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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“While older adults with MCI are at greater risk than those without MCI for developing dementia, it is not clear that everyone who develops dementia passes through a well demarcated clinical syndrome of MCI (Mitchell & Shiri-Feshki, 2008, 2009).”
Activity-Based Goals Generated by Older Adults With Mild Cognitive Impairment
Rodakowski, J. L., Becker, A. M., & Golias, K. W. (2018) · OTJR Occupational Therapy Journal of Research · doi:10.1177/1539449217751357 · Cited by 15
“Unfortunately, older adults with MCI are at risk for declining to disability (Mitchell & Shiri-Feshki, 2009), but they do not currently receive traditional rehabilitation interventions.”
Background
Preventing disability in older adults with mild cognitive impairment: A Strategy Training intervention study
Rodakowski, J. L., Golias, K. W., Reynolds, C. F., Butters, M. A., López, O. L., Dew, M. A., & Skidmore, E. R. (2019) · Contemporary Clinical Trials Communications · doi:10.1016/j.conctc.2019.100368 · Cited by 15
“While this is similar to other prevention intervention protocols [36], an ideal protocol would follow participants longer, because (1) preclinical disability, while present, is subtle [33] and (2) the rate of conversion from MCI to dementia is around 10% per year [37].”
Method
Caring for Older Adults with Mild Cognitive Impairment: An Update for Nurses
Lin, F. V., Vance, D. E., Gleason, C. E., & Heidrich, S. M. (2012) · Journal of Gerontological Nursing · doi:10.3928/00989134-20121106-03 · Cited by 15
Is Cardiac Rehabilitation Exercise Feasible for People with Mild Cognitive Impairment?
Intzandt, B., Black, S. E., Lanctôt, K. L., Herrmann, N., OH, P. I., & Middleton, L. E. (2015) · Canadian Geriatrics Journal · doi:10.5770/cgj.18.166 · Cited by 16
“People with MCI are at high risk for dementia and may be an appropriate target for interventions for dementia prevention, such as exercise.(4-6,20,21) However, symptoms of MCI such memory problems, anxiety, and apathy may make community exercise more difficult.”
Background
The learning profile of persistent mild cognitive impairment (MCI): a potential diagnostic marker of persistent amnestic MCI
Klekociuk, S. Z., & Summers, M. J. (2013) · European Journal of Neurology · doi:10.1111/ene.12333 · Cited by 15
“Despite evidence of higher rates of conversion from MCI to dementia [2], recent research indicates that MCI is longitudinally unstable [3,4].”
Background
Voices from the field: Expert reflections on mild cognitive impairment
Peters, K. R., & Katz, S. (2015) · Dementia · doi:10.1177/1471301214562135 · Cited by 16
“The rate of conversion to dementia is generally higher in clinic-based samples than in population-based samples (Farias, Mungas, Reed, Harvey, & DeCarli, 2009; Mitchell & Shiri-Feshki, 2009), which is another problem.”
Background
Vision and convolutional transformers for Alzheimer’s disease diagnosis: a systematic review of architectures, multimodal fusion and critical gaps
Afifi, I., Elgendy, M. A., Abdelfatah, M., & El–Sappagh, S. (2025) · Brain Informatics · doi:10.1186/s40708-025-00286-7 · Cited by 17
Preliminary evidence for an increased likelihood of a stable trajectory in mild cognitive impairment in individuals with higher motivational abilities
Thoma, M. V., Forstmeier, S., Schmid, R., Kellner, O., Xepapadakos, F., Schreiter-Gasser, U., Blessing, A., Ropohl, A., Bieri-Brüning, G., Debeer, D., et al. (2018) · BMC Geriatrics · doi:10.1186/s12877-018-0865-5 · Cited by 14
Microbleeds in fronto-subcortical circuits are predictive of dementia conversion in patients with vascular cognitive impairment but no dementia
Xiao, W., Chen, Y., Li, W., Ni, Z., Liu, Y., Xu, L., Qu, J., Ng, C., & Xiang, Y. (2018) · Neural Regeneration Research · doi:10.4103/1673-5374.239441 · Cited by 16
“V-CIND is associated with an increased risk of dementia, and the rate of dementia conversion in individuals with V-CIND is almost 10-fold higher than that in healthy participants (Mitchell and Shiri-Feshki, 2009).”
