Skip to main content
    • Aa
    • Aa

Mild cognitive impairment as predictor for Alzheimer's disease in clinical practice: effect of age and diagnostic criteria

  • P. J. Visser (a1) (a2) and F. R. J. Verhey (a1)

We investigated whether the predictive accuracy of mild cognitive impairment (MCI) for Alzheimer-type dementia (AD) in a clinical setting is dependent on age and the definition of MCI used.


Non-demented subjects older than 40 (n=320) who attended a memory clinic of a university hospital were reassessed 5 years later for the presence of AD. MCI was diagnosed according to the criteria of amnestic MCI, mild functional impairment (MFI), ageing-associated cognitive decline (AACD), and age-associated memory impairment (AAMI). The main outcome measure was the area under the curve (AUC) of a receiver operating characteristic (ROC) curve. Analyses were conducted on the entire sample and on subgroups of subjects aged 40–54, 55–69 and 70–85 years.


A diagnosis of AD at follow-up was made in 58 subjects. Four of them were in the 40–54 age group, 29 in the 55–69 age group and 25 in the 70–85 age group. The diagnostic accuracy in the entire sample was low to moderately high with AUCs ranging from 0.56 (AACD) to 0.75 (amnestic MCI). A good predictive accuracy with an AUC >0.80 was only observed in subjects aged 70–85 using the criteria of amnestic MCI (AUC=0.84).


The predictive accuracy of MCI for AD is dependent on age and the definition of MCI used. The predictive accuracy is good only for amnestic MCI in subjects 70–85 years. As subjects with prodromal AD are often younger than 70, the usefulness of MCI as predictor of AD in clinical practice is limited.

Corresponding author
*Address for correspondence: Dr P. J. Visser, Department of Psychiatry and Neuropsychology, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands. (Email:
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

G Blessed , BE Tomlinson , M Roth (1968). The association between quantitative measures of dementia and of senile changes in the cerebral grey matter of elderly subjects. British Journal of Psychiatry 114, 797811.

A Bozoki , B Giordani , JL Heidebrink , S Berent , NL Foster (2001). Mild cognitive impairments predict dementia in nondemented elderly patients with memory loss. Archives of Neurology 58, 411416.

A Busse , J Bischkopf , SG Riedel-Heller , MC Angermeyer (2003 a). Mild cognitive impairment: prevalence and predictive validity according to current approaches. Acta Neurologica Scandinavica 108, 7181.

A Busse , J Bischkopf , SG Riedel-Heller , MC Angermeyer (2003 b). Mild cognitive impairment: prevalence and incidence according to different diagnostic criteria. Results of the Leipzig Longitudinal Study of the Aged (LEILA75+). British Journal of Psychiatry 182, 449454.

T Crook , RT Bartus , SH Ferris , P Whitehouse , GD Cohen , S Gershon (1986). Age-associated memory impairment: proposed criteria and measures of clinical change. Report of the National Institute of Mental Health work group. Developmental Neuropsychology 2, 261276.

JD Fisk , K Rockwood (2005). Outcomes of incident mild cognitive impairment in relation to case definition. Journal of Neurology, Neurosurgery and Psychiatry 76, 11751177.

MF Folstein , SE Folstein , PR McHugh (1975). ‘Mini-Mental State’: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research 12, 189198.

DM Geslani , MC Tierney , N Herrmann , JP Szalai (2005). Mild cognitive impairment: an operational definition and its conversion rate to Alzheimer's disease. Dementia and Geriatric Cognitive Disorders 19, 383389.

WP Goldman , JC Morris (2001). Evidence that age-associated memory impairment is not a normal variant of aging. Alzheimer Disease and Associated Disorders 15, 7279.

M Grundman , RC Petersen , DA Bennett , HH Feldman , S Salloway , PJ Visser , LJ Thal , D Schenk , Z Khachaturian , W Thies ; for the Alzheimer's Association Research Roundtable (2006). Alzheimer's Association Research Roundtable meeting on mild cognitive impairment: what have we learned? Alzheimer's and Dementia 2, 393414.

VC Hachinski , LD Iliff , E Zilhka , GH Du Boulay , VL McAllister , J Marshall , RW Russell , L Symon (1975). Cerebral blood flow in dementia. Archives of Neurology 32, 632637.

M Hamilton (1960). A rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry 23, 5662.

O Hansson , H Zetterberg , P Buchhave , E Londos , K Blennow , L Minthon (2006). Association between CSF biomarkers and incipient Alzheimer's disease in patients with mild cognitive impairment: a follow-up study. Lancet Neurology 5, 228234.

JR Hodges , S Erzinclioglu , K Patterson (2006). Evolution of cognitive deficits and conversion to dementia in patients with mild cognitive impairment: a very-long-term follow-up study. Dementia and Geriatric Cognitive Disorders 21, 380391.

V Jelic , SE Johansson , O Almkvist , M Shigeta , P Julin , A Nordberg , B Winblad , LO Wahlund (2000). Quantitative electroencephalography in mild cognitive impairment: longitudinal changes and possible prediction of Alzheimer's disease. Neurobiology of Aging 21, 533540.

A Kluger , SH Ferris , J Golomb , MS Mittelman , B Reisberg (1999). Neuropsychological prediction of decline to dementia in nondemented elderly. Journal of Geriatric Psychiatry and Neurology 12, 168179.

