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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Circulating miR-127-3p as a Potential Biomarker for Differential Diagnosis in Frontotemporal Dementia
Piscopo, P., Grasso, M., Puopolo, M., D’Acunto, E., Talarico, G., Crestini, A., Gasparini, M., Campopiano, R., Gambardella, S., Castellano, A. E., et al. (2018) · Journal of Alzheimer’s Disease · doi:10.3233/jad-180364 · Cited by 58
“6% [66], even if an overall 18% rever434 sion rate from MCI to normal control was calculated 435 as well [67].”
Dementia.
Cunningham, E. L., McGuinness, B., Herron, B. M., & Passmore, A. P. (2015) · PubMed · Cited by 68
Imaging‐based enrichment criteria using deep learning algorithms for efficient clinical trials in mild cognitive impairment
Ithapu, V. K., Singh, V., Okonkwo, O. C., Chappell, R. J., Dowling, N. M., Johnson, S. C., & Initiative, A. D. N. (2015) · Alzheimer s & Dementia · doi:10.1016/j.jalz.2015.01.010 · Cited by 63
“dementia among MCI due to AD is 3%–20% across several studies [7], where the relatively lower rates are observed in population-based cohorts and higher rates in clinical settings.”
Background
Behavioral symptoms in mild cognitive impairment as compared with Alzheimer's disease and healthy older adults
der Mussele, S. V., Bastard, N. L., Vermeiren, Y., Saerens, J., Somers, N., Mariën, P., Goeman, J., Deyn, P. P. D., & Engelborghs, S. (2012) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.3820 · Cited by 63
“Mitchell and Shiri-Feshki (2009) confirmed these data in a meta-analysis.”
Background
Conversion from mild cognitive impairment to dementia: Influence of folic acid and vitamin B12 use in the vita cohort
Blasko, I., Hinterberger, M., Kemmler, G., Jungwirth, S., Krampla, W. W., Leitha, T., Tragl, K. H., & Fischer, P. A. (2012) · The journal of nutrition health & aging · doi:10.1007/s12603-012-0051-y · Cited by 63
Acupuncture for Amnestic Mild Cognitive Impairment: A Meta-Analysis of Randomised Controlled Trials
Deng, M., & Wang, X.-F. (2016) · Acupuncture in Medicine · doi:10.1136/acupmed-2015-010989 · Cited by 63
Aplicación práctica de los test cognitivos breves
Olazarán, J., de Hoyos-Alonso, M. C., del Ser, T., Barral, A. G., Conde‐Sala, J. L., Bermejo‐Pareja, F., Pousa, S. L., Pérez-Martínez, D. A., Villarejo‐Galende, A., Cacho, J. L., et al. (2015) · Neurología · doi:10.1016/j.nrl.2015.07.009 · Cited by 63
“La existencia de tratamientos farmacológi-cos y no farmacológicos, tanto preventivos como paliativos, que reducen signiﬁcativamente la carga personal, familiar y implicados 3—6 7—9 10 intervenciones preventivas 2 .”
Does Mild Traumatic Brain Injury Increase the Risk for Dementia? A Systematic Review and Meta-Analysis
Snowden, T. M., Hinde, A. K., Reid, H. M. O., & Christie, B. R. (2020) · Journal of Alzheimer s Disease · doi:10.3233/jad-200662 · Cited by 66
“MCI is a risk factor for further neurodegeneration; for example, a 2009 meta-analysis found a 9.6% annual conversion rate of MCI to dementia in an adjusted clinical setting, and 4.9% in community studies [8].”
Influential
Sum of boxes of the clinical dementia rating scale highly predicts conversion or reversion in predementia stages
Tzeng, R.-C., Yang, Y., Hsu, K.-C., Chang, H.-T., & Chiu, P. (2022) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2022.1021792 · Cited by 68
Complement Biomarkers as Predictors of Disease Progression in Alzheimer’s Disease
Hakobyan, S., Harding, K. E., Aiyaz, M., Hye, A., Dobson, R., Baird, A. L., Liu, B., Harris, C. L., Lovestone, S., & Morgan, B. P. (2016) · Journal of Alzheimer s Disease · doi:10.3233/jad-160420 · Cited by 64
“In our sample set, 328 26% of the MCI cases progressed to dementia at one 329 year; this is markedly higher than published annual 330 conversion rates, typically around 10%, although 331 considerable variation between sample sets has been 332 noted [27].”