Background
A Comparative Analysis of the Treatment of Decision-Making by or for Patients with Neurodegenerative Diseases in Four Legal Jurisdictions
Guzik-Makaruk, E. M., Pływaczewski, E. W., Laskowska, K., Filipkowski, W., Jurgielewicz-Delegacz, E., & Mroczko, P. (2019) · Journal of Alzheimer s Disease · doi:10.3233/jad-190259 · Cited by 14
“Ithasbeen assessed that progression to AD dementia may affect up to 35% of MCI patients, with an annual conversion rate of 5%–10% within a 3-year follow-up [12].”
Using intraindividual variability as an indicator of cognitive improvement in a physical exercise intervention of older women with mild cognitive impairment.
Brydges, C. R., Liu-Ambrose, T. Y. L., & Bielak, A. A. M. (2020) · Neuropsychology · doi:10.1037/neu0000638 · Cited by 15
“These individuals are still capable of living independently, but are at an increased risk of developing dementia (Mitchell & Shiri-Freshki, 2009).”
Background
Update on Major Neurocognitive Disorders
Jones, K. C. (2021) · FOCUS The Journal of Lifelong Learning in Psychiatry · doi:10.1176/appi.focus.20210004 · Cited by 17
Impact of Educational Level on Versions (Basic and Complete) of the Montreal Cognitive Assessment
Díaz, L. A., Arango, A., Parra, C., Rodríguez‐Lorenzana, A., & Ponce, T. Y. (2021) · Dementia and Geriatric Cognitive Disorders · doi:10.1159/000518747 · Cited by 15
The effect of remotely delivered lifestyle interventions on cognition in older adults without dementia: A systematic review and meta-analysis
Whitfield, T. J., McConnell, B., Renouf, P., Mansour, H., Zabihi, S., Aguirre, E., Walker, Z., Cooper, C., & Marchant, N. L. (2021) · Ageing Research Reviews · doi:10.1016/j.arr.2021.101505 · Cited by 14
“SCD or MCI), groups at increased risk of dementia (Mitchell et al., 2014; Mitchell and Shiri-Feshki, 2009).”
A Comparison of Operational Definitions for Mild Cognitive Impairment
Polcher, A. A., Wolfsgruber, S., Peters, O., Frölich, L., Wiltfang, J., Kornhuber, J., Hüll, M., Rüther, E., Lewczuk, P., Maier, W., et al. (2022) · Journal of Alzheimer s Disease · doi:10.3233/jad-215548 · Cited by 17
Is there a link between heart rate variability and cognitive decline? A cross-sectional study on patients with mild cognitive impairment and cognitively healthy controls
Grässler, B., Dordevic, M., Darius, S., Herold, F., Forte, G., Langhans, C., Halfpaap, N., Müller, P., Glanz, W., Dantas, E. H. M., et al. (2023) · Arquivos de Neuro-Psiquiatria · doi:10.1055/s-0042-1758862 · Cited by 15
“Based on the evidence (i) that older individuals with MCI have a higher risk of developing dementia compared with older adults with normal cognition 13 and (ii) that autonomic dysfunction is a vascular risk factor accelerating cognitive decline, 9 the evaluation of cardiac autonomic control through…”
Background
Psychological distress mediates the associations between neighborhood social cohesion (NSC) and cognitive performance in older adults
Kang, W. (2023) · Current Psychology · doi:10.1007/s12144-023-04887-5 · Cited by 16
“Mild cognitive impairment is generally considered as a precursor to different types of dementias (Mitchell & Shiri-Feshki, 2009), which causes the loss of independence, disability, and ultimately mortality (Cotter, 2007; Gill et al., 1995; Phelan et al., 2012).”
Deep learning for risk-based stratification of cognitively impaired individuals
Romano, M. F., Zhou, X., Balachandra, A. R., Jadick, M. F., Qiu, S., Nijhawan, D. A., Joshi, P. S., Mohammad, S., Lee, P. H., Smith, M. J., et al. (2023) · iScience · doi:10.1016/j.isci.2023.107522 · Cited by 13
“Not all individuals with mild cognitive impairment (MCI) develop AD.4 To this end, several frameworks have been constructed to identify individuals with normal cognition orMCI who progress to AD.”
