Predictors of progression from mild cognitive impairment to dementia

January 01, 0001

Predictors of progression from mild cognitive impairment to dementia

Mild cognitive impairement (MCI) is a common condition that in a subset of patients progresses on to further cognitive decline. These US researchers evaluated the prognostic value of various tests, including genetic, CSF, neuroimaging, and cognitive measurements, in predicting progression to dementia. APOE 4 allele frequency, the CSF proteins A Beta 1- 42, total tau, hyperphosphorylated tau (p-tau181p), glucose metabolism (FDG- PET), hippocampal volume, and episodic memory performance were evaluated in patients with MCI (n = 85). Data from a large multisite study, the Alzheimer's Disease Neuroimaging Initiative, were used. Patients’ results were compared with subsequent conversion to Alzheimer disease (AD) and cognitive decline (Alzheimer's Disease Assessment Scale-Cognitive Subscale) during follow-up (approximately two years).

The researchers report: "Patients with MCI converted to AD at an annual rate of 17.2%. Subjects with MCI who had abnormal results on both FDG- PET and episodic memory were 11.7 times more likely to convert to AD than subjects who had normal results on both measures. In addition, the CSF ratio p-tau181p/A Beta 1-42 and, marginally, FDG-PET predicted cognitive decline."

The researchers concluded: "Baseline FDG-PET and episodic memory predict conversion to AD, whereas p-tau181p/A Beta 1-42 and, marginally, FDG- PET predict longitudinal cognitive decline. Complementary information provided by these biomarkers may aid in future selection of patients for clinical trials or identification of patients likely to benefit from a therapeutic intervention."

This study sheds some light on the important question of which patients with mild cognitive impairment are at greater risk for progressing to dementia

For the full abstract, click here.

Neurology 75(3):230-238, 20 July 2010
© 2010 American Academy of Neurology
Comparing predictors of conversion and decline in mild cognitive impairment. S.M. Landau, D. Harvey, C.M. Madison, et al.. Correspondence to Susan M. Landau:

Category: N. Neurological. Keywords: dementia, mild cognitive impairment, biomarkers, CSF, neuroimaging, prospective trial, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 24 August 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.