Predictors That a Diagnosis of Mild Cognitive Impairment Will Remain Stable 3 Years Later

Abstract

Background and Objective In half to two thirds of patients who are diagnosed with mild cognitive impairment (MCI), the diagnosis neither converts to dementia nor reverts to normal cognition; however, little is known about predictors of MCI stability. Our study aimed to identify those predictors. Methods We obtained 3-year longitudinal data from the National Alzheimer’s Coordinating Center Uniform Data Set for patients with a baseline diagnosis of MCI. To predict MCI stability, we used the patients’ baseline data to conduct three logistic regression models: demographics, global function, and neuropsychological performance. Results Our final sample had 1,059 patients. At the end of 3 years, 596 still had MCI and 463 had converted to dementia. The most reliable predictors of stable MCI were higher baseline scores on delayed recall, processing speed, and global function; younger age; and especially the absence of ApoE4 alleles. Conclusions Not all patients with MCI progress to dementia. Of the protective factors that we identified from demographic, functional, and cognitive data, the absence of ApoE4 alleles best predicted MCI stability. Our predictors may help clinicians better evaluate and treat patients, and may help researchers recruit more homogeneous samples for clinical trials.

Classification and Graphical Analysis of Alzheimer’s Disease and Its Prodromal Stage Using Multimodal Features From Structural, Diffusion, and Functional Neuroimaging Data and the APOE Genotype

“…A prospective population-based study in the elderly showed that the conversion rate of MCIc patients to AD or to different forms of dementia is about 10-15% per year (Mitchell and Shiri-Feshki, 2009;Lopez et al, 2012;Wei et al, 2016). Despite our substantial knowledge of MCI converters, little is understood about the 47-67% (Ganguli et al, 2004;Lopez et al, 2012;Clem et al, 2017) of subjects diagnosed with MCI who neither return to normal cognition nor convert to dementia. In a study performed in a large community sample, 10 years identified as a MCI, 21% of those suspected to be at a greater risk for converting to dementia (Dubois and Albert, 2004;Jicha et al, 2006) managed to remain with a diagnosis of MCI (Ganguli et al, 2004;Clem et al, 2017).…”

“…Despite our substantial knowledge of MCI converters, little is understood about the 47-67% (Ganguli et al, 2004;Lopez et al, 2012;Clem et al, 2017) of subjects diagnosed with MCI who neither return to normal cognition nor convert to dementia. In a study performed in a large community sample, 10 years identified as a MCI, 21% of those suspected to be at a greater risk for converting to dementia (Dubois and Albert, 2004;Jicha et al, 2006) managed to remain with a diagnosis of MCI (Ganguli et al, 2004;Clem et al, 2017). These studies suggest that certain subjects may not convert to AD, but rather remain diagnostically stable over a period of time (this type of patient falls into an MCI-stable, or MCIs group).…”

A Multifactor Approach to Mild Cognitive Impairment

“…Predictors of stability include better neuropsychological test results (especially in speed of mentation and memory recall), younger age at diagnosis, and an absence of ApoE4. 23 Patients belonging to this category either had a single-phase damage to the brain or, more likely, have staved off progression to dementia via cognitive reserve or other less well understood mechanisms. 3.…”

Mild cognitive impairment in primary care: a clinical review

“…In a 2-year follow-up study of patients with MCI, it was found that multiple domains MCI, with or without memory impairment included, had even higher sensitivity than amnestic MCI alone in identifying subjects at risk of developing AD or vascular dementia, while amnestic MCI had higher specificity 56. Having a higher baseline scores on delayed recall, processing speed and global function; younger age and absence of apolipoprotein E4 alleles, were more likely associated with stable MCI 57. As to biomarkers, there is insufficient evidence to recommend their use in predicting progression of cognitive impairment 58…”