4.2 Article

Prognostic Accuracy of Mild Cognitive Impairment Subtypes at Different Cut-Off Levels

期刊

DEMENTIA AND GERIATRIC COGNITIVE DISORDERS
卷 43, 期 5-6, 页码 330-341

出版社

KARGER
DOI: 10.1159/000477341

关键词

Mild cognitive impairment; Dementia; Neuropsychology

资金

  1. Sahlgrenska University Hospital
  2. Swedish Research Council
  3. Swedish Brain Power
  4. Swedish Dementia Foundation
  5. Swedish Alzheimer Foundation
  6. Stiftelsen Psykiatriska forskningsfonden
  7. Hjalmar Svensson Foundation
  8. Fredrik och Ingrid Thurings stiftelse
  9. Stiftelsen Wilhelm och Martina Lundgrens Vetenskapsfond
  10. Insamlingsstiftelsen for neurologisk forskning
  11. Gun och Bertil Stohnes stiftelse

向作者/读者索取更多资源

Background/Aims: The prognostic accuracy of mild cognitive impairment (MCI) in clinical settings is debated, variable across criteria, cut-offs, subtypes, and follow-up time. We aimed to estimate the prognostic accuracy of MCI and the MCI subtypes for dementia using three different cut-off levels. Methods: Memory clinic patients were followed for 2 (n = 317, age 63.7 +/- 7.8) and 4-6 (n = 168, age 62.6 +/- 7.4) years. We used 2.0, 1.5, and 1.0 standard deviations (SD) below the mean of normal controls (n = 120, age 64.1 +/- 6.6) to categorize MCI and the MCI subtypes. Prognostic accuracy for dementia syndrome at follow-up was estimated. Results: Amnestic multi-domain MCI (aMCI-md) significantly predicted dementia under all conditions, most markedly when speed/attention, language, or executive function was impaired alongside memory. For aMCI-md, sensitivity increased and specificity decreased when the cut-off was lowered from 2.0 to 1.5 and 1.0 SD. Non-subtyped MCI had a high sensitivity and a low specificity. Conclusion: Our results suggest that aMCI-md is the only viable subtype for predicting dementia for both follow-up times. Lowering the cut-off decreases the positive predictive value and increases the negative predictive value of aMCI-md. The results are important for understanding the clinical prognostic utility of MCI, and MCI as a non-progressive disorder. (C) 2017 S. Karger AG, Basel

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