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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Chambers, L. W., Sivananthan, S., & Brayne, C. (2017) · Advances in Preventive Medicine · doi:10.1155/2017/9708413 · Cited by 36
“As many as 40% of individuals assessed as ‘mild cognitive impairment no dementia’may remain the same in the following five years and many improve [38, 39].”
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Alcohol Use Disorder and Dementia: A Review
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“57 Among patients with documented MCI, one-third progress to a diagnosis of Alzheimer’s disease, 58 which requires the presence of autopsy-detected neuritic plaques and neurofibrillary tangles.”
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Risk factors for incident dementia in the very old
Wallin, K., Boström, G., Kivipelto, M., & Gustafson, Y. (2013) · International Psychogeriatrics · doi:10.1017/s1041610213000409 · Cited by 34
“MCI as a diagnosis in the continuum toward dementia has been controversial, since subjects with MCI have been shown to proceed toward dementia, remain in the MCI group, or even in some cases to move toward normal cognition (Mitchell and Shiri-Feshki, 2009).”
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RETRACTED: Cognitive Frailty: Mechanisms, Tools to Measure, Prevention and Controversy
Fougère, B., Delrieu, J., del Campo, N., Soriano, G., Sourdet, S., & Vellas, B. J. (2017) · Clinics in Geriatric Medicine · doi:10.1016/j.cger.2017.03.001 · Cited by 35
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Severity of Depression Impacts Imminent Conversion from Mild Cognitive Impairment to Alzheimer’s Disease
Defrancesco, M., Marksteiner, J., Kemmler, G., Fleischhacker, W. W., Blasko, I., & Deisenhammer, E. (2017) · Journal of Alzheimer s Disease · doi:10.3233/jad-161135 · Cited by 33
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The effects of repetitive transcranial magnetic stimulation in older adults with mild cognitive impairment: a protocol for a randomized, controlled three-arm trial
Taylor, J. L., Hambro, B. C., Strossman, N. D., Bhatt, P., Hernandez, B., Ashford, J. W., Cheng, J. J., Iv, M., Adamson, M. M., Lazzeroni, L. C., et al. (2019) · BMC Neurology · doi:10.1186/s12883-019-1552-7 · Cited by 35
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Zeng, Q., Initiative, A. F. T. A. D. N., Li, K., Luo, X., Wang, S., Xu, X., Li, Z., Zhang, T., Liu, X., Fu, Y., et al. (2020) · Journal of Alzheimer s Disease · doi:10.3233/jad-200775 · Cited by 35
Disparities in Subjective Cognitive Impairment by Sexual Orientation and Gender in a National Population Based Study of U.S. Adults, 2013–2018
Fredriksen‐Goldsen, K. I., Jung, H. H., Kim, H., Petros, R., & Emlet, C. A. (2021) · Journal of Aging and Health · doi:10.1177/08982643211046466 · Cited by 35
“A meta-analysis revealed that about 40% of those with mild cognitive impairment developed dementia within 5 years (Mitchell & Shiri-Feshki, 2009).”
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Apathy as a Predictor for Conversion From Mild Cognitive Impairment to Dementia: A Systematic Review and Meta-Analysis of Longitudinal Studies
Fresnais, D., Humble, M. B., Bejerot, S., Meehan, A. D., & Fure, B. (2022) · Journal of Geriatric Psychiatry and Neurology · doi:10.1177/08919887221093361 · Cited by 37
“The number of patients presenting with apathy symptoms at baseline and the conversion rates from MCI to dementia are in line with what is reported in the literature.(41) Most studies used standard diagnostic criteria for MCI and dementia although diagnostic criteria varied between studies.”
