an increased risk of progressing to dementia, most remain stable or return to normality. The new criteria for diagnosing prodromal AD assume that, to increase the predictive value of the MCI, in addition to a defect of delayed recall there must also be the presence of abnormal biomarkers, investigating structural and molecular neuroimaging and cerebrospinal fluid (CSF) analysis of amyloid-β or tau proteins. Although acknowledging that the use of CSF degeneration biomarkers is advisable not only for research, but also for clinical purposes, the present review is centered upon the neuropsychological markers of conversion to AD, which are equally clinically important. In particular, results of this review suggest the following: (a) measures of delayed recall are the best neuropsychological predictors of conversion from MCI to AD; (b) memory tests providing controlled encoding and cued recall are not necessarily better predictors than free recall tests; (c) stringent cut-off points are necessary to increase the specificity of these predictors; (d) multi-domain amnestic MCI patients are the best candidates for clinical trials, but not for treatment with disease-modifying drugs; and (e) not only episodic but also semantic memory is significantly impaired in patients who will convert to AD. These data and the underlying neural mechanisms will be discussed, trying to distinguish results obtained in MCI patients from those obtained in a pre-MCI stage of the AD progression.
authors.affiliation: Center for Neuropsychological Research, Institute of Neurology of the Policlinico Gemelli, Catholic University of Rome, Rome, Italy IRCCS Fondazione Santa Lucia, Department of Clinical and Behavioral Neurology, Rome, Italy.
authors.forename: Guido
authors.initials: G
authors.lastname: Gainotti
authors.forename: Davide
authors.initials: D
authors.lastname: Quaranta
authors.forename: Maria Gabriella
authors.initials: MG
authors.lastname: Vita
authors.forename: Camillo
authors.initials: C
authors.lastname: Marra
mesh_terms: D000544:Alzheimer Disease / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000503:physiopathology; D015415:Biomarkers / Q000134:cerebrospinal fluid; D060825:Cognitive Dysfunction / Q000134:cerebrospinal fluid / Q000503:physiopathology*; D018450:Disease Progression; D006801:Humans; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests
chemical_list: D015415:Biomarkers
keywords: Delayed recall; episodic memory; mild cognitive impairment; neuropsychology; semantic memory