This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (163)  • Contact me when this article is cited  Related Content  • Related articles  • Similar articles in this journal  Topic Collections  • Aging/ Geriatrics  • Alzheimer Disease  • Behavioral Neurology  • Dementias  • Prognosis/ Outcomes  • Alert me on articles by topic  Social Bookmarking   What's this?

Ella Daly, MB, BCh; Deborah Zaitchik, PhD; Maura Copeland, MD; Jeremy Schmahmann, MD; Jeanette Gunther, MSW; Marilyn Albert, PhD

Arch Neurol. 2000;57:675-680.

Objective  To identify aspects of a standardized clinical assessment that can predict which individuals within the category of "questionable" Alzheimer disease (AD) have a high likelihood of converting to AD over time.

Design  Detailed semistructured interviews were performed at baseline and annually for 3 years.

Setting  University-based gerontology research program.

Patients  The patient population consisted of 165 individuals 65 years and older: 42 of the participants had a Clinical Dementia Rating (CDR) of normal cognition (CDR rating, 0.0) and 123 had a rating of questionable AD (CDR rating, 0.5). After 3 years of follow-up, 23 of the 123 subjects with questionable AD were diagnosed with probable AD.

Main Outcome Measures  The interview was used to generate a summary measure based on the sum of 6 CDR categories, known as the Total Box Score. The responses to 32 selected questions from the interview also were examined.

Results  Likelihood of progression to AD during the follow-up period was strongly related to the Total Box Score. For example, more than 50% of individuals with a Total Box Score of 2.0 or higher at baseline developed AD during the follow-up interval, whereas about 10% of individuals with a Total Box Score of 1.0 or lower developed AD during this same period. Selected questions from the standardized clinical interview also were highly predictive of subsequent conversion to AD among the study population. Eight selected questions from the clinical interview at baseline, combined with the CDR Total Box Score, identified 88.6% of such individuals accurately (questionable group, 82/91; converter group, 19/23).

Conclusions  A standardized clinical assessment can be used to identify the subgroup of individuals within the category of questionable AD who have a high likelihood of converting to AD over time. Subjects who met the criteria for questionable AD had a variety of trajectories during a 3-year follow-up, suggesting that diverse factors may influence the functional changes observed in this population.

From the Departments of Psychiatry (Drs Daly, Zaitchik, Copeland, and Albert and Ms Gunther) and Neurology (Drs Schmahmann and Albert), Massachusetts General Hospital, Harvard Medical School, Boston.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLES

Mild Cognitive Impairment or Questionable Dementia?
Ronald C. Petersen
Arch Neurol. 2000;57(5):643-644.
EXTRACT | FULL TEXT  

Archives of Neurology Reader's Choice: Continuing Medical Education
Arch Neurol. 2000;57(5):762-763.
FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Declining financial capacity in mild cognitive impairment: A 1-year longitudinal study
Triebel et al.
Neurology 2009;73:928-934.
ABSTRACT | FULL TEXT  

Progression of Mild Cognitive Impairment to Dementia in Clinic- vs Community-Based Cohorts
Farias et al.
Arch Neurol 2009;66:1151-1157.
ABSTRACT | FULL TEXT  

Functional and cognitive criteria produce different rates of mild cognitive impairment and conversion to dementia
Saxton et al.
J. Neurol. Neurosurg. Psychiatry 2009;80:737-743.
ABSTRACT | FULL TEXT  

Temporoparietal MR Imaging Measures of Atrophy in Subjects with Mild Cognitive Impairment That Predict Subsequent Diagnosis of Alzheimer Disease
Desikan et al.
Am. J. Neuroradiol. 2009;30:532-538.
ABSTRACT | FULL TEXT  

Diagnosis and Treatment of Dementia: 3. Mild Cognitive Impairment and Cognitive Impairment Without Dementia
Chertkow et al.
Focus 2009;7:64-78.
ABSTRACT | FULL TEXT  

Hippocampal activation in adults with mild cognitive impairment predicts subsequent cognitive decline
Miller et al.
J. Neurol. Neurosurg. Psychiatry 2008;79:630-635.
ABSTRACT | FULL TEXT  

