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Early versus late MCI: Improved MCI staging using a neuropsychological approach
Author(s) -
Edmonds Emily C.,
McDonald Carrie R.,
Marshall Anisa,
Thomas Kelsey R.,
Eppig Joel,
Weigand Alexandra J.,
DelanoWood Lisa,
Galasko Douglas R.,
Salmon David P.,
Bondi Mark W.
Publication year - 2019
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.2018.12.009
Subject(s) - neuropsychology , neuroimaging , psychology , neuropsychological test , cognitive impairment , cognition , neuropsychological assessment , medicine , psychiatry
The Alzheimer's Disease Neuroimaging Initiative (ADNI) separates “early” and “late” mild cognitive impairment (MCI) based on a single memory test. We compared ADNI's MCI classifications to our neuropsychological approach, which more broadly assesses cognitive abilities. Methods Three hundred thirty‐six ADNI‐2 participants were classified as “early” or “late” MCI. Cluster analysis was performed on neuropsychological test data, and participants were reclassified based on cluster results. These two staging approaches were compared on progression rates, cerebrospinal fluid biomarkers, and cortical thickness profiles. Results There was little correspondence between the two staging methods. ADNI's early MCI group included a large proportion of false‐positive diagnostic errors. The reclassified neuropsychological MCI groups showed steeper survival curves and more abnormal biomarkers. Conclusions Our novel neuropsychological approach improved the staging of MCI by (1) capturing individuals at an early symptomatic stage, (2) minimizing false‐positive cases, and (3) identifying a late MCI group further along the disease trajectory.