Conversion from subtypes of mild cognitive impairment to Alzheimer dementia

Objective: To compare the rates of conversion to Alzheimer dementia (AD) between subtypes of mild cognitive impairment (MCI) in a community-based birth cohort investigated at age 75 and followed up after 30 months. Methods: The Vienna Trans-Danube Aging Study investigated every inhabitant of the area on the left shore of the river Danube who was born between May 1925 and June 1926. With use of the official voting registry, 1505 subjects were contacted and 697 participated. Data refer to the cohort of 581 nondemented individuals who completed extensive neuropsychological examination at baseline. Follow-up after 30 months was possible in 476 probands (35 deceased). Results: The 141 patients with MCI at baseline were classified into two subtypes. At follow-up, 41 of these patients with MCI were diagnosed with AD. Conversion rates to AD were 48.7% (CI: 32.4 to 65.2) for amnestic MCI and 26.8% (CI: 17.6 to 37.8) for nonamnestic MCI. Another 49 AD cases originated from cognitive health at baseline (12.6%; CI: 9.4 to 16.3). Conclusions: Patients with mild cognitive impairment (MCI) showed a high probability to be diagnosed with Alzheimer dementia (AD) after 30 months. Subtypes of MCI were not useful in defining early stages of various types of dementia: Not only amnestic MCI but also nonamnestic MCI converted frequently to AD, and conversion to vascular dementia and dementia with Lewy bodies was not restricted to nonamnestic MCI.

[1]  M. Folstein,et al.  Clinical diagnosis of Alzheimer's disease , 1984, Neurology.

[2]  J. Morris,et al.  Clinical outcomes of possible versus probable Alzheimer’s disease , 2003, Neurology.

[3]  J. Touchon,et al.  Classification criteria for mild cognitive impairment , 2001, Neurology.

[4]  S. DeKosky,et al.  Mild cognitive impairment, amnestic type , 2004, Neurology.

[5]  Simon Lovestone,et al.  Is MCI really just early dementia? A systematic review of conversion studies , 2004, International Psychogeriatrics.

[6]  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.

[7]  K. Andersen,et al.  Incidence of very mild to severe dementia and Alzheimer’s disease in Denmark , 1999, Neurology.

[8]  P. Fischer,et al.  Vienna Transdanube Aging "VITA": study design, recruitment strategies and level of participation. , 2002, Journal of neural transmission. Supplementum.

[9]  S. Zehetmayer,et al.  VITA: subtypes of mild cognitive impairment in a community‐based cohort at the age of 75 years , 2005, International journal of geriatric psychiatry.

[10]  John C Morris,et al.  Mild cognitive impairment is early-stage Alzheimer disease: time to revise diagnostic criteria. , 2006, Archives of neurology.

[11]  J. Fisk,et al.  Outcomes of incident mild cognitive impairment in relation to case definition , 2005, Journal of Neurology, Neurosurgery & Psychiatry.

[12]  R B D'Agostino,et al.  Incidence of dementia and probable Alzheimer's disease in a general population , 1993, Neurology.

[13]  S. Riedel-Heller,et al.  Mild cognitive impairment: prevalence and incidence according to different diagnostic criteria , 2003, British Journal of Psychiatry.

[14]  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.

[15]  R. Petersen,et al.  Mild cognitive impairment , 2006, The Lancet.

[16]  L. Bouter,et al.  Association between memory complaints and incident Alzheimer's disease in elderly people with normal baseline cognition. , 1999, The American journal of psychiatry.

[17]  J. Gustafsson,et al.  Estrogen Receptor-Beta Regulates Epithelial Cell Differentiation in the Mouse Ventral Prostate , 2004, Hormone Research in Paediatrics.

[18]  J. Morris,et al.  Current concepts in mild cognitive impairment. , 2001, Archives of neurology.

[19]  M. Albert,et al.  Amnestic MCI or prodromal Alzheimer's disease? , 2004, The Lancet Neurology.

[20]  R. Mayeux,et al.  Implementing diagnostic criteria and estimating frequency of mild cognitive impairment in an urban community. , 2005, Archives of neurology.

[21]  H. Amièva,et al.  Incidence and outcome of mild cognitive impairment in a population-based prospective cohort , 2002, Neurology.

[22]  M. Lawton,et al.  Assessment of older people: self-maintaining and instrumental activities of daily living. , 1969, The Gerontologist.

[23]  P. Despland,et al.  Persistent worsening of stroke sequelae after delayed seizures. , 1992, Archives of neurology.

[24]  P. Fischer,et al.  Subjective Memory Complaints and Objective Memory Impairment in the Vienna‐Transdanube Aging Community , 2004, Journal of the American Geriatrics Society.

[25]  A. Monsch,et al.  Normal ranges of neuropsychological tests for the diagnosis of Alzheimer's disease. , 2000, Studies in health technology and informatics.

[26]  R Brookmeyer,et al.  Age-specific incidence rates of Alzheimer’s disease , 2000, Neurology.

[27]  R. Petersen.  Mild cognitive impairment as a diagnostic entity , 2004, Journal of internal medicine.

[28]  M. Seeck,et al.  SEIZURES DURING STROKE THROMBOLYSIS HERALDING DRAMATIC NEUROLOGIC RECOVERY , 2007, Neurology.

[29]  D. Jolley,et al.  Cost benefits of a medically supervised day treatment program for patients with Alzheimer's disease and other forms of dementia , 1989 .

[30]  H. Fukuyama,et al.  Partial Epilepsy Manifesting Atonic Seizure: Report of Two Cases , 2002, Epilepsia.

[31]  G. C. Román,et al.  Vascular dementia , 1993, Neurology.

[32]  M. Torricelli,et al.  Effects of Dexamethasone and Dexamethasone plus Naltrexone on Pituitary Response to GnRH and TRH in Normal Women , 1999, Hormone Research in Paediatrics.

[33]  K. Kosaka,et al.  Consensus guidelines for the clinical and pathologic diagnosis of dementia with Lewy bodies (DLB) , 1996, Neurology.

[34]  D. Bennett,et al.  Vitamin E and donepezil for the treatment of mild cognitive impairment. , 2005, The New England journal of medicine.

[35]  T. Yoshikawa.  State of the Journal: 3 Years and Looking Ahead , 2004, Journal of the American Geriatrics Society.

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

[37]  A. Alexandrov,et al.  Early Dramatic Recovery During Intravenous Tissue Plasminogen Activator Infusion: Clinical Pattern and Outcome in Acute Middle Cerebral Artery Stroke , 2002, Stroke.