Background
Kidney Transplant Outcomes in Recipients With Cognitive Impairment: A National Registry and Prospective Cohort Study
Thomas, A. G., Ruck, J. M., Shaffer, A. A., Haugen, C. E., Ying, H., Warsame, F., Chu, N. M., Carlson, M. C., Gross, A. L., Norman, S. P., et al. (2018) · Transplantation · doi:10.1097/tp.0000000000002431 · Cited by 61
“Although there are no standardized thresholds for cognitive impairment in the KT candidate population, it is common in the literature to use standard deviation (SD) thresholds to define cognitive impairment in novel populations.(24,25) Consistent with this convention, we defined any cognitive impairment as a 3MS score…”
Method
Progression of Subjective Cognitive Decline to MCI or Dementia in Relation to Biomarkers for Alzheimer Disease
Rostamzadeh, A., Bohr, L., Wagner, M., Baethge, C., & Jessen, F. (2022) · Neurology · doi:10.1212/wnl.0000000000201072 · Cited by 61
“The latter findings are similar to conversion rates from MCI to dementia, where progression rates of approximately 60%within 3 years afterMCI diagnosis have been reported.(22)”
Result
Clinical outcomes in older surgical patients with mild cognitive impairment
Racine, A. M., Fong, T. G., Gou, Y., Travison, T. G., Tommet, D., Erickson, K., Jones, R. N., Dickerson, B. C., Metzger, E. D., Marcantonio, E. R., et al. (2017) · Alzheimer s & Dementia · doi:10.1016/j.jalz.2017.10.010 · Cited by 62
“About 1/3 of patients withMCI will progress to ADwithin 10 years [47], and this rate is even higher in individuals with high amyloid deposition, with at least one study suggesting a conversion rate of 82% over 3 years [48].”
Background
Prosaccade and Antisaccade Paradigms in Persons with Alzheimer’s Disease: A Meta-Analytic Review
Levy, N. K., Michal Lavidor, B., & Vakil, E. (2017) · Neuropsychology Review · doi:10.1007/s11065-017-9362-4 · Cited by 62
“Also, eye tracking is often used to evaluate executive functions (Hutton and Ettinger 2006; Leigh and Kennard 2004) including in early-stage AD (Mitchell and Shiri-Feshki 2009).”
Background
Effects of a Mixed Reality-based Cognitive Training System Compared to a Conventional Computer-assisted Cognitive Training System on Mild Cognitive Impairment: A Pilot Study
Park, E., Yun, B., Min, Y.-S., Lee, Y., Moon, S.-J., Huh, J., Cha, H., Chang, Y., & Jung, T. (2019) · Cognitive and Behavioral Neurology · doi:10.1097/wnn.0000000000000197 · Cited by 61
“M ild cognitive impairment (MCI) has been shown to precede dementia in an estimated 5% to 10% of dementia cases each year (Knopman et al, 2015; Mitchell and Shiri-Feshki, 2009).”
Background
Association between alcohol intake, mild cognitive impairment and progression to dementia: a dose–response meta-analysis
Lao, Y., Hou, L., Li, J., Xu, H., Yan, P., & Yang, K. (2020) · Aging Clinical and Experimental Research · doi:10.1007/s40520-020-01605-0 · Cited by 62
“1 3 conservatively estimated at 5–10% per year in a systematic review and meta-analysis [3].”
Background
Accelerated cognitive aging following severe traumatic brain injury: A review
Wood, R. L. (2017) · Brain Injury · doi:10.1080/02699052.2017.1332387 · Cited by 62
“mately 5–10% [96], significantly higher than the incidence rates from normal elderly to dementia (1–2% per year).”
