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Lookup NU author(s): Professor Bloss Stephan, Professor Carol Brayne, Professor John Bond, Professor Ian McKeith
This is the authors' accepted manuscript of an article that has been published in its final definitive form by Lippincott Williams & Wilkins, 2010.
For re-use rights please refer to the publisher's terms and conditions.
Background: Criteria for mild cognitive impairment (MCI) predict dementia risk in the clinic. Dementia risk in the population is different and whether there is an optimal MCI-derived threshold for discriminating at-risk from not-at-risk cases in the general older population is not known. Methods: Data were from the Medical Research Council Cognitive Function and Ageing Study. Two risk thresholds were derived from each of seven different concepts of MCI including: Mayo Clinic-defined amnestic, nonamnestic, multiple, and revised MCI, MCI based on Mini-Mental State Examination derived categories, and the definitions of Cognitive Impairment No Dementia and Age-Related Cognitive Decline ( ARCD). Receiver operating characteristic analysis was used to compare the predictive validity of 2-year incident dementia for each risk threshold across the different MCI definitions. Findings: MCI-derived risk thresholds varied in their ability to predict dementia. MCI thresholds were accurate in identifying individuals not at-risk of dementia progression (false-negative range: 0%-3.4%). No MCI-derived threshold accurately identified an at-risk group with a 2-year progression rate greater than 20%. Criteria for ARCD defined the threshold with the highest sensitivity and specificity for dementia conversion. Interpretation: MCI-derived thresholds do not reliably identify individuals at-risk of incident dementia at 2 years when applied in the general population. A large subpopulation of individuals not at-risk was more reliably identified. What is considered a sufficient level of accuracy for identification of individuals at increased risk of dementia depends on the motivation for screening and on the safety and efficacy of available interventions. (Am J Geriatr Psychiatry 2010; 18: 662-673)
Author(s): Stephan BCM, Savva GM, Brayne C, Bond J, McKeith IG, Matthews FE, Med Res Council Cognitive Function
Publication type: Article
Publication status: Published
Journal: American Journal of Geriatric Psychiatry
Year: 2010
Volume: 18
Issue: 8
Pages: 662-673
Print publication date: 01/08/2010
Date deposited: 09/11/2010
ISSN (print): 1064-7481
ISSN (electronic): 1545-7214
Publisher: Lippincott Williams & Wilkins
URL: http://dx.doi.org/10.1097/JGP.0b013e3181e0450d
DOI: 10.1097/JGP.0b013e3181e0450d
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