Mild cognitive impairment can be distinguished from Alzheimer disease and normal aging for clinical trials
Abstract
BACKGROUND: Mild cognitive impairment (MCI) represents a transitional state between the cognitive changes of normal aging and very early dementia and is becoming increasingly recognized as a risk factor for Alzheimer disease (AD). The Memory Impairment Study (MIS) is a multicenter clinical trial in patients with MCI designed to evaluate whether vitamin E or donepezil is effective at delaying the time to a clinical diagnosis of AD. OBJECTIVE: To describe the baseline characteristics of patients with MCI recruited for the MIS and compare them with those of elderly controls and patients with AD in another clinical trial. DESIGN: Descriptive and comparative study of patients with MCI participating in a multicenter clinical trial. SETTING: Memory disorder centers in the United States and Canada. PATIENTS: A total of 769 patients with MCI, 107 cognitively normal elderly controls, 122 patients with very mild AD (Clinical Dementia Rating [CDR] 0.5), and 183 patients with mild AD (CDR 1.0) were evaluated. Patients in the MIS met operational criteria for amnestic MCI. Controls were recruited in parallel with the MCI group, underwent the same assessments, and had a CDR of 0. MAIN OUTCOME MEASURES: Clinical, neuropsychologic, functional, neuroimaging, and genetic measures. RESULTS: Mean +/- SD Alzheimer's Disease Assessment Scale-Cognitive Subscale scores were 5.6 +/- 3.3 for controls, 11.3 +/- 4.4 for patients with MCI, 18.0 +/- 6.2 for the AD CDR 0.5 group, and 25.2 +/- 8.8 for the AD CDR 1.0 group. Compared with controls, patients with MCI were most impaired on memory tasks, with less severe impairments in other cognitive domains. Patients with MCI were more likely than controls but less likely than patients with AD to carry the apolipoprotein E epsilon4 allele. Patients with MCI had hippocampal volumes that were intermediate between those of controls and patients with AD. CONCLUSIONS: Patients with MCI had a predominant memory impairment with relative sparing of other cognitive domains and were intermediate between clinically normal individuals and patients with AD on cognitive and functional ratings. These results demonstrate the successful implementation of operational criteria for this unique group of at-risk patients in a multicenter clinical trial.
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Mild cognitive impairment could be considered a prodromal phase, representing a transitional condition between healthy aging and very mild Alzheimer's disease.
“MCI could be considered a prodromal phase, representing a transitional condition between healthy aging and very mild AD [28].”
From Multi-Target Mechanisms of Phytochemicals in Alzheimer’s Disease: Effects on Oxidative Stress, Neuroinflammation and Protein Aggregation (2022) · cites this paper as [28]
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- Authors
- Grundman, M.
- Affiliations
- University of California San Diego (US)
- Corresponding author
- Grundman, Michael
- Venue
- Archives of Neurology
- Publisher
- American Medical Association (AMA)
- Published
- 2004-01-01
- Volume
- 61
- Issue
- 1
- Pages
- 59
- ISSN
- 0003-9942 (ISSN-L)
- OpenAlex
- W2112436745
- Cited by
- 972
- References
- 34
- Citations by year
- 2026: 15 · 2025: 19 · 2024: 34 · 2023: 34 · 2022: 37 · 2021: 60 · 2020: 52 · 2019: 49 · 2018: 44 · 2017: 52 · 2016: 37 · 2015: 42 · 2014: 51 · 2013: 62 · 2012: 47
- FWCI
- 32.14
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Neurology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Aging (AG 010483, U19AG010483)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cancer-related cognitive impairment studies
- Keywords
- mild cognitive impairment, Alzheimer's disease, normal aging, amnestic MCI, memory impairment, APOE ε4, hippocampal volume, Clinical Dementia Rating, vitamin E, donepezil, dementia risk, inclusion and exclusion criteria
- MeSH terms
- Aged, Aging, Alzheimer Disease, Brain, Clinical Trials as Topic, Cognition Disorders, Female, Humans, Magnetic Resonance Imaging, Male, Neuropsychological Tests, Risk Factors
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