Cited by 1,659Dementia and Cognitive Impairment ResearchCancer-related cognitive impairment studiesNeurological Disease Mechanisms and Treatments

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Rate of progression of mild cognitive impairment to dementia – meta‐analysis of 41 robust inception cohort studies

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Mitchell, A. J., Shiri‐Feshki, M.·2009·Acta Psychiatrica Scandinavica

DOI 10.1111/j.1600-0447.2008.01326.x

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Abstract

Objective: To quantify the risk of developing dementia in those with mild cognitive impairment (MCI). Method: Meta‐analysis of inception cohort studies. Results: Forty‐one robust cohort studies were identified. To avoid heterogeneity clinical studies, population studies and clinical trials were analysed separately. Using Mayo defined MCI at baseline and adjusting for sample size, the cumulative proportion who progressed to dementia, to Alzheimer’s disease (AD) and to vascular dementia (VaD) was 39.2%, 33.6% and 6.2%, respectively in specialist settings and 21.9%, 28.9% and 5.2%, respectively in population studies. The adjusted annual conversion rate (ACR) from Mayo defined MCI to dementia, AD and VaD was 9.6%, 8.1% and 1.9%, respectively in specialist clinical settings and 4.9%, 6.8% and 1.6% in community studies. Figures from non‐Mayo defined MCI and clinical trials are also reported. Conclusion: The ACR is approximately 5–10% and most people with MCI will not progress to dementia even after 10 years of follow‐up.

