CoChat
Sign Up
Cited by 823Dementia and Cognitive Impairment ResearchCancer-related cognitive impairment studiesPsychological Testing and Assessment

Quantification of Five Neuropsychological Approaches to Defining Mild Cognitive Impairment

Open access
Jak, Amy J., Bondi, Mark W., Delano-Wood, Lisa, Wierenga, Christina, Corey-Bloom, Jody, Salmon, David P., Delis, Dean C.·2009·The American Journal of Geriatric Psychiatry
DOI 10.1097/jgp.0b013e31819431d5PMC PMC2743175
Open this paper in CoChat — free account

Abstract

Objectives Operational definitions of cognitive impairment have varied widely in diagnosing mild cognitive impairment (MCI). Identifying clinical subtypes of MCI has further challenged diagnostic approaches because varying the components of the objective cognitive assessment can significantly impact diagnosis. Therefore, the authors investigated the applicability of diagnostic criteria for clinical subtypes of MCI in a naturalistic research sample of community elders and quantified the variability in diagnostic outcomes that results from modifying the neuropsychological definition of objective cognitive impairment. Design Cross-sectional and longitudinal study. Setting San Diego, CA, Veterans Administration Hospital. Participants Ninety nondemented, neurologically normal, community-dwelling older adults were initially assessed and 73 were seen for follow-up approximately 17 months later. Measurements Participants were classified via consensus diagnosis as either normally aging or having MCI via each of the five diagnostic strategies, which varied the cutoff for objective impairment and the number of neuropsychological tests considered in the diagnostic process. Results A range of differences in the percentages identified as MCI versus cognitively normal were demonstrated, ranging from 10-74%, depending on the classification criteria used. A substantial minority of individuals demonstrated diagnostic instability over time and across diagnostic approaches. The single domain nonamnestic subtype diagnosis was particularly unstable (e.g., prone to reclassification as normal at follow up). Conclusion Our findings provide empirical support for a neuropsychologically derived operational definition of clinical subtypes of MCI and point to the importance of using comprehensive neuropsychological assessments. Diagnoses, particularly involving nonamnestic MCI, were variable over time. The applicability and utility of this particular MCI subtype warrants further investigation.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1097/jgp.0b013e31819431d5

Cites

4 of 4 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • The percentage of older adults classified as MCI ranges greatly from 11% to 74% depending on the number of tests considered in the diagnosis and the cutoffs used to define objective cognitive impairment.

    “Jak and Bondi and colleagues [24, 25] have found that the percentage of older adults classified as MCI ranges greatly from 11% to 74% depending on the number of tests considered in the diagnosis and the cutoffs used to define objective cognitive impairment (see also [26]).”

    From Neuropsychological Criteria for Mild Cognitive Impairment Improves Diagnostic Precision, Biomarker Associations, and Progression Rates (2014) · cites this paper as [25]

    The Results report that 10–74% of participants were classified as MCI depending on the diagnostic strategy, not 11–74%. The Methods describe those strategies as differing in the number of impaired tests required and the cutoff used to define impairment. Thus the explanation and upper bound are supported, but the stated lower bound differs from our copy. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Several studies suggest that a cut-point for impairment of -1 SD below normative means provides an optimal balance of sensitivity and specificity.

    “and several studies suggest that a cut-point for impairment of -1 SD below normative means provides an optimal balance of sensitivity and specificity [25, 44, 45].”

    From Neuropsychological Criteria for Mild Cognitive Impairment Improves Diagnostic Precision, Biomarker Associations, and Progression Rates (2014) · cites this paper as [25]

    The Methods (§2.3; page unavailable) say the authors adopted a −1 SD cutoff as part of comprehensive criteria requiring impairment on at least two tests within a cognitive domain. The Comment (§4; page unavailable) says those combined criteria may offer a better balance of sensitivity and specificity, but does not establish that the −1 SD cut-point alone provides an optimal balance. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 22

