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Two year outcome of MCI subtypes and aetiologies in the Goteborg MCI study.

Journal article
Authors Arto Nordlund
Sindre Rolstad
Ola Klang
Åke Edman
Stefan Hansen
Anders Wallin
Published in Journal of neurology, neurosurgery, and psychiatry
Volume 81
Issue 5
Pages 541-6
ISSN 1468-330X
Publication year 2010
Published at Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry
Department of Psychology
Pages 541-6
Language en
Links dx.doi.org/10.1136/jnnp.2008.171066
Subject categories Psychiatry

Abstract

The objective was to study the two year outcome of subjects diagnosed with Mild Cognitive Impairment (MCI). Two hundred and nine subjects diagnosed with MCI were examined with a comprehensive neuropsychological test battery and followed up after two years. After two years 34 subjects (16%) were lost for follow-up. Those subjects did not differ significantly in terms of MCI subclassification, MMSE score or age and education. Of the 175 subjects followed up, 8 (4.5%) had improved to normal, two with amnestic MCI, one from multiple domains MCI, three with single domain MCI and two without any significant impairment at baseline. Forty-four subjects (25%) had progressed to dementia. Out of these 35 were from the multidomain amnestic group and 9 from the multidomain non-amnestic group. The combination of Alzheimer-typical biomarkers (total-tau and amyloid beta) and multidomain amnestic MCI was the strongest predictor of progression to Alzheimer's disease, while vascular disease and multidomain amnestic MCI preceded mixed and vascular dementia. The results suggest that memory impairment alone, or impairment in any one cognitive domain alone, are rather benign conditions. Impairment in several cognitive domains is associated with a more severe outcome over two years. Also, 20% of the subjects who progressed to dementia, including Alzheimer's disease, did not show memory impairment at baseline, which suggests that memory impairment is not always the first symptom of even the most common dementia disorders.

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