Mild cognitive impairment due to Alzheimer disease in the community
Open accessAbstract
Objective: The newly proposed National Institute on Aging–Alzheimer's Association (NIA‐AA) criteria for mild cognitive impairment (MCI) due to Alzheimer disease (AD) suggest a combination of clinical features and biomarker measures, but their performance in the community is not known. Methods: The Mayo Clinic Study of Aging (MCSA) is a population‐based longitudinal study of nondemented subjects in Olmsted County, Minnesota. A sample of 154 MCI subjects from the MCSA was compared to a sample of 58 amnestic MCI subjects from the Alzheimer's Disease Neuroimaging Initiative 1 (ADNI‐1) to assess the applicability of the criteria in both settings and to assess their outcomes. Results: Fourteen percent of MCSA and 16% of ADNI‐1 of subjects were biomarker negative. In addition, 14% of MCSA and 12% of ADNI‐1 subjects had evidence for amyloid deposition only, whereas 43% of MCSA and 55% of ADNI‐1 subjects had evidence for amyloid deposition plus neurodegeneration (magnetic resonance imaging atrophy, fluorodeoxyglucose positron emission tomography hypometabolism, or both). However, a considerable number of subjects had biomarkers inconsistent with the proposed AD model; for example, 29% of MCSA subjects and 17% of ADNI‐1 subjects had evidence for neurodegeneration without amyloid deposition. These subjects may not be on an AD pathway. Neurodegeneration appears to be a key factor in predicting progression relative to amyloid deposition alone. Interpretation: The NIA‐AA criteria apply to most MCI subjects in both the community and clinical trials settings; however, a sizeable proportion of subjects had conflicting biomarkers, which may be very important and need to be explored. Ann Neurol 2013;74:199–208
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The rate of cognitive decline is significantly greater for cognitively impaired and CU individuals who have abnormalities in both an amyloid biomarker and a second biomarker type (CSF T-tau or P-tau, atrophy, or hypometabolism) in comparison to individuals who have neither or only one of these biomarker abnormalities.
“The rate of cognitive decline is significantly greater for cognitively impaired and CU individuals who have abnormalities in both an amyloid biomarker and a second biomarker type (which could be CSF T-tau or P-tau, atrophy, or hypometabolism) in comparison to individuals who have neither or only one of these biomarker abnormalities [30–35,39,40,42–45].”
From NIA‐AA Research Framework: Toward a biological definition of Alzheimer's disease (2018) · cites this paper as [39]
The Results report that, among participants with MCI, progression to dementia was most common in the amyloid-plus-neurodegeneration and neurodegeneration-only groups. The Discussion says the neurodegeneration-only group had the highest progression rate in the community cohort, although the difference was not statistically significant. The paper does not establish the claimed significantly faster cognitive decline across both cognitively impaired and cognitively unimpaired people; the Methods also state that CSF biomarkers were unavailable. (LLM, conf=0.88)
Experimental — accuracy not yet measuredThe combination of an abnormal MRI, CSF T-tau, or FDG PET study with an abnormal amyloid biomarker provides much more powerful prediction of future cognitive decline than an abnormal amyloid study alone.
“However, the combination of an abnormal MRI, CSF T-tau, or FDG PET study with an abnormal amyloid biomarker provides much more powerful prediction of future cognitive decline [30–35,39,40,42–45] than an abnormal amyloid study alone.”
From NIA‐AA Research Framework: Toward a biological definition of Alzheimer's disease (2018) · cites this paper as [39]
The Results (page unavailable) report that, in both MCI cohorts, progression to dementia was most frequent in the amyloid-plus-neurodegeneration and neurodegeneration-only groups, and did not occur in the amyloid-only group. The study used MRI and FDG PET measures, but its Methods (page unavailable) state that CSF was not available. It therefore does not support the CSF T-tau part of the claim, and its outcome was progression to dementia rather than cognitive decline generally. (LLM, conf=0.88)
Experimental — accuracy not yet measuredStudies using PET scans to assess Alzheimer's disease biomarkers have reported that about half of people with mild cognitive impairment have Alzheimer's-related brain changes.
“studies assessing biomarkers for Alzheimer's disease with PET scans have reported that about half of people with MCI have Alzheimer's-related brain changes.230,231”
From 2023 Alzheimer's disease facts and figures (2023) · cites this paper as [230]
Studies assessing biomarkers for Alzheimer's disease with PET scans have reported that about half of people with MCI have Alzheimer's-related brain changes.
“Meanwhile, studies assessing biomarkers for Alzheimer's disease with PET scans have reported that about half of people with MCI have Alzheimer's‐related brain changes.”
From 2024 Alzheimer's disease facts and figures (2024) · cites this paper as [246]
MCI with negative biomarkers versus 1 or more AD pathology biomarkers or biomarkers of neurodegeneration has a 2 to 3 relative risk of progression to dementia (8% vs 17%-22% per year).
“MCI with negative biomarkers versus 1 or more AD pathology biomarkers (ie, AD pattern in CSF, high amyloid load in amyloid PET) or biomarkers of neurodegeneration (eg, AD pattern on structural MRI or fluorodeoxyglucose [FDG]-PET; high CSF tau and phospho-tau levels) has a 2 to 3 relative risk of progression to dementia (8% vs 17%-22% per year 33 ).”
From The Alzheimer’s Disease Clinical Spectrum (2019) · cites this paper as [33]
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Self-citation
- Authors
- Petersen, R. C., Aisen, P., Boeve, B. F., Geda, Y. E., Ivnik, R. J., Knopman, D. S., Mielke, M., Pankratz, V. S., Roberts, R., Rocca, W. A., Weigand, S., Weiner, M., Wiste, H., & Jack, C. R.
- Affiliations
- Mayo Clinic (US)
- University of California San Diego (US)
- University of California, San Francisco (US)
- Corresponding author
- Petersen, Ronald C.
- ORCID
- Venue
- Annals of Neurology
- Publisher
- Wiley
- Published
- 2013-08
- Volume
- 74
- Issue
- 2
- Pages
- 199-208
- ISSN
- 0364-5134 (ISSN-L)
- 1531-8249
- PMC
- PMC3804562
- OpenAlex
- W1559001474
- Cited by
- 265
- References
- 51
- Citations by year
- 2026: 11 · 2025: 11 · 2024: 15 · 2023: 13 · 2022: 16 · 2021: 21 · 2020: 18 · 2019: 31 · 2018: 25 · 2017: 26 · 2016: 28 · 2015: 25 · 2014: 18 · 2013: 7
- FWCI
- 18.42
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Annals of Neurology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institutes of Health (5u01ag024904-10)
- Canadian Institutes of Health Research
- National Institute on Aging (U01-AG-024904, R01AG034676, P30AG010129, U01AG006786, K01AG030514, R01AG011378, R01AG041851, P50AG016574)
- 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, NIA-AA criteria, amyloid deposition, neurodegeneration, biomarkers, amyloid PET, FDG-PET hypometabolism, brain atrophy, conversion to dementia, Mayo Clinic Study of Aging, non-demented elderly
- MeSH terms
- Aged, Aged, 80 and over, Aging, Alzheimer Disease, Amyloid, Female, Humans, Male, Neuropsychological Tests, Random Allocation, Residence Characteristics, Biomarkers, Cognitive Dysfunction
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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