Abstract
Objectives: To refine mild cognitive impairment (MCI) diagnostic criteria, we examined progression to dementia using two approaches to identifying MCI. Methods: A total of 1203 Framingham Heart Study participants were classified at baseline as cognitively normal or MCI (overall and four MCI subtypes) via conventional Petersen/Winblad criteria (single cognitive test impaired per domain, >1.5 SD below expectations) or Jak/Bondi criteria (two tests impaired per domain, >1 SD below norms). Cox proportional hazards models were constructed to examine the association between each MCI definition and incident dementia. Results: The Petersen/Winblad criteria classified 34% of participants as having MCI while the Jak/Bondi criteria classified 24% as MCI. Over a mean follow-up of 9.7 years, 58 participants (5%) developed incident dementia. Both MCI criteria were associated with incident dementia [Petersen/Winblad: hazards ratio (HR) = 2.64; p-value = .0002; Jak/Bondi: HR = 3.30; p-value <.0001]. When both MCI definitions were included in the same model, only the Jak/Bondi definition remained statistically significantly associated with incident dementia (HR = 2.47; p-value = .008). Multi-domain amnestic and single domain non-amnestic MCI subtypes were significantly associated with incident dementia for both diagnostic approaches (all p-values <.01). Conclusions: The Jak/Bondi MCI criteria had a similar association with dementia as the conventional Petersen/Winblad MCI criteria, despite classifying ∼30% fewer participants as having MCI. Further exploration of alternative methods to conventional MCI diagnostic criteria is warranted.
Original language | English (US) |
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Pages (from-to) | 937-943 |
Number of pages | 7 |
Journal | Journal of the International Neuropsychological Society |
Volume | 22 |
Issue number | 9 |
DOIs | |
State | Published - Oct 1 2016 |
Externally published | Yes |
Keywords
- Cognition
- Dementia
- Diagnosis
- Longitudinal
- Mild cognitive impairment
- Subtype
ASJC Scopus subject areas
- Clinical Neurology
- Psychiatry and Mental health
- Clinical Psychology
- General Neuroscience