Neuropsychological Criteria for Mild Cognitive Impairment and Dementia Risk in the Framingham Heart Study

Amy J. Jak, Sarah R. Preis, Alexa S. Beiser, Sudha Seshadri, Philip A. Wolf, Mark W. Bondi, Rhoda Au

Research output: Contribution to journalArticlepeer-review

98 Scopus citations


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 languageEnglish (US)
Pages (from-to)937-943
Number of pages7
JournalJournal of the International Neuropsychological Society
Issue number9
StatePublished - Oct 1 2016
Externally publishedYes


  • Cognition
  • Dementia
  • Diagnosis
  • Longitudinal
  • Mild cognitive impairment
  • Subtype

ASJC Scopus subject areas

  • Clinical Neurology
  • Psychiatry and Mental health
  • Clinical Psychology
  • General Neuroscience


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