Journal Article

DZNE-2022-01391

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png A Comparison of Operational Definitions for Mild Cognitive Impairment.

Polcher, A.DZNE* ; Wolfsgruber, S.DZNE* ; Peters, O.DZNE* ; Frölich, L.Extern* ; Wiltfang, J.DZNE* ; Kornhuber, J. ; Hüll, M. ; Rüther, E.Extern* ; Lewczuk, P. ; Maier, W.DZNE* ; Jessen, F.DZNE* ; Wagner, M. (Last author)DZNE*

2022
IOS Press Amsterdam

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Please use a persistent id in citations: doi:10.3233/JAD-215548

Abstract: Consideration of many tests from different cognitive domains in defining mild cognitive impairment (MCI) is clinical routine, but guidelines for a neuropsychological operationalization of MCI are lacking.Among different operational MCI criteria, to identify those which are best in predicting either conversion to dementia, or a biomarker profile indicative for Alzheimer's disease (AD).Memory-clinic patients without dementia (N = 558; mean age = 66; up to 3 years of follow-up; n = 360 with baseline CSF biomarkers) were included in an observational study using most liberal criteria of cognitive impairment. Four operational definitions of MCI were retrospectively applied: 1) amnestic MCI (word list delayed recall), 2) CERAD total score, 3) comprehensive criteria and 4) base rate corrected CERAD. We compared their accuracy in predicting incident all-cause dementia or AD dementia within three years, or a concurrent CSF Aβ42/tau-ratio indicative of AD.The four definitions overlapped considerably, classified 35-58% of the original sample as impaired and were associated with markedly increased PPVs regarding incident all-cause dementia (39-46% versus 26% of the original sample), AD dementia and AD biomarker positivity. The base-rate corrected MCI definition had the highest prognostic accuracy.he operational criteria examined seem suitable to specify MCI in memory clinic settings, as they identify subjects at high risk of clinical progression. Depending on the neuropsychological battery in use, one or several of these criteria could help to calibrate the clinical judgment of test results, reduce false-positive decisions, and define risk-enriched groups for clinical trials.

Keyword(s): Aged (MeSH) ; Alzheimer Disease: psychology (MeSH) ; Amyloid beta-Peptides (MeSH) ; Biomarkers (MeSH) ; Cognitive Dysfunction: etiology (MeSH) ; Disease Progression (MeSH) ; Humans (MeSH) ; Male (MeSH) ; Neuropsychological Tests (MeSH) ; Retrospective Studies (MeSH) ; Alzheimer’s disease ; DSM-5 mild NCD ; biomarker ; cognition ; conversion ; dementia ; diagnosis ; mild cognitive impairment ; prognosis

Note: CC BY-NC: https://creativecommons.org/licenses/by-nc/4.0/

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Contributing Institute(s):

1. Neuropsychology (AG Wagner)
2. Vascular Pathology (AG Dirnagl)
3. Alzheimer Biomarker and Clinical Study Group (AG Wiltfang)
4. Clinical Research- coordination (AG Klockgether)
5. Patient studies cologne (AG Jessen)

Research Program(s):

1. 353 - Clinical and Health Care Research (POF4-353) (POF4-353)

Appears in the scientific report 2022

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Database coverage:
; ; ; BIOSIS Previews ; Biological Abstracts ; Clarivate Analytics Master Journal List ; Current Contents - Life Sciences ; Ebsco Academic Search ; Essential Science Indicators ; IF < 5 ; JCR ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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