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Early diagnosis of Alzheimer’s disease using combined features from voxel-based morphometry and cortical, subcortical, and hippocampus regions of MRI T1 brain images
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“Predictors of this conversion include whether the patients are carriers of ε4 alleles of the apolipoprotein E (APOE) gene, brain atrophy, clinical severity, patterns of cerebrospinal fluid (CSF) biomarkers, cerebral glucose metabolism, and A(β) deposition [8,9].”
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Neuropsychological tests for the diagnosis of Alzheimer’s disease dementia and other dementias: a generic protocol for cross-sectional and delayed-verification studies
Davis, D. H. J., Creavin, S., Noel-Storr, A., Quinn, T. J., Smailagic, N., Hyde, C., Brayne, C., McShane, R. H., & Cullum, S. J. (2013) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd010460 · Cited by 109
The Link between Obstructive Sleep Apnea and Neurocognitive Impairment: An Official American Thoracic Society Workshop Report
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Elderly-Onset Essential Tremor and Mild Cognitive Impairment: A Population-Based Study (NEDICES)
Benito‐León, J., Louis, E. D., Mitchell, A. J., & Bermejo‐Pareja, F. (2011) · Journal of Alzheimer s Disease · doi:10.3233/jad-2011-101572 · Cited by 106
“MCI is a useful clinical construct, and individuals with MCI should be monitored due to their increased likelihood of progressing to dementia [2].”
Self-citation
Mild Cognitive Impairment that Does Not Progress to Dementia: A Population‐Based Study
Ganguli, M., Jia, Y., Hughes, T. F., Snitz, B. E., Chang, C. H., Berman, S., Sullivan, K., & Kamboh, M. I. (2018) · Journal of the American Geriatrics Society · doi:10.1111/jgs.15642 · Cited by 107
“This pattern, typical of community samples, in contrast to clinic samples, 4,5,9,13,22–24 has been attributed to selection factors.(6) More fundamentally, it reflects different distributions of underlying morbidities and risk factors (the heterogeneity of MCI at the population level).”
Mild cognitive impairment
Visser, P. J., Legdeur, N., ten Kate, M., & Bertens, D. (2017) · Oxford University Press eBooks · doi:10.1093/med/9780198701590.003.0125 · Cited by 106
Mild Cognitive Impairment: Diagnosis and Subtypes
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Alzheimer's Disease and Amnestic Mild Cognitive Impairment Weaken Connections Within the Default-Mode Network: A Multi-Modal Imaging Study
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Progression from normal cognition to mild cognitive impairment in a diverse clinic-based and community-based elderly cohort
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“MCI often represents the earliest form of Alzheimer’s disease (AD), with most estimates ranging from 10%–15% per year [2].”
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Detecting early egocentric and allocentric impairments deficits in Alzheimer’s disease: an experimental study with virtual reality
Serino, S., Morganti, F., Stefano, F. D., & Riva, G. (2015) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2015.00088 · Cited by 109
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The effect of dance interventions on cognition, neuroplasticity, physical function, depression, and quality of life for older adults with mild cognitive impairment: A systematic review and meta-analysis
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“Annual rates for conversion of mild cognitive impairment to dementia of around 10% are quoted but meta-analysis suggests lower conversion over longer follow-up periods [38].”
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Multimodal hyper-connectivity of functional networks using functionally-weighted LASSO for MCI classification
Li, Y., Liu, J., Gao, X., Jie, B., Kim, M., Yap, P., Chong-yaw Wee, A., & Shen, D. G. (2018) · Medical Image Analysis · doi:10.1016/j.media.2018.11.006 · Cited by 101
Conceptual Evolution in Alzheimer's Disease: Implications for Understanding the Clinical Phenotype of Progressive Neurodegenerative Disease
Jicha, G. A., & Carr, S. A. (2010) · Journal of Alzheimer s Disease · doi:10.3233/jad-2010-1237 · Cited by 107
“Reversion or stability rates as high as 70% have been reported [69, 70].”
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Incidence of mild cognitive impairment in the Pittsburgh Cardiovascular Health Study–Cognition Study
López, O. L., Becker, J. T., Chang, Y.-F., Sweet, R. A., DeKosky, S. T., Gach, M. H., Carmichael, O. T., McDade, E., & Kuller, L. H. (2012) · Neurology · doi:10.1212/wnl.0b013e31826e25f0 · Cited by 101
From allo- to egocentric spatial ability in early Alzheimer’s disease: A study with virtual reality spatial tasks
Morganti, F., Stefanini, S., & Riva, G. (2013) · Cognitive Neuroscience · doi:10.1080/17588928.2013.854762 · Cited by 107
“In recent years, Mitchell and Shiri-Feshki (2009) investigated the impairment of ego- and allocentric memory in patients with Mild Cognitive Impairment (MCI), indicating how the early detection of spatial amnesia could be highly informative regarding the possibility of developing AD.”
Background
Cerebral small vessel disease and the risk of Alzheimer’s disease: A systematic review
Liu, Y., Braidy, N., Poljak, A., Chan, D. K. Y., & Sachdev, P. S. (2018) · Ageing Research Reviews · doi:10.1016/j.arr.2018.06.002 · Cited by 107
Chemical sensing platforms for detecting trace-level Alzheimer's core biomarkers
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Profiles of cognitive subtest impairment in the Montreal Cognitive Assessment (MoCA) in a research cohort with normal Mini-Mental State Examination (MMSE) scores
Markwick, A., Zamboni, G., & de Jager, C. A. (2012) · Journal of Clinical and Experimental Neuropsychology · doi:10.1080/13803395.2012.672966 · Cited by 99
“5 compared to healthy elderly ( Mitchell & Shiri-Feshki, 2009 ).”
BackgroundResultInfluential
Identifying Medicare beneficiaries with dementia
Moura, L. M. V. R., Festa, N., Price, M., Volya, M., Benson, N. M., Zafar, S. F., Weiss, M., Blacker, D., Normand, S. T., Newhouse, J. P., et al. (2021) · Journal of the American Geriatrics Society · doi:10.1111/jgs.17183 · Cited by 98
Verbal fluency and risk of dementia
Sutin, A. R., Stéphan, Y., & Terracciano, A. (2019) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.5081 · Cited by 97
Association between enrollment factors and incident cognitive impairment in Blacks and Whites: Data from the Alzheimer's Disease Center
Gleason, C. E., Norton, D., Zuelsdorff, M. L., Benton, S. F., Wyman, M. F., Nystrom, N. C., Lambrou, N. H., Salazar, H., Koscik, R. L., Jonaitis, E. M., et al. (2019) · Alzheimer s & Dementia · doi:10.1016/j.jalz.2019.07.015 · Cited by 98
Impact of Yoga on cognition and mental health among elderly: A systematic review
Chobe, S. V., Chobe, M. P., Metri, K., Patra, S. K., & Raghuram, N. (2020) · Complementary Therapies in Medicine · doi:10.1016/j.ctim.2020.102421 · Cited by 102
Alpha Power and Functional Connectivity in Cognitive Decline: A Systematic Review and Meta-Analysis