Diagnosis and treatment of dementia: 3. Mild cognitive impairment and cognitive impairment without dementia
Chertkow et al.
CMAJ 2008;178:1273-1285.
ABSTRACT | FULL TEXT  

Potential Role of Diffusion Tensor MRI in the Differential Diagnosis of Mild Cognitive Impairment and Alzheimer's Disease
B. Parente et al.
Am. J. Roentgenol. 2008;190:1369-1374.
ABSTRACT | FULL TEXT  

Spatial Distribution of White-Matter Hyperintensities in Alzheimer Disease, Cerebral Amyloid Angiopathy, and Healthy Aging
Holland et al.
Stroke 2008;39:1127-1133.
ABSTRACT | FULL TEXT  

A 74-Year-Old Man With Memory Loss and Neuropathy Who Enjoys Alcoholic Beverages
Brust
JAMA 2008;299:1046-1054.
ABSTRACT | FULL TEXT  

Magnetic Resonance Imaging White Matter Hyperintensities and Brain Volume in the Prediction of Mild Cognitive Impairment and Dementia
Smith et al.
Arch Neurol 2008;65:94-100.
ABSTRACT | FULL TEXT  

Clinical Prediction of Alzheimer Disease Dementia Across the Spectrum of Mild Cognitive Impairment
Dickerson et al.
Arch Gen Psychiatry 2007;64:1443-1450.
ABSTRACT | FULL TEXT  

Conversion to Dementia From Questionable Dementia in an Ethnic Chinese Population
Liu et al.
J Geriatr Psychiatry Neurol 2007;20:76-83.
ABSTRACT  

Neuropsychological Measures in Normal Individuals That Predict Subsequent Cognitive Decline
Blacker et al.
Arch Neurol 2007;64:862-871.
ABSTRACT | FULL TEXT  

Single photon emission computed tomography perfusion differences in mild cognitive impairment
Johnson et al.
J. Neurol. Neurosurg. Psychiatry 2007;78:240-247.
ABSTRACT | FULL TEXT  

Alterations in Memory Networks in Mild Cognitive Impairment and Alzheimer's Disease: An Independent Component Analysis
Celone et al.
J. Neurosci. 2006;26:10222-10231.
ABSTRACT | FULL TEXT  

Quantitative MR Imaging in Alzheimer Disease
Ramani et al.
Radiology 2006;241:26-44.
ABSTRACT | FULL TEXT  

Mild cognitive impairment: Risk of Alzheimer disease and rate of cognitive decline
Boyle et al.
Neurology 2006;67:441-445.
ABSTRACT | FULL TEXT  

Longitudinal course and neuropathologic outcomes in original vs revised MCI and in pre-MCI
Storandt et al.
Neurology 2006;67:467-473.
ABSTRACT | FULL TEXT  

Conversion to dementia from mild cognitive disorder: the Cache County Study.
Tschanz et al.
Neurology 2006;67:229-234.
ABSTRACT | FULL TEXT  

The Significance of Thyroid-Stimulating Hormone and Homocysteine in the Development of Alzheimer's Disease in Mild Cognitive Impairment: A 6-Year Follow-up Study
Annerbo et al.
AM J ALZHEIMERS DIS OTHER DEMEN 2006;21:182-188.
ABSTRACT  

Neuropsychological Markers of Progression From Mild Cognitive Impairment to Alzheimer's Disease
Marcos et al.
AM J ALZHEIMERS DIS OTHER DEMEN 2006;21:189-196.
ABSTRACT  

Functional connectivity of the fusiform gyrus during a face-matching task in subjects with mild cognitive impairment
Bokde et al.
Brain 2006;129:1113-1124.
ABSTRACT | FULL TEXT  

Neuropathologic Substrate of Mild Cognitive Impairment
Markesbery et al.
Arch Neurol 2006;63:38-46.
ABSTRACT | FULL TEXT  

Children of Alzheimer Patients: An Overview
Jarvik and Blazer
J Geriatr Psychiatry Neurol 2005;18:181-186.
 