Background
18F PET with florbetapir for the early diagnosis of Alzheimer’s disease dementia and other dementias in people with mild cognitive impairment (MCI)
Martínez, G., Vernooij, R. W. M., Padilla, P. F., Zamora, J., Bonfill, X., & Flicker, L. A. (2017) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012216.pub2 · Cited by 62
Alterations of brain local functional connectivity in amnestic mild cognitive impairment
Zhen, D., Xia, W., Yi, Z.-Q., Zhao, P.-W., Zhong, J., Shi, H.-C., Li, H.-L., Dai, Z.-Y., & Pan, P.-L. (2018) · Translational Neurodegeneration · doi:10.1186/s40035-018-0134-8 · Cited by 57
“Individuals with aMCI are at a high risk for developing Alzheimer’s dementia (AD), which is the most common type of dementia in the elderly and has been a growing public health problem worldwide [2, 3].”
Background
Dementia and Cognitive Impairment Prevalence and Associated Factors in Indigenous Populations: A Systematic Review
de Souza-Talarico, J. N., de Carvalho, A. P., Brucki, S. M. D., Nitrini, R., & Ferretti-Rebustini, R. E. D. L. (2016) · Alzheimer Disease & Associated Disorders · doi:10.1097/wad.0000000000000140 · Cited by 58
“The data extracted were: (1) prevalence of dementia and CIND, or percentage of indigenous people with low cognitive performance as a primary outcome variable; (2) sociodemographic data (age, sex, ethnicity); (3) sample size; (4) neuropsychological tests used; and (5) study design (cross-sectional or longitudinal).”
Method
Factors for predicting reversion from mild cognitive impairment to normal cognition: A meta‐analysis
Xue, H., Hou, P. K., Li, Y., Mao, X., Wu, L., & Liu, Y. (2019) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.5159 · Cited by 63
A New dispersion entropy and fuzzy logic system methodology for automated classification of dementia stages using electroencephalograms
Amézquita-Sánchez, J. P., Mammone, N., Morabito, F. C., & Adeli, H. (2020) · Clinical Neurology and Neurosurgery · doi:10.1016/j.clineuro.2020.106446 · Cited by 58
Validity Evidence for the Research Category, “Cognitively Unimpaired – Declining,” as a Risk Marker for Mild Cognitive Impairment and Alzheimer’s Disease
Koscik, R. L., Hermann, B. P., Allison, S. L., Clark, L. R., Jonaitis, E. M., Mueller, K. D., Betthauser, T. J., Christian, B. T., Du, L., Okonkwo, O. C., et al. (2021) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2021.688478 · Cited by 58
“…groups atrisk for later development of dementia due to AD, the majority of research has focused on individuals with a diagnosis of MCI, as well as those with subjective memory complaints or modifiable risk factors (Mitchell and Shiri-Feshki, 2009; Mitchell et al., 2014; Cooper et al., 2015).”
Background
Depressive symptoms and cognitive impairment: A 10-year follow-up study from the Survey of Health, Ageing and Retirement in Europe
Han, F.-F., Wang, H., Wu, J.-J., Yao, W., Hao, C., & Pei, J.-J. (2021) · European Psychiatry · doi:10.1192/j.eurpsy.2021.2230 · Cited by 64
“Studies have found that people with MCI are at greater risk of dementia, with the annual progression rates 3–5% in community-based populations [7] and 10–15% in clinical settings [8].”
Background
Efficacy and Moderators of Virtual Reality for Cognitive Training in People with Dementia and Mild Cognitive Impairment: A Systematic Review and Meta-Analysis
Papaioannou, T., Voinescu, A., Petrini, K., & Fraser, D. S. (2022) · Journal of Alzheimer s Disease · doi:10.3233/jad-210672 · Cited by 67
“MCI is considered a risk factor for developing dementia while estimates of progression rates are around 5-10% [4].”
The prognosis of mild cognitive impairment: A systematic review and meta‐analysis
Salemme, S., Lombardo, F. L., Lacorte, E., Sciancalepore, F., Remoli, G., Bacigalupo, I., Piscopo, P., Zamboni, G., Rossini, P. M., Cappa, S. F., et al. (2025) · Alzheimer s & Dementia Diagnosis Assessment & Disease Monitoring · doi:10.1002/dad2.70074 · Cited by 58
“However, similar to previous systematic reviews, 10–12 Including studies with long follow-up periods is a further strength of our study, as it improves the characterization of a clinical condition that can progress slowly over time.”