Lejko, N., Larabi, D. I., Herrmann, C. S., Aleman, A., & Ćurĉić‐Blake, B. (2020) · Journal of Alzheimer s Disease · doi:10.3233/jad-200962 · Cited by 112
Cognitive Impairment and Disability in Older Japanese Adults
Shimada, H., Makizako, H., Doi, T., Tsutsumimoto, K., Lee, S., & Suzuki, T. (2016) · PLoS ONE · doi:10.1371/journal.pone.0158720 · Cited by 95
“GCI and MCI are closely associated with dementia onset in older adults [27].”
Background
Microstructural White Matter Alterations in Mild Cognitive Impairment and Alzheimer’s Disease
Fu, X., Shrestha, S., Sun, M., Wu, Q., Luo, Y., Zhang, X., Yin, J., & Ni, H. (2019) · Clinical Neuroradiology · doi:10.1007/s00062-019-00805-0 · Cited by 98
A Deep Learning approach for Diagnosis of Mild Cognitive Impairment Based on MRI Images
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“Although MCI does not always lead to dementia, people with MCI, mainly those who complain about memory problems, are more likely to develop AD [1,2].”
Background
Weight Loss Predicts Progression of Mild Cognitive Impairment to Alzheimer’s Disease
Cova, I., Clerici, F., Rossi, A., Cucumo, V., Ghiretti, R., Maggiore, L., Pomati, S., Galimberti, D., Scarpini, E. A., Mariani, C. B., et al. (2016) · PLoS ONE · doi:10.1371/journal.pone.0151710 · Cited by 94
“This rate is slightly higher than that reported in population-based studies [2] but is consistent with what was reported in previous clinical studies, confirming that memory clinics represent selected subpopulations of people with an increased risk of progression to dementia as compared to those included in population…”
Result
Application of Artificial Intelligence techniques for the detection of Alzheimer’s disease using structural MRI images
Zhao, X., Ang, C. K. E., Acharya, U. R., & Cheong, K. H. (2021) · Journal of Applied Biomedicine · doi:10.1016/j.bbe.2021.02.006 · Cited by 96
Effects of music participation for mild cognitive impairment and dementia: A systematic review and meta‐analysis
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“Up to 38% of these adults will go on to develop Alzheimer's within 5 years.(3) The early stages of dementia and Alzheimer's can have devastating outcomes, including cognitive decline,(4) changes in emotional regulation,(5) and decreased social engagement.”
Background
Potentially Modifiable Risk Factors for Dementia and Mild Cognitive Impairment: An Umbrella Review and Meta-Analysis
Jones, A., Ali, M. U., Kenny, M., Mayhew, A., Mokashi, V., He, H. T., Lin, S. H., Yavari, E., Paik, K., Subramanian, D., et al. (2024) · Dementia and Geriatric Cognitive Disorders · doi:10.1159/000536643 · Cited by 114
“While mild NCD is not necessarily progressive, between 30% and 50% of older adults with mild degrees of impaired cognition progress to a major NCD within 5 years [4 – 6].”
Background
Risk of conversion from mild cognitive impairment to dementia in low‐ and middle‐income countries: A systematic review and meta‐analysis
McGrattan, A., Pakpahan, E., Siervo, M., Mohan, D., Reidpath, D. D., Prina, M. A., Allotey, P. A., Zhu, Y., Shulin, C., Yates, J., et al. (2022) · Alzheimer s & Dementia Translational Research & Clinical Interventions · doi:10.1002/trc2.12267 · Cited by 103
“(6) Improving early detection and diagnosis of breast cancer among multi-ethnic rural communities in Malaysia—the implementation of the community education and navigation programme (CENP).”
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“Additionally, a pooled proportion metaanalysis could also result in heterogeneity in methodology to some extent.(50)”
Nonlinear feature transformation and deep fusion for Alzheimer's Disease staging analysis
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“Individuals with amnestic Mild Cognitive Impairment (MCI) condition have been shown to have a high likelihood of progression to AD, with an annual conversion rate of 5− 10% [2].”
Background
Neuropsychiatric Symptoms in Older People with and without Cognitive Impairment
Brodaty, H., Heffernan, M., Draper, B., Reppermund, S., Kochan, N. A., Slavin, M. J., Trollor, J. N., & Sachdev, P. S. (2012) · Journal of Alzheimer s Disease · doi:10.3233/jad-2012-120169 · Cited by 89
“tia but has various outcomes [7].”
Widespread white matter degeneration preceding the onset of dementia
Maier-Hein, K. H., Westin, C., Shenton, M. E., Weiner, M. W., Raj, A., Thomann, P. A., Kikinis, R., Stieltjes, B., & Pasternak, O. (2014) · Alzheimer s & Dementia · doi:10.1016/j.jalz.2014.04.518 · Cited by 89
“Mild cognitive impairment (MCI) is often a pre-stage of Alzheimer’s disease (AD) with a tenfold higher risk of developing dementia compared with healthy subjects (3).”
Alzheimer’s disease polygenic risk score as a predictor of conversion from mild-cognitive impairment
Chaudhury, S. R., Brookes, K. J., Patel, T., Fallows, A., Guetta‐Baranes, T., Turton, J. C., Guerreiro, R. J., Brás, J., Hardy, J., Francis, P. T., et al. (2019) · Translational Psychiatry · doi:10.1038/s41398-019-0485-7 · Cited by 94
Mediterranean diet and cognitive function: From methodology to mechanisms of action
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RETRACTED ARTICLE: Cognitive function assessed by Mini-mental state examination and risk of all-cause mortality: a community-based prospective cohort study
Su, Y., Dong, J., Sun, J., Zhang, Y., Ma, S., Li, M., Zhang, A., Cheng, B., Cai, S., Bao, Q., et al. (2021) · BMC Geriatrics · doi:10.1186/s12877-021-02471-9 · Cited by 90
Retracted
Eye movement analysis and cognitive processing: detecting indicators of conversion to Alzheimer’s disease
Pereira, M. L. G. D. F., Camargo, M. V. Z. D. A., Aprahamian, I., & Forlenza, O. V. (2014) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s55371 · Cited by 90
“1% (clinical settings).(20) Other findings report a more significant association between amnestic (a)MCI groups and the progression to AD.”
Neuroanatomic changes and their association with cognitive decline in mild cognitive impairment: a meta-analysis
Nickl‐Jockschat, T., Kleiman, A., Schulz, J. B., Schneider, F. W., Laird, A. R., Fox, P. T., Eickhoff, S. B., & Reetz, K. (2011) · Brain Structure and Function · doi:10.1007/s00429-011-0333-x · Cited by 86
“A meta-analysis in cohort studies revealed a yearly rate of progression of MCI to dementia of approximately 5–10% (Mitchell and Shiri-Feshki 2009).”
Blood biomarkers for the diagnosis of amnestic mild cognitive impairment and Alzheimer’s disease: A systematic review and meta-analysis
Qu, Y., Ma, Y., Huang, Y., Ou, Y., Shen, X., Chen, S.-D., Dong, Q., Tan, L., & Yu, J. (2021) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2021.07.007 · Cited by 85
Examining the Association between Life-Space Mobility and Cognitive Function in Older Adults: A Systematic Review
Silva, N. A. D., Gregory, M. A., Venkateshan, S., Verschoor, C. P., & Kuspinar, A. (2019) · Journal of Aging Research · doi:10.1155/2019/3923574 · Cited by 89
“In fact, less than 40% of those with mild cognitive impairment have been reported to progress to dementia and Alzheimer’s disease [8].”
Background

