Neuropsychological predictors of transition from healthy cognitive aging to mild cognitive impairment: The PATH through life study.

OBJECTIVE To identify neuropsychological predictors of transition from healthy cognitive aging to mild cognitive impairment (MCI) or any mild cognitive disorder (any-MCD) in a community-based longitudinal study of aging. DESIGN Longitudinal PARTICIPANTS Two thousand eighty-two individuals, aged 60–64 years and participating in a prospective epidemiologic study of mental health, and aging were assessed at two time points 4 years apart for MCI using the International Consensus Criteria, the clinical dementia rating scale (CDR, 0.5), or any of a suite of criteria sets for MCDs (any-MCD). MEASUREMENTS Logistic regression was used to assess the neuropsychological predictors of conversion to diagnosis including the Mini-Mental State Examination, immediate and delayed recall (IR and DR), Digit Backward, Spot-the-Word (STW), Symbol Digits Modalities Test (SDMT), simple and choice reaction time, and reaction time variability. RESULTS Of the 2,082 participants with no cognitive impairment in the first wave of data collection, 18 participants were diagnosed with MCI, 32 with CDR 0.5, and 64 participants presented with any-MCD 4 years later. The main neuropsychological predictors of conversion identified in multivariate analyses were measures of IR/DR, STW, Symbol Digit Modalities Task, and reaction time variability. CONCLUSIONS Although most measures were significant predictors of conversion to MCI or any-MCD when assessed independently, four tests (IR/DR, STW, SDMT, and simple reaction time variability) accounted for the explained variance in diagnosis when all tests were assessed together. When predictive value, stability across clinical categories, and psychometric characteristics were considered together, the reaction time variability measure was the best predictor of future cognitive disorder.

[1]  R. Reitan.  Validity of the Trail Making Test as an Indicator of Organic Brain Damage , 1958 .

[2]  V. A. Kral,et al.  Senescent forgetfulness: benign and malignant. , 1962, Canadian Medical Association journal.

[3]  Arthur L. Benton,et al.  Word fluency and brain damage , 1967 .

[4]  S. Folstein,et al.  "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. , 1975, Journal of psychiatric research.

[5]  S. Ferris,et al.  Age‐associated memory impairment: Proposed diagnostic criteria and measures of clinical change — report of a national institute of mental health work group , 1986 .

[6]  R. Mohs,et al.  Consortium to establish a registry for Alzheimer's disease (CERAD) clinical and neuropsychological assessment of Alzheimer's disease. , 2002, Psychopharmacology bulletin.

[7]  G. Wolf-Klein,et al.  Screening for Alzheimer's Disease by Clock Drawing , 1989, Journal of the American Geriatrics Society.

[8]  J. Morris,et al.  The Consortium to Establish a Registry for Alzheimer's Disease (CERAD). Part I. Clinical and neuropsychological assesment of Alzheimer's disease , 1989, Neurology.

[9]  Barry Gordon,et al.  The basis for choice reaction time slowing in Alzheimer's disease , 1990, Brain and Cognition.

[10]  J. Morris.  The Clinical Dementia Rating (CDR) , 1993, Neurology.

[11]  H. Braak,et al.  Close-meshed prevalence rates of different stages as a tool to uncover the rate of Alzheimer's disease-related neurofibrillary changes , 1995, Neuroscience.

[12]  T. Salthouse.  The processing-speed theory of adult age differences in cognition. , 1996, Psychological review.

[13]  E. Tangalos,et al.  Mild Cognitive Impairment Clinical Characterization and Outcome , 1999 .

[14]  R. Vanderploeg,et al.  Spot-the-Word: a measure for estimating premorbid intellectual functioning. , 2000, Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists.

[15]  S. MacDonald,et al.  Intraindividual variability in cognitive performance in older adults: comparison of adults with mild dementia, adults with arthritis, and healthy adults. , 2000, Neuropsychology.

[16]  G Ratcliff,et al.  Normative Data on the Boston Naming Test and Two Equivalent 30-Item Short Forms , 2000, The Clinical neuropsychologist.

[17]  J. Mortimer,et al.  Elderly norms for the Spot-the-Word test. , 2002, Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists.