Four-year outcome of mild cognitive impairment: The contribution of executive dysfunction.
Aretouli, E., Tsilidis, K. K., & Brandt, J. (2012) · Neuropsychology · doi:10.1037/a0030481 · Cited by 62
Mild cognitive impairment and dementia in primary care: the value of medical history
Olazarán, J., Torrero, P., Cruz, I., Aparicio, E., Sanz, A., Mula, N., Marzana, G., Cabezon, D., & Begué, C. (2011) · Family Practice · doi:10.1093/fampra/cmr005 · Cited by 58
The impact of social isolation from COVID-19-related public health measures on cognitive function and mental health among older adults: A systematic review and meta-analysis
Prommas, P., Lwin, K. S., Chen, Y. C., Hyakutake, M., Ghaznavi, C., Sakamoto, H., Miyata, H., & Nomura, S. (2022) · Ageing Research Reviews · doi:10.1016/j.arr.2022.101839 · Cited by 57
“Typically, annual conversion rates from MCI to dementia range from 5% to 10% (Mitchell and Shiri-Feshki, 2009) to 10–15% (Mayo Clinic, 2022; Mitchell and Shiri-Feshki, 2009).”
Background
Effects of functional tasks exercise on cognitive functions of older adults with mild cognitive impairment: a randomized controlled pilot trial
Law, L. L. F., Mok, V., & Yau, M. K.-S. (2019) · Alzheimer s Research & Therapy · doi:10.1186/s13195-019-0548-2 · Cited by 57
Protein Intake and Cognitive Function in Older Adults: A Systematic Review and Meta-Analysis
Coelho‐Júnior, H. J., Calvani, R., Landi, F., Picca, A., & Marzetti, E. (2021) · Nutrition and Metabolic Insights · doi:10.1177/11786388211022373 · Cited by 61
High Prevalence of Mild Cognitive Impairment and Alzheimer's Disease in Arabic Villages in Northern Israel: Impact of Gender and Education
Afgin, A. E., Massarwa, M., Schechtman, E., Israeli‐Korn, S., Strugatsky, R., Abuful, A., Farrer, L. A., Friedland, R. P., & Inzelberg, R. (2012) · Journal of Alzheimer s Disease · doi:10.3233/jad-2011-111667 · Cited by 56
“8% [47–49].”
C‐type lectin‐like receptor 2 and zonulin are associated with mild cognitive impairment and Alzheimer's disease
Wang, X., Liu, G., Gao, Q., Li, N., & Wang, R. (2020) · Acta Neurologica Scandinavica · doi:10.1111/ane.13196 · Cited by 51
Brain-Derived Neurotrophic Factor: the Link Between Amyloid-β and Memory Loss
Fahnestock, M. L. (2011) · Future Neurology · doi:10.2217/fnl.11.44 · Cited by 57
Mild cognitive impairment (MCI) twenty years on
Ritchie, K. A., & Ritchie, C. W. (2011) · International Psychogeriatrics · doi:10.1017/s1041610211002067 · Cited by 55
“The application of the concept to general practice and general population samples has subsequently shown cumulative conversion rates to any type of dementia – even after long-term follow-up – to be only around 30%, with high rates of reversion to normal, and many subjects classified as non-MCI subsequently developing…”
Background
Utility of the Mini-Cog for Detection of Cognitive Impairment in Primary Care: Data from Two Spanish Studies
Pardo, C. C., Cruz, I., Espejo-Martínez, B., Martos-Aparicio, C., López-Alcalde, S., & Olazarán, J. (2013) · International Journal of Alzheimer s Disease · doi:10.1155/2013/285462 · Cited by 61
“The aging of the population has come along with an increase in the incidence of cognitive impairment (CI) [1], a clinical syndrome that, in about one-third of the patients, precedes dementia [2].”