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DNA-repair in mild cognitive impairment and Alzheimer's disease
Bucholtz, N., & Demuth, I. (2013) · DNA Repair · doi:10.1016/j.dnarep.2013.07.005 · Cited by 34
Toward Prevention of Mild Cognitive Impairment in Older Adults With Depression: An Observational Study of Potentially Modifiable Risk Factors
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New horizons in the diagnosis and management of Alzheimer’s Disease in older adults
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“In practice, MCI has an annual conversion rate to dementia of 5–20% [23, 24]; however, cognitive performance may deteriorate, remain stable, or even improve over time [25].”
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Patterns of cognitive domain abnormalities enhance discrimination of dementia risk prediction: The ARIC study
Knopman, D. S., Pike, J. R., Gottesman, R. F., Sharrett, A. R., Windham, B. G., Mosley, T. H., Sullivan, K., Albert, M., Walker, K. A., Yaşar, S., et al. (2024) · Alzheimer s & Dementia · doi:10.1002/alz.13876 · Cited by 30
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Oh, E., & Lee, A. Y. (2016) · Journal of the Korean Neurological Association · doi:10.17340/jkna.2016.3.1 · Cited by 33
Combination of Hippocampal Volume and Cerebrospinal Fluid Biomarkers Improves Predictive Value in Mild Cognitive Impairment
Eckerström, C., Andréasson, U., Olsson, E., Rolstad, S., Blennow, K., Zetterberg, H., Malmgren, H., Edman, Å., & Wallin, A. (2010) · Dementia and Geriatric Cognitive Disorders · doi:10.1159/000289814 · Cited by 32
“Community studies have found that 23p of MCI patients convert to dementia by an annual conversion rate of 5p, whereas the majority of patients convert to Alzheimer’s disease (AD) [”
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Predicting conversion to dementia in a memory clinic: A standard clinical approach compared with an empirically defined clustering method (latent profile analysis) for mild cognitive impairment subtyping
McGuinness, B., Barrett, S., McIlvenna, J., Passmore, A. P., & Shorter, G. W. (2015) · Alzheimer s & Dementia Diagnosis Assessment & Disease Monitoring · doi:10.1016/j.dadm.2015.10.003 · Cited by 36
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“At clinical followup almost all participants were again diagnosed with MCI while two participants progressed to AD (corresponding to an annual conversion rate of 8%, which is in line with the current literature; e.g., Mitchell and Shiri-Feshki, 2009).”
Test-retest variability of resting-state networks in healthy aging and prodromal Alzheimer's disease
Conwell, K., von Reutern, B., Richter, N., Kukolja, J., Fink, G. R., & Onur, O. A. (2018) · NeuroImage Clinical · doi:10.1016/j.nicl.2018.06.016 · Cited by 32
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Cummings, J. L., Passmore, P., McGuinness, B., Mok, V., Chen, C., Engelborghs, S., Woodward, M., Manzano, S., García‐Ribas, G., Cappa, S. F., et al. (2019) · Alzheimer s Research & Therapy · doi:10.1186/s13195-019-0528-6 · Cited by 35
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“It is suggested that MCI is a transitional state between age-appropriate “normal” and dementia (Petersen et al., 1999), which is often associated with an increased probability of turning into dementia (Mitchell & Shiri-Feshki, 2009).”
Background
Using multivariate base rates of low scores to understand early cognitive declines on the uniform data set 3.0 Neuropsychological Battery.
Kiselica, A. M., Webber, T. A., & Benge, J. F. (2020) · Neuropsychology · doi:10.1037/neu0000640 · Cited by 32
“Conversion to dementia was rare in our sample (5.30%), but occurred at a similar rate as reported in prior work, with annual rates of conversion ranging from 1.6 to 4.9% in community samples (Mitchell & Shiri-Feshki, 2009).”
Influential
Changes of Regional Neural Activity Homogeneity in Preclinical Alzheimer’s Disease: Compensation and Dysfunction
Zhang, Z., Cui, L., Huang, Y., Chen, Y., Li, Y., & Guo, Q. (2021) · Frontiers in Neuroscience · doi:10.3389/fnins.2021.646414 · Cited by 33
“Although still retain roughly intact functional activities, patients with aMCI have a high conversion rate to AD (Mitchell and Shiri-Feshki, 2009).”
