Progression and improvement after mild cognitive impairment

Objective

We studied progression to dementia and improvement rates of mild cognitive impairment (MCI) to help clinicians decide whether or not to screen older people for MCI.

Method

Prospective cohort study in which 156 vulnerable patients with (n = 24) and without (n = 132) MCI are followed and reassessed after two years with MMSE and Camdex.

Results

Nine (38%) out of 24 patients initially diagnosed with MCI and 20 (15%) out of 132 considered normal or depressed progressed to dementia within two years. This results in a relative risk of progression of 2.48 (95% confidence interval = 1.29-4.77), a sensitivity of 31%(95%CI = 16-51) and a predictive value of 38% (95%CI = 20-59). Out of 24 people with MCI at baseline, 8 (33%; 95%CI = 16-55) had improved at follow-up.

Conclusion

The low sensitivity of MCI for subsequent occurrence of dementia and the high improvement rate found in our study as well as by others, and the absence of a proven therapy, provide cumulative evidence against screening for MCI.