title: Neuropsychological Criteria for Mild Cognitive Impairment and Dementia Risk in the Framingham Heart Study.
abstract: To refine mild cognitive impairment (MCI) diagnostic criteria, we examined progression to dementia using two approaches to identifying MCI.
  
  
  
  A total of 1203 Framingham Heart Study participants were classified at baseline as cognitively normal or MCI (overall and four MCI subtypes) via conventional Petersen/Winblad criteria (single cognitive test impaired per domain, >1.5 SD below expectations) or Jak/Bondi criteria (two tests impaired per domain, >1 SD below norms). Cox proportional hazards models were constructed to examine the association between each MCI definition and incident dementia.
  
  
  
  The Petersen/Winblad criteria classified 34% of participants as having MCI while the Jak/Bondi criteria classified 24% as MCI. Over a mean follow-up of 9.7 years, 58 participants (5%) developed incident dementia. Both MCI criteria were associated with incident dementia [Petersen/Winblad: hazards ratio (HR) = 2.64; p-value=.0002; Jak/Bondi: HR=3.30; p-value <.0001]. When both MCI definitions were included in the same model, only the Jak/Bondi definition remained statistically significantly associated with incident dementia (HR=2.47; p-value=.008). Multi-domain amnestic and single domain non-amnestic MCI subtypes were significantly associated with incident dementia for both diagnostic approaches (all p-values <.01).
  
  
  
  The Jak/Bondi MCI criteria had a similar association with dementia as the conventional Petersen/Winblad MCI criteria, despite classifying ~30% fewer participants as having MCI. Further exploration of alternative methods to conventional MCI diagnostic criteria is warranted. (JINS, 2016, 22, 937-943).
authors.affiliation: 1VA San Diego Healthcare System,San Diego,California.
authors.forename: Amy J
authors.initials: AJ
authors.lastname: Jak
authors.affiliation: 3Framingham Heart Study,Framingham,Massachusetts.
authors.forename: Sarah R
authors.initials: SR
authors.lastname: Preis
authors.affiliation: 3Framingham Heart Study,Framingham,Massachusetts.
authors.forename: Alexa S
authors.initials: AS
authors.lastname: Beiser
authors.affiliation: 3Framingham Heart Study,Framingham,Massachusetts.
authors.forename: Sudha
authors.initials: S
authors.lastname: Seshadri
authors.affiliation: 3Framingham Heart Study,Framingham,Massachusetts.
authors.forename: Philip A
authors.initials: PA
authors.lastname: Wolf
authors.affiliation: 1VA San Diego Healthcare System,San Diego,California.
authors.forename: Mark W
authors.initials: MW
authors.lastname: Bondi
authors.affiliation: 3Framingham Heart Study,Framingham,Massachusetts.
authors.forename: Rhoda
authors.initials: R
authors.lastname: Au
mesh_terms: D000368:Aged; D060825:Cognitive Dysfunction / Q000145:classification / Q000175:diagnosis* / Q000000981:diagnostic imaging; D003704:Dementia / Q000145:classification / Q000175:diagnosis* / Q000000981:diagnostic imaging; D018450:Disease Progression; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000592:standards*; D017410:Practice Guidelines as Topic / Q000592:standards*; D018570:Risk Assessment
keywords: Cognition; Dementia; Diagnosis; Longitudinal; Mild cognitive impairment; Subtype