Journal
JOURNAL OF ALZHEIMERS DISEASE
Volume 52, Issue 2, Pages 685-691Publisher
IOS PRESS
DOI: 10.3233/JAD-150986
Keywords
Alzheimer's disease; mild cognitive impairment; misclassification; misdiagnosis; neuropsychology
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Funding
- National Institutes of Health [R01 AG049810, K24 AG026431, P50 AG05131]
- Alzheimer's Disease Neuroimaging Initiative (ADNI) (National Institutes of Health) [U01 AG024904]
- DOD ADNI (Department of Defense) [W81XWH-12-2-0012]
- National Institute on Aging
- National Institute of Biomedical Imaging and Bioengineering
- Canadian Institutes of Health Research
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Mild cognitive impairment (MCI) is typically diagnosed using subjective complaints, screening measures, clinical judgment, and a single memory score. Our prior work has shown that this method is highly susceptible to false-positive diagnostic errors. We examined whether the criteria also lead to false-negative errors by diagnostically reclassifying 520 participants using novel actuarial neuropsychological criteria. Results revealed a false-negative error rate of 7.1%. Participants' neuropsychological performance, cerebrospinal fluid biomarkers, and rate of decline provided evidence that an MCI diagnosis is warranted. The impact of missed cases of MCI has direct relevance to clinical practice, research studies, and clinical trials of prodromal Alzheimer's disease.
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