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Predictive validity and diagnostic stability of mild cognitive impairment subtypes
Author(s) -
Han Ji Won,
Kim Tae Hui,
Lee Seok Bum,
Park Joon Hyuk,
Lee Jung Jae,
Huh Yoonseok,
Park Jee Eun,
Jhoo Jin Hyeong,
Lee Dong Young,
Kim Ki Woong
Publication year - 2012
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2011.08.007
Subject(s) - dementia , odds ratio , confidence interval , logistic regression , cognition , medicine , psychology , pediatrics , psychiatry , disease
Background Mild cognitive impairment (MCI) is subclassified into four subtypes by the presence of impairment in the memory domain (amnestic vs nonamnestic) and the number of impaired cognitive domains (single vs multiple). However, predictive validity for outcomes of these criteria and the diagnostic stability of the subtypes are questionable. Methods We investigated the outcomes of 140 patients with MCI who participated in the baseline study of the Korean Longitudinal Study on Health and Aging and completed the 18‐month follow‐up evaluation (mean duration of follow‐up = 1.57 ± 0.24 years). We evaluated the predictive validity of the criteria using multinomial logistic regression analyses, and the diagnostic stability of MCI subtypes using annual conversion rates between subtypes. Results Compared with the single‐domain type (MCIs), the multiple‐domain type (MCIm) had a lower chance of reversion to normal cognition (MCIm = 10.94%, MCIs = 43.42%) and higher risk of conversion to dementia (MCIm = 23.44%, MCIs = 5.26%). The difference in the reversion rate between the multiple‐ and single‐domain type was statistically significant (odds ratio = 0.233, 95% confidence interval = 0.070–0.771, P = .017). However, neither the chance of reversion nor the risk of conversion was different between amnestic and nonamnestic subtypes. Among the 81 participants who neither converted to dementia nor reverted to normal cognition, 39 converted to different subtype (annual conversion rate = 17.74%). Conclusions The number of impaired cognitive domains, but not the presence of memory impairment, predicted poor outcomes in people with MCI. However, MCI subtype was diagnostically unstable.