title: Prognostic Significance of Mild Cognitive Impairment Subtypes for Dementia and Mortality: Data from the NEDICES Cohort.
abstract: BACKGROUND
  The predictive value of diverse subtypes of mild cognitive impairment (MCI) for dementia and death is highly variable.
  
  
  OBJECTIVE
  To compare the predictive value of several MCI subtypes in progression to dementia and/or mortality in the NEDICES (Neurological Disorders in Central Spain) elderly cohort.
  
  
  METHODS
  Retrospect algorithmic MCI subgroups were established in a non-dementia baseline NEDICES cohort using Spanish adaptations of the original Mini-Mental State Examination (MMSE-37) and Pfeffer's Functional Activities Questionnaire (Pfeffer-11). The presence of MCI was defined according two cognitive criteria: using two cut-offs points on the total MMSE-37 score. Five cognitive domains were used to establish the MCI subtypes. Functional capacity (Pfeffer-11) was preserved or minimally impaired in all MCI participants. The incident dementia diagnoses were established by specialists and the mortality data obtained from Spanish official registries.
  
  
  RESULTS
  3,411 participants without dementia were assessed in 1994-5. The baseline prevalence of MCI varied according to the MCI definition (4.3%-31.8%). The follow-up was a mean of 3.2 years (1997-8). The dementia incidence varied between 14.9 and 71.8 per 1,000/person-years. The dementia conversion rate was increased in almost all MCI subgroups (p >  0.01), and mortality rate was raised only in four MCI subtypes. The amnestic-multi-domain MCI (aMd-MCI) had the best dementia predictive accuracy (highest positive likelihood ratio and highest clinical utility when negative).
  
  
  CONCLUSIONS
  Those with aMd-MCI were at greatest risk of progression to dementia, as in other surveys and might be explored with increased attention in MCI research and in dementia preventive trials.
authors.affiliation: Consultant Neurologist of the Clinical Research Unit (Imas12), University Hospital "12 de Octubre", Madrid, Spain.|Ciberned, Carlos III Research Institute, Madrid, Spain.
authors.forename: Félix
authors.initials: F
authors.lastname: Bermejo-Pareja
authors.affiliation: Department of Basic Psychology, Psychobiology and Methodology of Behavioral Sciences, University of Salamanca, Spain.
authors.forename: Israel
authors.initials: I
authors.lastname: Contador
authors.affiliation: Ciberned, Carlos III Research Institute, Madrid, Spain.
authors.forename: Rocío
authors.initials: R
authors.lastname: Trincado
authors.affiliation: Clinical Research Unit (Imas12- CIBERESP), University Hospital "12 de Octubre", Madrid, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Lora
authors.affiliation: Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, MA, USA.|Centro Integral de Neurociencias A.C., Fundación Hospitales de Madrid, Móstoles, Madrid, Spain.
authors.forename: Álvaro
authors.initials: Á
authors.lastname: Sánchez-Ferro
authors.affiliation: Department of Cancer and Molecular Medicine, University of Leicester, UK.
authors.forename: Alex J
authors.initials: AJ
authors.lastname: Mitchell
authors.affiliation: Clinical Research Unit (Imas12- CIBERESP), University Hospital "12 de Octubre", Madrid, Spain.
authors.forename: Elina
authors.initials: E
authors.lastname: Boycheva
authors.affiliation: Department of Neurology, University Hospital "12 de Octubre", Madrid, Spain.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Herrero
authors.affiliation: Ciberned, Carlos III Research Institute, Madrid, Spain.|Department of Neurology, University Hospital "12 de Octubre", Madrid, Spain.|Department of Medicine, Complutense University (UCM), Madrid, Spain.
authors.forename: Jesús
authors.initials: J
authors.lastname: Hernández-Gallego
authors.affiliation: Clinical Research Unit (Imas12- CIBERESP), University Hospital "12 de Octubre", Madrid, Spain.
authors.forename: Sara
authors.initials: S
authors.lastname: Llamas
authors.affiliation: Ciberned, Carlos III Research Institute, Madrid, Spain.|Department of Neurology, University Hospital "12 de Octubre", Madrid, Spain.
authors.forename: Alberto
authors.initials: A
authors.lastname: Villarejo Galende
authors.affiliation: Ciberned, Carlos III Research Institute, Madrid, Spain.|Department of Neurology, University Hospital "12 de Octubre", Madrid, Spain.
authors.forename: Julián
authors.initials: J
authors.lastname: Benito-León
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D060825:Cognitive Dysfunction / Q000145:classification / Q000175:diagnosis / Q000401:mortality; D015331:Cohort Studies; D003704:Dementia / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D013030:Spain
keywords: Amnesic multidomain MCI; MCI mortality; MCI subtypes; MMSE-37; NEDICES; Pfeffer’s FAQ; dementia; dementia conversion