A point-based tool to predict conversion from mild cognitive impairment to probable Alzheimer's disease

Background: Our objective in this study was to develop a point-based tool to predict conversion from amnestic mild cognitive impairment (MCI) to probable Alzheimer's disease (AD). Methods: Subjects were participants in the first part of the Alzheimer's Disease Neuroimaging Initiative. Cox proportional hazards models were used to identify factors associated with development of AD, and a point score was created from predictors in the final model. Results: The final point score could range from 0 to 9 (mean 4.8) and included: the Functional Assessment Questionnaire (2-3 points); magnetic resonance imaging (MRI) middle temporal cortical thinning (1 point); MRI hippocampal subcortical volume (1 point); Alzheimer's Disease Cognitive Scale cognitive subscale (2-3 points); and the Clock Test (1 point). Prognostic accuracy was good (Harrell's c = 0.78; 95% CI 0.75, 0.81); 3-year conversion rates were 6% (0-3 points), 53% (4-6 points), and 91% (7-9 points). Conclusions: A point-based risk score combining functional dependence, cerebral MRI measures, and neuropsychological test scores provided good accuracy for prediction of conversion from amnestic MCI to AD. (C) 2014 The Alzheimer's Association. All rights reserved.