An investigation of PreMCI: Subtypes and longitudinal outcomes

David A. Loewenstein, Maria T. Greig, John A. Schinka, Warren Barker, Qian Shen, Elizabeth Potter, Ashok Raj, Larry Brooks, Daniel Varon, Michael Schoenberg, Jessica Banko, Huntington Potter, Ranjan Duara

Research output: Contribution to journalArticlepeer-review

30 Scopus citations


Background/Aims: To investigate the clinical features and rates of progression of conditions that are not considered to be normal, but do not fulfill criteria for mild cognitive impairment (MCI). Methods: We longitudinally evaluated 269 elderly subjects who did not meet formal criteria for MCI at baseline but had: (1) a clinical history suggesting MCI without neuropsychological deficits (PreMCI-Clinical); or (2) neuropsychological deficits on one or more memory measures in conjunction with a negative clinical examination (amnestic PreMCI-NP) or were normal on both neuropsychological and clinical examination. Results: The rate of progression to MCI or dementia over an average of 2- to 3 years was 3.7% for no cognitive impairment subjects, whereas it was significantly greater for all PreMCI subtypes (22.0% for PreMCI-Clinical, 38.9% for amnestic PreMCI-NP subjects with two or more memory impairments). Among PreMCI subjects as a whole, lower baseline scores on object memory and category fluency tests were the best predictors of progression to MCI or dementia. Cardiovascular risk factors, Parkinsonian symptoms, and hippocampal atrophy were not associated with progression. Conclusion: Distinct PreMCI subtypes defined on the basis of clinical and neuropsychological evaluations were found to have distinct characteristics, but both subtypes demonstrated elevated risk for progression to MCI or dementia. Despite the lack of evidence of clinical impairment, subjects with neuropsychological deficits in two memory domains were particularly at increased risk for progression of their deficits.

Original languageEnglish (US)
Pages (from-to)172-179
Number of pages8
JournalAlzheimer's and Dementia
Issue number3
StatePublished - May 2012


  • Alzheimer's disease
  • Amnestic MCI
  • Hippocampal volumes
  • Memory impairment
  • Mild cognitive impairment
  • MRI
  • Neuropsychological tests
  • PreMCI

ASJC Scopus subject areas

  • Health Policy
  • Epidemiology
  • Geriatrics and Gerontology
  • Psychiatry and Mental health
  • Cellular and Molecular Neuroscience
  • Developmental Neuroscience
  • Clinical Neurology


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