  1. [2]Petersen RC Doody RS Kurz A Current Concepts in Mild Cognitive Impairment Arch Neurol 2001 58 12 1985 1992 11735772
  2. [3]Petersen RC Morris JC Mild cognitive impairment as a clinical entity and treatment target Arch Neurol 2005 62 1160 1163 16009779
  3. [5]Tabert MH Manly JJ Liu X Neuropsychological prediction of conversion to alzheimer disease in patients with mild cognitive impairment Arch Gen Psychiatry 2006 63 8 916 924 16894068
  4. [6]Busse A Hensel A Guhne U Angermeyer MC Riedel-Heller SG Mild cognitive impairment: Long-term course of four clinical subtypes Neurology 2006 67 12 2176 2185 17190940
  5. [8]Bickel H Mösch E Seigerschmidt E Siemen M Förstl H Prevalence and Persistence of Mild Cognitive Impairment among Elderly Patients in General Hospitals Dement Geriatr Cogn Disord 2006 21 4 242 250 16465052
  6. [9]Zanetti M Ballabio C Abbate C Cutaia C Vergani C Bergamaschini L Mild Cognitive Impairment Subtypes and Vascular Dementia in Community-Dwelling Elderly People: A 3-Year Follow-Up Study J Am Geriatr Soc 2006 54 4 580 586 16686866
  7. [10]Smith G Machulda M Kantarci K Tuokko HA Hultsch DF A perspective from the Mayo Clinic Mild Cognitive Impairment: International Perspectives 2006 131 162 Taylor & Francis New York
  8. [14]Alladi S Arnold R Mitchell J Nestor PJ Hodges JR Mild cognitive impairment: applicability of research criteria in a memory clinic and characterization of cognitive profile Psychol Med 2006 36 4 1 9 16426486
  9. [15]Kramer JH Nelson A Johnson JK Multiple Cognitive Deficits in Amnestic Mild Cognitive Impairment Dement Geriatr Cogn Disord 2006 22 4 306 311 16931884 PMC2631274
  10. [16]Lopez OL Becker JT Jagust WJ Neuropsychological characteristics of mild cognitive impairment subgroups J Neurol Neurosurg Psychiatry 2006 77 2 159 165 16103044 PMC2077558
  11. [17]Portet F Ousset PJ Visser PJ Mild cognitive impairment (MCI) in medical practice: a critical review of the concept and new diagnostic procedure. Report of the MCI Working Group of the European Consortium on Alzheimer's Disease J Neurol Neurosurg Psychiatry 2006 77 6 714 718 16549412 PMC2077456
  12. [18]Ritchie K Artero S Touchon J Classification criteria for mild cognitive impairment: A population-based validation study Neurology 2001 56 1 37 42 11148233
  13. [19]Petersen RC Mild cognitive impairment as a diagnostic entity J Intern Med 2004 256 183 194 15324362
  14. [20]Yaffe K Petersen RC Lindquist K Kramer J Miller B Subtype of Mild Cognitive Impairment and Progression to Dementia and Death Dement Geriatr Cogn Disord 2006 22 4 312 319 16940725
  15. [23]Yesavage JA Brink TL Rose TL Development and validation of a geriatric depression screening scale: a preliminary report Journal of Psychiatr Res 1982 17 1 37 49 7183759
  16. [24]Loewenstein DA Acevedo A Agron J Duara R Stability of Neurocognitive Impairment in Different Subtypes of Mild Cognitive Impairment Dement Geriatr Cogn Disord 2007 23 2 82 86 17124415
  17. [25]Storandt M Grant EA Miller JP Morris JC Longitudinal course and neuropathologic outcomes in original vs revised MCI and in pre-MCI Neurology 2006 67 467 473 16894109
  18. [30]Reitan RM Wolfson D The Halstead-Reitan Neuropsychological Test Battery 1985 Neuropsychology Press Tucson, AZ
  19. [34]Lineweaver TT Bondi MW Thomas RG Salmon DP A normative study of Nelson's (1976) modified version of the Wisconsin Card Sorting Test in healthy older adults The Clin Neuropsychol 1999 13 3 328 347 10726604
  20. [36]Reitan RM Wolfson D The Halstead-Reitan Neuropsychological Test Battery 1985 Neuropsychology Press Tucson, AZ
  21. [37]Norman MA Evan JD Miller WS Heaton RK Demographically corrected norms for the California Verbal Learning Test J Clini Exp Neuropsychol 2000 22 1 80 95 10649547
  22. [38]Gladsjo JA Schuman CC Evans JD Peavy GM Miller SW Heaton RK Norms for Letter and Category Fluency: Demographic Corrections for Age, Education, and Ethnicity Assessment 1999 6 2 147 178 10335019

Cited by

Sorted by citations

Authors
Jak, A. J., Bondi, M. W., Delano-Wood, L., Wierenga, C., Corey-Bloom, J., Salmon, D. P., & Delis, D. C.
Affiliations
University of California San Diego (US)
Corresponding author
Jak, Amy J.
ORCID
Venue
The American Journal of Geriatric Psychiatry
Publisher
Elsevier BV
Published
2009-05
Volume
17
Issue
5
Pages
368-375
ISSN
1064-7481 (ISSN-L)
DOI
10.1097/jgp.0b013e31819431d5
PMC
PMC2743175
OpenAlex
W2006859518
Cited by
823
References
4
Citations by year
2026: 64 · 2025: 96 · 2024: 92 · 2023: 80 · 2022: 81 · 2021: 77 · 2020: 70 · 2019: 54 · 2018: 36 · 2017: 29 · 2016: 31 · 2015: 20 · 2014: 26 · 2013: 21 · 2012: 15
FWCI
9.07
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • American Journal of Geriatric Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute on Aging (P50AG005131, R01AG012674, K24 AG26431, R01 AG12674, K24AG026431, P50-AG05131)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cancer-related cognitive impairment studies
  • Social Sciences › Psychology › Applied Psychology › Psychological Testing and Assessment
Keywords
mild cognitive impairment, non-amnestic MCI, amnestic MCI, diagnostic instability, reclassification, older adults, neuropsychological assessment, cognitive aging, community-dwelling older adults
MeSH terms
Aged, Aged, 80 and over, Cognition Disorders, Cross-Sectional Studies, Female, Humans, Longitudinal Studies, Male, Middle Aged, Neuropsychological Tests, Neuropsychology, Psychiatric Status Rating Scales, Psychometrics, Residence Characteristics, Geriatric Assessment

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 ›

Are you an author, or do you see a problem with this page? Request a review