Background
Cost-effectiveness of using amyloid positron emission tomography in individuals with mild cognitive impairment
Lee, Y.-S., Youn, H., Jeong, H., Lee, T.-J., Han, J. W., Park, J. H., & Kim, K. W. (2021) · Cost Effectiveness and Resource Allocation · doi:10.1186/s12962-021-00300-9 · Cited by 33
The Mini-Cog, Clock Drawing Test, and Three-Item Recall Test: Rapid Cognitive Screening Tools with Comparable Performance in Detecting Mild NCD in Older Patients
Limpawattana, P., & Manjavong, M. (2021) · Geriatrics · doi:10.3390/geriatrics6030091 · Cited by 34
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Self-Administered Gerocognitive Examination: longitudinal cohort testing for the early detection of dementia conversion
Scharre, D. W., Chang, S. I., Nagaraja, H. N., Wheeler, N. C., & Kataki, M. (2021) · Alzheimer s Research & Therapy · doi:10.1186/s13195-021-00930-4 · Cited by 34
“Among the 164 patients with baseline MCI, 70 patients converted to dementia, a 43% conversion rate over 3 to 4 years, similar to rates from other academic center-based studies [16, 17].”
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What is the role of spatial processing in the decline of episodic memory in Alzheimer’s disease? The “mental frame syncing” hypothesis
Serino, S., & Riva, G. (2014) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2014.00033 · Cited by 34
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Motivational processes in mild cognitive impairment and Alzheimer’s disease: results from the Motivational Reserve in Alzheimer’s (MoReA) study
Forstmeier, S., & Maercker, A. R. A. (2015) · BMC Psychiatry · doi:10.1186/s12888-015-0666-8 · Cited by 32
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Yang, Y., Hsu, K.-C., Wei, C., Tzeng, R.-C., & Chiu, P. (2021) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2021.705782 · Cited by 36
Cognitive screening instruments for the diagnosis of mild cognitive impairment
Larner, A. J. (2016) · Progress in Neurology and Psychiatry · doi:10.1002/pnp.421 · Cited by 32
Multimodal Discrimination between Normal Aging, Mild Cognitive Impairment and Alzheimer’s Disease and Prediction of Cognitive Decline
Bauer, C. M., Cabral, H., & Killiany, R. (2018) · Diagnostics · doi:10.3390/diagnostics8010014 · Cited by 32
Group-Level Progressive Alterations in Brain Connectivity Patterns Revealed by Diffusion-Tensor Brain Networks across Severity Stages in Alzheimer’s Disease
Rasero, J., Alonso-Montes, C., Diez, I. P., Olabarrieta‐Landa, L., Remaki, L., Escudero, I., Goñi, B. M., Bonifazi, P., Fernández, M., Arango‐Lasprilla, J. C., et al. (2017) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2017.00215 · Cited by 32
“Importantly, although EMCI and LMCI patients have memory impairment (Medina et al. 2006), the conversion rate to AD is only between 8-15% per year (Mitchell and Shiri-Feshki 2009), making this group have a special relevance in the development of novel imaging techniques that could correlate with…”
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Education, Activity Engagement, and Cognitive Function in US Chinese Older Adults
Zhang, W., Tang, F., Chen, Y., Silverstein, M. D., Liu, S., & Dong, X. (2019) · Journal of the American Geriatrics Society · doi:10.1111/jgs.15560 · Cited by 33
Does the neuropsychiatric inventory predict progression from mild cognitive impairment to dementia? A systematic review and meta-analysis
Mallo, S. C., Patten, S. B., Ismail, Z., Pereiro, A. X., Facal-Mayo, D., Otero, C., & Juncos‐Rabadán, O. (2019) · Ageing Research Reviews · doi:10.1016/j.arr.2019.101004 · Cited by 35
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Lin, P., LaMonica, H. M., Naismith, S. L., & Mowszowski, L. (2020) · Journal of the International Neuropsychological Society · doi:10.1017/s1355617719000912 · Cited by 32
“However, 40–50% of people with MCI may remain stable over time or may even return to normal (i.e., age-appropriate) cognitive functioning (Mitchell & Shiri-Feshki, 2009).”