Background
The trajectory of cognitive decline in the pre-dementia phase in memory clinic visitors: findings from the 4C-MCI study
Hamel, R. E. G., Köhler, S., Sistermans, N., Koene, T., Pijnenburg, Y. A. L., van der Flier, W. M., Scheltens, P., Aalten, P., Verhey, F. R. J., Visser, P. J., et al. (2014) · Psychological Medicine · doi:10.1017/s0033291714002645 · Cited by 60
“However, when we compare our conversion rate (21.3% over a mean period of 2.7 years) with the established conversion estimates in a systematic review (6.5%/year) (Mitchell & Shiri-Feshki, 2009) our ratio corresponds to the established estimates.”
BackgroundResultInfluential
Mild cognitive impairment in older adults with pre‐dialysis patients with chronic kidney disease: Prevalence and association with physical function
Otobe, Y., Hiraki, K., Hotta, C., Nishizawa, H., Izawa, K. P., Taki, Y., Imai, N., Sakurada, T., & Shibagaki, Y. (2017) · Nephrology · doi:10.1111/nep.13173 · Cited by 55
“community-dwelling older adults with MCI will progress to dementia.(11) However, 14–44% of community-dwelling”
Background
Predicting conversion from mild cognitive impairment to Alzheimer's disease using brain 1H-MRS and volumetric changes: A two- year retrospective follow-up study
Mitolo, M., Maserati, M. S., Capellari, S., Testa, C. M., Rucci, P., Poda, R., Oppi, F., Gallassi, R., Sambati, L., Rizzo, G., et al. (2019) · NeuroImage Clinical · doi:10.1016/j.nicl.2019.101843 · Cited by 55
“T ranging from the development of Alzheimer's Disease (AD) or non-AD dementias to the stabilization or even reversion of cognitive impairments (Mitchell and Shiri-Feshki, 2009).”
Background
Selective memory and behavioral alterations after ambient ultrafine particulate matter exposure in aged 3xTgAD Alzheimer’s disease mice
Jew, K., Herr, D., Wong, C., Kennell, A., Morris‐Schaffer, K., Oberdörster, G., O’Banion, M. K., Cory‐Slechta, D. A., & Elder, A. C. P. (2019) · Particle and Fibre Toxicology · doi:10.1186/s12989-019-0323-3 · Cited by 55
Towards a Redefinition of Cognitive Frailty
Mantovani, E., Zucchella, C., Schena, F. F., Romanelli, M. G., Venturelli, M., & Tamburin, S. (2020) · Journal of Alzheimer s Disease · doi:10.3233/jad-200137 · Cited by 56
“eral population (1–2%) of conversion to dementia [48, 49].”
Background
Urban-rural differences in the prevalence and correlates of mild cognitive impairment in community-dwelling older adults in Taiwan: The EMCIT study
Chuang, Y., Liu, Y., Tseng, H.-Y., Lin, P.-X., Li, C.-Y., Shih, M., Lin, K., Yang, T. O., Yan, S., & Chiu, Y. (2021) · Journal of the Formosan Medical Association · doi:10.1016/j.jfma.2021.03.005 · Cited by 57
The Effects of Transcutaneous Vagus Nerve Stimulation on Functional Connectivity Within Semantic and Hippocampal Networks in Mild Cognitive Impairment
Murphy, A. J., O’Neal, A. G., Cohen, R. A., Lamb, D. G., Porges, E. C., Bottari, S. A., Ho, B., Trifilio, E. R., DeKosky, S. T., Heilman, K. M., et al. (2022) · Neurotherapeutics · doi:10.1007/s13311-022-01318-4 · Cited by 57
“Not all patients with MCI progress to AD, depending on the population from whom subjects are selected, the number of MCI cases that progress to AD vary from 5 to 40% (highest in populations like the population from which research clinics draw) [67].”
Background
Comorbid Depression and Diabetes as a Risk for Mild Cognitive Impairment and Alzheimer’s Disease in Elderly Mexican Americans
Johnson, L. A., Gamboa, A., Vintimilla, R., Cheatwood, A. J., Grant, A., Trivedi, A., Edwards, M., Hall, J. R., & O’Bryant, S. E. (2015) · Journal of Alzheimer s Disease · doi:10.3233/jad-142907 · Cited by 54
“dementia of 5–10% [4], is considered an intermediate”

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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