title: "Missed" Mild Cognitive Impairment: High False-Negative Error Rate Based on Conventional Diagnostic Criteria.
abstract: Mild cognitive impairment (MCI) is typically diagnosed using subjective complaints, screening measures, clinical judgment, and a single memory score. Our prior work has shown that this method is highly susceptible to false-positive diagnostic errors. We examined whether the criteria also lead to "false-negative" errors by diagnostically reclassifying 520 participants using novel actuarial neuropsychological criteria. Results revealed a false-negative error rate of 7.1%. Participants' neuropsychological performance, cerebrospinal fluid biomarkers, and rate of decline provided evidence that an MCI diagnosis is warranted. The impact of "missed" cases of MCI has direct relevance to clinical practice, research studies, and clinical trials of prodromal Alzheimer's disease.
authors.affiliation: Department of Psychiatry, University of California San Diego, School of Medicine, La Jolla, CA, USA.
authors.forename: Emily C
authors.initials: EC
authors.lastname: Edmonds
authors.affiliation: Department of Psychiatry, University of California San Diego, School of Medicine, La Jolla, CA, USA.|Veterans Affairs San Diego Healthcare System, San Diego, CA, USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Delano-Wood
authors.affiliation: Department of Psychiatry, University of California San Diego, School of Medicine, La Jolla, CA, USA.|Veterans Affairs San Diego Healthcare System, San Diego, CA, USA.
authors.forename: Amy J
authors.initials: AJ
authors.lastname: Jak
authors.affiliation: Department of Psychiatry, University of California San Diego, School of Medicine, La Jolla, CA, USA.|Veterans Affairs San Diego Healthcare System, San Diego, CA, USA.|Department of Neurosciences, University of California San Diego, School of Medicine, La Jolla, CA, USA.
authors.forename: Douglas R
authors.initials: DR
authors.lastname: Galasko
authors.affiliation: Department of Neurosciences, University of California San Diego, School of Medicine, La Jolla, CA, USA.
authors.forename: David P
authors.initials: DP
authors.lastname: Salmon
authors.affiliation: Department of Psychiatry, University of California San Diego, School of Medicine, La Jolla, CA, USA.|Veterans Affairs San Diego Healthcare System, San Diego, CA, USA.
authors.forename: Mark W
authors.initials: MW
authors.lastname: Bondi
mesh_terms: D000368:Aged; D016229:Amyloid beta-Peptides / Q000134:cerebrospinal fluid; D015415:Biomarkers / Q000134:cerebrospinal fluid; D060825:Cognitive Dysfunction / Q000175:diagnosis*; D015331:Cohort Studies; D018450:Disease Progression; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D010446:Peptide Fragments / Q000134:cerebrospinal fluid; D010766:Phosphorylation; D016016:Proportional Hazards Models; D016875:tau Proteins / Q000134:cerebrospinal fluid
chemical_list: D016229:Amyloid beta-Peptides; D015415:Biomarkers; C054369:MAPT protein, human; D010446:Peptide Fragments; C075222:amyloid beta-protein (1-42); D016875:tau Proteins
keywords: Alzheimer’s disease; mild cognitive impairment; misclassification; misdiagnosis; neuropsychology