[18]  Howard Chertkow,et al.  Increased variability accompanies frontal lobe damage in dementia , 2002, Journal of the International Neuropsychological Society.

[19]  R. Hu.  Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) , 2003 .

[20]  Kathleen N Lohr,et al.  Screening for Dementia in Primary Care: A Summary of the Evidence for the U.S. Preventive Services Task Force , 2003, Annals of Internal Medicine.

[21]  H. Amièva,et al.  Annual Rate and Predictors of Conversion to Dementia in Subjects Presenting Mild Cognitive Impairment Criteria Defined according to a Population-Based Study , 2004, Dementia and Geriatric Cognitive Disorders.

[22]  H. Christensen,et al.  Prevalence of Mild Cognitive Impairment in 60- to 64-Year-Old Community-Dwelling Individuals: The Personality and Total Health through Life 60+ Study , 2005, Dementia and Geriatric Cognitive Disorders.

[23]  H. Christensen,et al.  Within-occasion intraindividual variability and preclinical diagnostic status: is intraindividual variability an indicator of mild cognitive impairment? , 2005, Neuropsychology.

[24]  H. Christensen,et al.  Biomarkers, Health, Lifestyle, and Demographic Variables as Correlates of Reaction Time Performance in Early, Middle, and Late Adulthood , 2005, The Quarterly journal of experimental psychology. A, Human experimental psychology.

[25]  Erminia Mariani,et al.  Conversion of Mild Cognitive Impairment to Dementia: Predictive Role of Mild Cognitive Impairment Subtypes and Vascular Risk Factors , 2005, Dementia and Geriatric Cognitive Disorders.

[26]  H. Braak,et al.  Staging of Alzheimer disease-associated neurofibrillary pathology using paraffin sections and immunocytochemistry , 2006, Acta Neuropathologica.

[27]  Yee Lee Shing,et al.  Within-person trial-to-trial variability precedes and predicts cognitive decline in old and very old age: Longitudinal data from the Berlin Aging Study , 2007, Neuropsychologia.

[28]  H. Christensen,et al.  White matter hyperintensities and within-person variability in community-dwelling adults aged 60–64 years , 2007, Neuropsychologia.

[29]  A. Fleisher,et al.  Clinical predictors of progression to Alzheimer disease in amnestic mild cognitive impairment , 2007, Neurology.

[30]  J. Wesson Ashford,et al.  APOE genotype effects on alzheimer’s disease onset and epidemiology , 2007, Journal of Molecular Neuroscience.

[31]  Rachel L. Mistur,et al.  FDG-PET changes in brain glucose metabolism from normal cognition to pathologically verified Alzheimer’s disease , 2009, European Journal of Nuclear Medicine and Molecular Imaging.

[32]  H. Engler,et al.  PET imaging of amyloid deposition in patients with mild cognitive impairment , 2008, Neurobiology of Aging.

[33]  H. Christensen,et al.  Follow-Up of Mild Cognitive Impairment and Related Disorders over Four Years in Adults in Their Sixties: The PATH Through Life Study , 2008, Dementia and Geriatric Cognitive Disorders.

[34]  D. Loewenstein,et al.  Stability of Different Subtypes of Mild Cognitive Impairment among the Elderly over a 2- to 3-Year Follow-Up Period , 2009, Dementia and Geriatric Cognitive Disorders.

[35]  O L Lopez,et al.  Functional and cognitive criteria produce different rates of mild cognitive impairment and conversion to dementia , 2009, Journal of Neurology, Neurosurgery, and Psychiatry.

[36]  H. Christensen,et al.  Risk Factors of Transition from Normal Cognition to Mild Cognitive Disorder: The PATH through Life Study , 2009, Dementia and Geriatric Cognitive Disorders.

[37]  Severity of mild cognitive impairment is a predictor of conversion to dementia: The canton ticino study , 2009, Alzheimer's & Dementia.

[38]  Celeste A de Jager,et al.  Detection of MCI in the clinic: evaluation of the sensitivity and specificity of a computerised test battery, the Hopkins Verbal Learning Test and the MMSE. , 2009, Age and ageing.