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Neuropsychological Criteria for Mild Cognitive Impairment and Dementia Risk in the Framingham Heart Study

Published online by Cambridge University Press:  31 March 2016

Amy J. Jak ,
Sarah R. Preis ,
Alexa S. Beiser ,
Sudha Seshadri ,
Philip A. Wolf ,
Mark W. Bondi  and
Rhoda Au
Amy J. Jak*
Affiliation:
VA San Diego Healthcare System, San Diego, California Department of Psychiatry, University of California, San Diego, San Diego, California
Sarah R. Preis
Affiliation:
Framingham Heart Study, Framingham, Massachusetts Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts
Alexa S. Beiser
Affiliation:
Framingham Heart Study, Framingham, Massachusetts Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts Department of Neurology, Boston University School of Medicine, Boston, Massachusetts
Sudha Seshadri
Affiliation:
Framingham Heart Study, Framingham, Massachusetts Department of Neurology, Boston University School of Medicine, Boston, Massachusetts
Philip A. Wolf
Affiliation:
Framingham Heart Study, Framingham, Massachusetts Department of Neurology, Boston University School of Medicine, Boston, Massachusetts
Mark W. Bondi
Affiliation:
VA San Diego Healthcare System, San Diego, California Department of Psychiatry, University of California, San Diego, San Diego, California
Rhoda Au
Affiliation:
Framingham Heart Study, Framingham, Massachusetts Department of Neurology, Boston University School of Medicine, Boston, Massachusetts
*
Correspondence and reprint requests to: Amy Jak, 3350 La Jolla Village Drive, (116B), San Diego, CA 92161. E-mail: ajak@ucsd.edu
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Abstract

Objectives: To refine mild cognitive impairment (MCI) diagnostic criteria, we examined progression to dementia using two approaches to identifying MCI. Methods: A total of 1203 Framingham Heart Study participants were classified at baseline as cognitively normal or MCI (overall and four MCI subtypes) via conventional Petersen/Winblad criteria (single cognitive test impaired per domain, >1.5 SD below expectations) or Jak/Bondi criteria (two tests impaired per domain, >1 SD below norms). Cox proportional hazards models were constructed to examine the association between each MCI definition and incident dementia. Results: The Petersen/Winblad criteria classified 34% of participants as having MCI while the Jak/Bondi criteria classified 24% as MCI. Over a mean follow-up of 9.7 years, 58 participants (5%) developed incident dementia. Both MCI criteria were associated with incident dementia [Petersen/Winblad: hazards ratio (HR) = 2.64; p-value=.0002; Jak/Bondi: HR=3.30; p-value <.0001]. When both MCI definitions were included in the same model, only the Jak/Bondi definition remained statistically significantly associated with incident dementia (HR=2.47; p-value=.008). Multi-domain amnestic and single domain non-amnestic MCI subtypes were significantly associated with incident dementia for both diagnostic approaches (all p-values <.01). Conclusions: The Jak/Bondi MCI criteria had a similar association with dementia as the conventional Petersen/Winblad MCI criteria, despite classifying ~30% fewer participants as having MCI. Further exploration of alternative methods to conventional MCI diagnostic criteria is warranted. (JINS, 2016, 22, 937–943)

Keywords

Mild cognitive impairmentDiagnosisSubtypeCognitionDementiaLongitudinal
Type
Brief Communications
Information
Journal of the International Neuropsychological Society , Volume 22 , Issue 9 , October 2016 , pp. 937 - 943
Copyright
Copyright © The International Neuropsychological Society 2016 

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