Background
A Community-Based Study Identifying Metabolic Biomarkers of Mild Cognitive Impairment and Alzheimer’s Disease Using Artificial Intelligence and Machine Learning
Yılmaz, A., Ustun, I., Ugur, Z., Akyol, S., Hu, W. T., Fiandaca, M. S., Mapstone, M. E., Federoff, H. J., Maddens, M. E., & Graham, S. F. (2020) · Journal of Alzheimer s Disease · doi:10.3233/jad-200305 · Cited by 33
Associations Between Amyloid and Tau Pathology, and Connectome Alterations, in Alzheimer’s Disease and Mild Cognitive Impairment
King‐Robson, J., Initiative, A. D. N., Wilson, H., & Politis, M. (2021) · Journal of Alzheimer s Disease · doi:10.3233/jad-201457 · Cited by 29
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Xu, Z., Sun, W. J., Zhang, D., Chung, V. C., Sit, R. W. S., & Wong, S. Y. S. (2021) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2021.653340 · Cited by 35
“MCI patients are also a high-risk group of developing dementia (Mitchell and Shiri-Feshki, 2009).”
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The effect of a game training intervention on cognitive functioning and depression symptoms in the elderly with mild cognitive impairment: A randomized controlled trial
Xue, B., Xiao, A., Luo, X., & Li, R. (2021) · International Journal of Methods in Psychiatric Research · doi:10.1002/mpr.1887 · Cited by 32
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Caffò, A. O., Spano, G., Tinella, L., Lopez, A., Ricciardi, E., Stasolla, F., & Bosco, A. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19053097 · Cited by 34
“Mitchell and ShiriFeshki [4] found that MCI cases ranged from 2% to 30% in a normal population and from 6% to 85% (with an average value of 40%) in a clinical setting.”
BackgroundInfluential
Subjective Memory Complaint Only Relates to Verbal Episodic Memory Performance in Mild Cognitive Impairment
Gifford, K. A., Initiative, A. D. N., Liu, D., Damon, S. M., Chapman, G. W., Romano, R. R., Samuels, L. R., Lu, Z., & Jefferson, A. L. (2015) · Journal of Alzheimer s Disease · doi:10.3233/jad-140636 · Cited by 33
A hierarchy of predictors for dementia‐free survival in old‐age: results of the AgeCoDe study
Luck, T., Riedel-Heller, S. G., Luppa, M., Wiese, B., Bachmann, C., Jessen, F., Bickel, H., Weyerer, S. B., Pentzek, M., König, H. ‐., et al. (2013) · Acta Psychiatrica Scandinavica · doi:10.1111/acps.12129 · Cited by 32
“Annual conversion rates from such impairments to dementia are approximately 5–10%, but there are also substantial numbers of cognitively impaired people who do not progress to dementia even after 10 years of follow-up [meta-analysis of 41 cohort studies (5)].”
Background
Relationship Between Body Mass Index, ApoE4 Status, and PET-Based Amyloid and Neurodegeneration Markers in Amyloid-Positive Subjects with Normal Cognition or Mild Cognitive Impairment
Blautzik, J., Initiative, A. D. N., Kotz, S., Brendel, M., Sauerbeck, J., Vettermann, F. J., Winter, Y., Bartenstein, P., Ishii, K., & Rominger, A. (2017) · Journal of Alzheimer s Disease · doi:10.3233/jad-170064 · Cited by 32
“33 Later-life weight loss has been also associated with 34 mild cognitive impairment (MCI) [8], which is con35 sidered a prodromal stage of AD [9], having an annual 36 conversion rate as high as 10% [10].”

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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