Universität zu Köln

Polcher, Alexandra, Wolfsgruber, Steffen, Peters, Oliver ORCID: 0000-0003-0568-2998, Froelich, Lutz, Wiltfang, Jens, Kornhuber, Johannes, Huell, Michael, Ruether, Eckart, Lewczuk, Piotr, Maier, Wolfgang, Jessen, Frank and Wagner, Michael (2022). A Comparison of Operational Definitions for Mild Cognitive Impairment. J. Alzheimers Dis., 88 (4). S. 1663 - 1679. AMSTERDAM: IOS PRESS. ISSN 1875-8908

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Abstract

Background: Consideration of many tests from different cognitive domains in defining mild cognitive impairment (MCI) is clinical routine, but guidelines for a neuropsychological operationalization of MCI are lacking. Objective: Among different operational MCI criteria, to identify those which are best in predicting either conversion to dementia, or a biomarker profile indicative for Alzheimer's disease (AD). Methods: Memory clinic patients without dementia (N= 558; mean age = 66; up to 3 years of follow-up; n = 360 with baseline CSF biomarkers) were included in an observational study using most liberal criteria of cognitive impairment. Four operational definitions of MCI were retrospectively applied: 1) amnestic MCI (CERAD word list delayed recall), 2) CERAD total score, 3) comprehensive criteria and 4) base rate corrected CERAD. We compared their accuracy in predicting incident all-cause dementia or AD dementia within three years, or a concurrent CSF A beta(42)/tau-ratio indicative of AD. Results: The four definitions overlapped considerably, classified 35-58% of the original sample as impaired and were associated with markedly increased PPVs regarding incident all-cause dementia (39-46% versus 26% of the original sample), AD dementia and AD biomarker positivity. The base rate corrected MCI definition had the highest prognostic accuracy. Conclusion: The operational criteria examined seem suitable to specify MCI in memory clinic settings, as they identify subjects at high risk of clinical progression. Depending on the neuropsychological battery in use, one or several of these criteria could help to calibrate the clinical judgment of test results, reduce false-positive decisions, and define risk-enriched groups for clinical trials.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Polcher, Alexandra UNSPECIFIED UNSPECIFIED UNSPECIFIED Wolfsgruber, Steffen UNSPECIFIED UNSPECIFIED UNSPECIFIED Peters, Oliver UNSPECIFIED orcid.org/0000-0003-0568-2998 UNSPECIFIED Froelich, Lutz UNSPECIFIED UNSPECIFIED UNSPECIFIED Wiltfang, Jens UNSPECIFIED UNSPECIFIED UNSPECIFIED Kornhuber, Johannes UNSPECIFIED UNSPECIFIED UNSPECIFIED Huell, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Ruether, Eckart UNSPECIFIED UNSPECIFIED UNSPECIFIED Lewczuk, Piotr UNSPECIFIED UNSPECIFIED UNSPECIFIED Maier, Wolfgang UNSPECIFIED UNSPECIFIED UNSPECIFIED Jessen, Frank UNSPECIFIED UNSPECIFIED UNSPECIFIED Wagner, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-693642
DOI:	10.3233/JAD-215548
Journal or Publication Title:	J. Alzheimers Dis.
Volume:	88
Number:	4
Page Range:	S. 1663 - 1679
Date:	2022
Publisher:	IOS PRESS
Place of Publication:	AMSTERDAM
ISSN:	1875-8908
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language NEUROPSYCHOLOGICAL ASSESSMENT BATTERY; HEALTHY OLDER-ADULTS; ALZHEIMERS-DISEASE; TOTAL SCORE; CEREBROSPINAL-FLUID; BASE RATES; CERAD; DEMENTIA; PROGRESSION; DIAGNOSIS Multiple languages Neurosciences Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/69364