Pre-MCI and MCI: Neuropsychological, clinical, and imaging features and progression rates

Ranjan Duara, David A. Loewenstein, Maria T. Greig, Elizabeth Potter, Warren Barker, Ashok Raj, John Schinka, Amy Borenstein, Michael Schoenberg, Yougui Wu, Jessica Banko, Huntington Potter

Research output: Contribution to journalArticle

79 Scopus citations

Abstract

OBJECTIVE:: To compare clinical, imaging, and neuropsychological characteristics and longitudinal course of subjects with pre-mild cognitive impairment (pre-MCI), who exhibit features of MCI on clinical examination but lack impairment on neuropsychological examination, to subjects with no cognitive impairment (NCI), nonamnestic MCI (naMCI), amnestic MCI (aMCI), and mild dementia. METHODS:: For 369 subjects, clinical dementia rating sum of boxes (CDR-SB), ApoE genotyping, cardiovascular risk factors, parkinsonism (UPDRS) scores, structural brain MRIs, and neuropsychological testing were obtained at baseline, whereas 275 of these subjects received an annual follow-up for 2-3 years. RESULTS:: At baseline, pre-MCI subjects showed impairment on tests of executive function and language, higher apathy scores, and lower left hippocampal volumes (HPCV) in comparison to NCI subjects. Pre-MCI subjects showed less impairment on at least one memory measure, CDR-SB and UPDRS scores, in comparison to naMCI, aMCI and mild dementia subjects. Follow-up over 2-3 years showed 28.6% of pre-MCI subjects, but less than 5% of NCI subjects progressed to MCI or dementia. Progression rates to dementia were equivalent between naMCI (22.2%) and aMCI (34.5%) groups, but greater than for the pre-MCI group (2.4%). Progression to dementia was best predicted by the CDR-SB, a list learning and executive function test. CONCLUSION:: This study demonstrates that clinically defined pre-MCI has cognitive, functional, motor, behavioral and imaging features that are intermediate between NCI and MCI states at baseline. Pre-MCI subjects showed accelerated rates of progression to MCI as compared to NCI subjects, but slower rates of progression to dementia than MCI subjects.

Original languageEnglish (US)
Pages (from-to)951-960
Number of pages10
JournalAmerican Journal of Geriatric Psychiatry
Volume19
Issue number11
DOIs
StatePublished - Nov 2011

Keywords

  • Algorithmic diagnosis
  • Alzheimer disease
  • Amnestic MCI
  • Clinical diagnosis
  • Dementia
  • Hippocampal volume
  • Longitudinal analysis
  • MCI
  • Mild cognitive impairment
  • MRI
  • Neuropsychological tests
  • Pre-MCI

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Geriatrics and Gerontology

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    Duara, R., Loewenstein, D. A., Greig, M. T., Potter, E., Barker, W., Raj, A., Schinka, J., Borenstein, A., Schoenberg, M., Wu, Y., Banko, J., & Potter, H. (2011). Pre-MCI and MCI: Neuropsychological, clinical, and imaging features and progression rates. American Journal of Geriatric Psychiatry, 19(11), 951-960. https://doi.org/10.1097/JGP.0b013e3182107c69