Authors: Mitchell, A. J., & Shiri‐Feshki, M.
Affiliations: University of Leicester (GB)
Nottinghamshire Healthcare NHS Foundation Trust (GB)
Corresponding author: Mitchell, A. J.
ORCID: Mitchell, A. J.
Venue: Acta Psychiatrica Scandinavica
Publisher: Wiley
Published: 2009-03-03
Volume: 119
Issue: 4
Pages: 252-265
ISSN: 0001-690X (ISSN-L)
1600-0447
DOI: 10.1111/j.1600-0447.2008.01326.x
OpenAlex: W2052226124
Cited by: 1,659
References: 87
Citations by year: 2026: 84 · 2025: 98 · 2024: 135 · 2023: 118 · 2022: 129 · 2021: 176 · 2020: 165 · 2019: 115 · 2018: 96 · 2017: 86 · 2016: 88 · 2015: 85 · 2014: 62 · 2013: 75 · 2012: 55
FWCI: 5.80
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: Acta Psychiatrica Scandinavica (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
Health Sciences › Medicine › Oncology › Cancer-related cognitive impairment studies
Life Sciences › Neuroscience › Neurology › Neurological Disease Mechanisms and Treatments
Keywords: mild cognitive impairment, dementia progression, Alzheimer's disease, vascular dementia, Mayo criteria
MeSH terms: Aged, Alzheimer Disease, Cognition Disorders, Dementia, Follow-Up Studies, Humans, Middle Aged, Neuropsychological Tests, Severity of Illness Index, Dementia, Vascular, Cohort Studies, Prevalence, Disease Progression

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Rate of progression of mild cognitive impairment to dementia – meta‐analysis of 41 robust inception cohort studies

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