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Comparative Study
. 2011;27(3):543-51.
doi: 10.3233/JAD-2011-110740.

Mild cognitive impairment: prodromal Alzheimer's disease or something else?

William G Britt 3rd  1 , Anne M Hansen, Sofia Bhaskerrao, James P Larsen, Floyd Petersen, April Dickson, Cindy Dickson, Wolff M Kirsch
Affiliations
Comparative Study

Mild cognitive impairment: prodromal Alzheimer's disease or something else?

William G Britt 3rd et al. J Alzheimers Dis. 2011.

Abstract

The majority of mild cognitive impairment (MCI) studies use baseline and one follow-up measurement to determine the clinical course of the disorder. This report of MCI clinical course is based on the a statistical evaluation of multiple neurocognitive tests over a 60 month period in elderly normal and MCI cohorts. The data includes serial informant-based measures (Clinical Dementia Rating [CDR]) and a comprehensive battery of neuropsychological tests analyzed by two different regression methods. Twenty-nine elderly participants entered the study as neurocognitively normal; 26 remained normal, 2 progressed to MCI, and 1 progressed to dementia. Eighty-three participants entered the study as multiple domain MCI cases; 10 became normal, 46 remained MCI, and 27 progressed to dementia. Three of the 27 demented died with full necropsies performed (one case was progressive supranuclear palsy and two confirmed Alzheimer's disease with severe cerebral amyloid angiopathy (CAA)). Without serial measures, 1 in 8 MCI could be misclassified as "stable MCI" despite reverting to normal. The stable MCI cohorts did not benefit from practice effects though the normal subjects did. Applying Classification and Regression Tree (CART) analysis enabled prediction of the endpoint status of participants from baseline values with 78.6% accuracy. The fluctuating cognitive status of the multiple domain MCI cases implies a remitting pathologic process with elements of recovery consistent with a progressive microvasculopathy such as CAA.

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Figures

Fig. 1
Fig. 1
Fitted Lines from the Slope-Intercept Model over Time for Q1-Logical Memory II.
Fig. 2
Fig. 2
Fitted Lines from the Slope-Intercept Model over Time for Q2-Set Shifting (Trails-B).
Fig. 3
Fig. 3
Fitted Lines from the Slope-Intercept Model over Time for Q3-Word Fluency-Phonemic.
Fig. 4
Fig. 4
Endpoint Classification Tree based on Baseline Evaluation. Note. This tree model was fit using the software CART; equal priors and equal costs were assumed.
See this image and copyright information in PMC

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