Increased hippocampal activation in mild cognitive impairment compared to normal aging and AD
Dickerson et al.
Neurology 2005;65:404-411.
ABSTRACT | FULL TEXT  

Fast decay of iconic memory in observers with mild cognitive impairments
Lu et al.
Proc. Natl. Acad. Sci. USA 2005;102:1797-1802.
ABSTRACT | FULL TEXT  

Mild cognitive impairment, amnestic type: An epidemiologic study
Ganguli et al.
Neurology 2004;63:115-121.
ABSTRACT | FULL TEXT  

Mild Cognitive Impairment Can Be Distinguished From Alzheimer Disease and Normal Aging for Clinical Trials
Grundman et al.
Arch Neurol 2004;61:59-66.
ABSTRACT | FULL TEXT  

Mild cognitive impairment: Directions for future research
Luis et al.
Neurology 2003;61:438-444.
ABSTRACT | FULL TEXT  

MRI-Guided SPECT Perfusion Measures and Volumetric MRI in Prodromal Alzheimer Disease
El Fakhri et al.
Arch Neurol 2003;60:1066-1072.
ABSTRACT | FULL TEXT  

Neuropsychological prediction of conversion to dementia from questionable dementia: statistically significant but not yet clinically useful
Tian et al.
J. Neurol. Neurosurg. Psychiatry 2003;74:433-438.
ABSTRACT | FULL TEXT  

Impaired financial abilities in mild cognitive impairment: A direct assessment approach
Griffith et al.
Neurology 2003;60:449-457.
ABSTRACT | FULL TEXT  

Longitudinal changes in verbal memory in older adults: Distinguishing the effects of age from repeat testing
Lamar et al.
Neurology 2003;60:82-86.
ABSTRACT | FULL TEXT  

Incidence and outcome of mild cognitive impairment in a population-based prospective cohort
Larrieu et al.
Neurology 2002;59:1594-1599.
ABSTRACT | FULL TEXT  

Natural history of mild cognitive impairment in older persons
Bennett et al.
Neurology 2002;59:198-205.
ABSTRACT | FULL TEXT  

Achieving and Maintaining Cognitive Vitality With Aging
Fillit et al.
Mayo Clin Proc. 2002;77:681-696.
ABSTRACT  

Increase of Brain Oxidative Stress in Mild Cognitive Impairment: A Possible Predictor of Alzheimer Disease
Pratico et al.
Arch Neurol 2002;59:972-976.
ABSTRACT | FULL TEXT  

MRI measures of entorhinal cortex vs hippocampus in preclinical AD
Killiany et al.
Neurology 2002;58:1188-1196.
ABSTRACT | FULL TEXT  

Independent Predictors of Cognitive Decline in Healthy Elderly Persons
Marquis et al.
Arch Neurol 2002;59:601-606.
ABSTRACT | FULL TEXT  

Differential Evolution of Cognitive Impairment in Nondemented Older Persons: Results From the Kungsholmen Project
Palmer et al.
Am. J. Psychiatry 2002;159:436-442.
ABSTRACT | FULL TEXT  

Abnormalities in the Pattern of Platelet Amyloid Precursor Protein Forms in Patients With Mild Cognitive Impairment and Alzheimer Disease
Padovani et al.
Arch Neurol 2002;59:71-75.
ABSTRACT | FULL TEXT  

Current Concepts in Mild Cognitive Impairment
Petersen et al.
Arch Neurol 2001;58:1985-1992.
ABSTRACT | FULL TEXT  

Practice parameter: Early detection of dementia: Mild cognitive impairment (an evidence-based review): Report of the Quality Standards Subcommittee of the American Academy of Neurology
Petersen et al.
Neurology 2001;56:1133-1142.
ABSTRACT | FULL TEXT  

Mild Cognitive Impairment Represents Early-Stage Alzheimer Disease
Morris et al.
Arch Neurol 2001;58:397-405.
ABSTRACT | FULL TEXT  

Alzheimer's disease: What is it, how many people have it, and why do we need to know?
Albert and Drachman
Neurology 2000;55:166-168.
FULL TEXT  

Mild Cognitive Impairment or Questionable Dementia?
Petersen
Arch Neurol 2000;57:643-644.
FULL TEXT