CA Luis , WW Barker , DA Loewenstein , TA Crum , E Rogaeva , T Kawarai , P St George-Hyslop , R Duara (2004). Conversion to dementia among two groups with cognitive impairment. A preliminary report. Dementia and Geriatric Cognitive Disorders 18, 307313.

G McKhann , D Drachman , M Folstein , R Katzman , D Price , EM Stadlan (1984). Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work-Group under the auspices of the Department of Health and Human Services Task Force on Alzheimer's disease. Neurology 34, 939944.

JC Morris , M Storandt , JP Miller , DW McKeel , JL Price , EH Rubin , L Berg (2001). Mild cognitive impairment represents early-stage Alzheimer disease. Archives of Neurology 58, 397405.

D Neary , JS Snowden , L Gustafson , U Passant , D Stuss , S Black , M Freedman , A Kertesz , PH Robert , M Albert , K Boone , BL Miller , J Cummings , DF Benson (1998). Frontotemporal lobar degeneration: a consensus on clinical diagnostic criteria. Neurology 51, 15461554.

RC Petersen , GE Smith , SC Waring , RJ Ivnik , EG Tangalos , E Kokmen (1999). Mild cognitive impairment. Clinical characterization and outcome. Archives of Neurology 56, 303308.

SMC Rasquin , J Lodder , PJ Visser , R Lousberg , FRJ Verhey (2005). Predictive accuracy of MCI-subtypes for Alzheimer's disease and vascular dementia in subjects with mild cognitive impairment: a 2-year follow-up study. Dementia and Geriatric Cognitive Disorders 19, 113119.

R Reitan (1958). Validity of the Trail Making Test as an indication of organic brain damage. Perceptual and Motor Skills 8, 271276.

K Ritchie , S Artero , J Touchon (2001). Classification criteria for mild cognitive impairment: a population-based validation study. Neurology 56, 3742.

GC Roman , TK Tatemichi , T Erkinjuntti , JL Cummings , JC Masdeu , JH Garcia , L Amaducci , J-M Orgogozo , A Brun , A Hofman , DM Moody , MD O'Brien , T Yamaguchi , J Grafman , BP Drayer , DA Bennett , M Fisher , J Ogata , E Kokmen , F Bermejo , PA Wolf , PB Gorelick , KL Bick , AK Pajeau , MA Bell , C Decarli , A Culebras , AD Korczyn , J Bogousslavsky , A Hartmann , P Scheinberg (1993). Vascular dementia: diagnostic criteria for research studies. Report of the NINDS-AIREN International Workshop. Neurology 43, 250260.

V Solfrizzi , F Panza , AM Colacicco , A D'Introno , C Capurso , F Torres , F Grigoletto , S Maggi , A Del Parigi , EM Reiman , RJ Caselli , E Scafato , G Farchi , A Capurso (2004). Vascular risk factors, incidence of MCI, and rates of progression to dementia. Neurology 63, 18821891.

J Stokholm , O Jakobsen , JM Czarna , HV Mortensen , G Waldemar (2005). Years of severe and isolated amnesia can precede the development of dementia in early-onset Alzheimer's disease. Neurocase 11, 4855.

M Storandt , EA Grant , JP Miller , JC Morris (2006). Longitudinal course and neuropathologic outcomes in original vs revised MCI and in pre-MCI. Neurology 67, 467473.

J Stroop (1935). Studies of interference in serial verbal reactions. Journal of Experimental Psychology 18, 643662.

PJ Visser , A Kester , J Jolles , F Verhey (2006). Ten-year risk of dementia in subjects with mild cognitive impairment. Neurology 67, 12011207.

PJ Visser , P Scheltens , FR Verhey (2005). Do MCI criteria in drug trials accurately identify subjects with predementia Alzheimer's disease? Journal of Neurology, Neurosurgery and Psychiatry 76, 13481354.

PJ Visser , FRJ Verhey , RWHM Ponds , A Kester , J Jolles (2000). Distinction between preclinical dementia and depression. Journal of the American Geriatrics Society 48, 479484.

PJ Visser , FRJ Verhey , P Scheltens , M Cruts , RWHM Ponds , PAM Hofman , CM Van Broeckhoven , J Jolles (2002). Diagnostic accuracy of the Preclinical AD Scale (PAS) in cognitively mildly impaired subjects. Journal of Neurology 249, 312319.

B Winblad , K Palmer , M Kivipelto , V Jelic , L Fratiglioni , LO Wahlund , A Nordberg , L Backman , M Albert , O Almkvist , H Arai , H Basun , K Blennow , M de Leon , C DeCarli , T Erkinjuntti , E Giacobini , C Graff , J Hardy , C Jack , A Jorm , K Ritchie , C van Duijn , P Visser , RC Petersen (2004). Mild cognitive impairment – beyond controversies, towards a consensus: report of the International Working Group on Mild Cognitive Impairment. Journal of Internal Medicine 256, 240246.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Psychological Medicine
  • ISSN: 0033-2917
  • EISSN: 1469-8978
  • URL: /core/journals/psychological-medicine
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Full text views

Total number of HTML views: 1
Total number of PDF views: 23 *
Loading metrics...

Abstract views

Total abstract views: 125 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 26th June 2017. This data will be updated every 24 hours.