BackgroundInfluential
Investigating Sex Differences in Risk and Protective Factors in the Progression of Mild Cognitive Impairment to Dementia: A Systematic Review
Martin, J., Reid, N., Ward, D. D., King, S. J., Hubbard, R. E., & Gordon, E. H. (2023) · Journal of Alzheimer s Disease · doi:10.3233/jad-230700 · Cited by 15
Exercise interventions for preventing dementia or delaying cognitive decline in people with mild cognitive impairment
Forbes, S. C., Forbes, D. A., Forbes, S. C., Blake, C. M., Chong, L. Y., Thiessen, E., Little, J. P., & Rutjes, A. W. (2015) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd011706 · Cited by 15
Retracted
Long-term safety, efficacy, and tolerability of imidafenacin in the treatment of overactive bladder: a review of the Japanese literature
Masumori, N. (2013) · Patient Preference and Adherence · doi:10.2147/ppa.s28160 · Cited by 14
“Although there was no control arm in this study, it is speculated that this annual conversion rate in OAB patients receiving imidafenacin treatment is comparable with that in the general population, ie, 5%–10%, reported in a meta-analysis.(54) Of these 65 patients, 12 were followed for 48 weeks.”
Classification of Mild Cognitive Impairment Stages Using Machine Learning Methods
Cabrera-León, Y., Báez, P. G., Ruiz‐Alzola, J., & Suárez-Araujo, C. P. (2018) · IEEE International Conference on Intelligent Engineering Systems (INES) · doi:10.1109/ines.2018.8523858 · Cited by 14
“Patients with MCI have a probability of annually converting to dementia of 5−10% [5], higher than CN.”
Background
Famous faces naming test predicts conversion from mild cognitive impairment to Alzheimer’s disease
García, S., Cuetos, F., Novelli, A., & Martínez, C. (2020) · Acta Neurologica Belgica · doi:10.1007/s13760-020-01483-3 · Cited by 14
Cognitive subtypes in individuals with essential tremor seeking deep brain stimulation
Ratajska, A. M., Lopez, F. V., Kenney, L. E., Jacobson, C. E., Foote, K. D., Okun, M. S., & Bowers, D. (2021) · The Clinical Neuropsychologist · doi:10.1080/13854046.2021.1882578 · Cited by 14
“Indeed, annual conversion rates of MCI to dementia in ET have ranged from 8.4% to 12.5% across studies (Radler et al., 2020; Sinoff & Badarny, 2014), compared to approximately 2% to 7% in the general population (Mitchell & Shiri-Feshki, 2009).”
BackgroundInfluential
Automated Classification of Normal Control and Early-Stage Dementia Based on Activities of Daily Living (ADL) Data Acquired from Smart Home Environment
Kwon, L.-N., Yang, D., Hwang, M., Lim, S., Kim, Y., Kim, J.-G., Cho, K.-H., Chun, H.-W., & Park, K. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph182413235 · Cited by 15
Assessing and disclosing test results for ‘mild cognitive impairment’: the perspective of old age psychiatrists in Scotland
Saunders, S., Ritchie, C. W., Russ, T. C., Terrera, G. M., & Milne, R. (2022) · BMC Geriatrics · doi:10.1186/s12877-021-02693-x · Cited by 16
Automated MR morphometry to predict Alzheimer’s disease in mild cognitive impairment
Fritzsche, K. H., Stieltjes, B., Schlindwein, S., van Bruggen, T., Essig, M., & Meinzer, H.-P. (2010) · International Journal of Computer Assisted Radiology and Surgery · doi:10.1007/s11548-010-0412-0 · Cited by 14
Full diffusion characterization implicates regionally disparate neuropathology in Mild Cognitive Impairment
Boespflug, E. L., Storrs, J. M., Sadat-Hossieny, S., Eliassen, J. C., Shidler, M. D., Norris, M. M., & Krikorian, R. (2013) · Brain Structure and Function · doi:10.1007/s00429-013-0506-x · Cited by 14
“While clinical classification of individuals with MCI provides a means for identifying those at an increased risk for progression, not all persons with MCI progress to AD (Mitchell and Shiri-Feshki 2009).”
Background
Efficacy and Safety of MLC601 in the Treatment of Mild Cognitive Impairment: A Pilot, Randomized, Double-Blind, Placebo-Controlled Study
Pakdaman, H., Harandi, A. A., Abbasi, M., Kasmaei, H. D., Ashrafi, F., Gharagozli, K., Assarzadegan, F., Behnam, B., & Ahmadi, M. A. (2017) · Dementia and Geriatric Cognitive Disorders Extra · doi:10.1159/000458521 · Cited by 14
Neural correlates of delayed episodic memory in patients with mild cognitive impairment--a FDG PET study.
Schönknecht, O. D. P., Hunt, A. M., Toro, P., Henze, M., Haberkorn, U., & Schröder, J. (2009) · Neuroscience Letters · doi:10.1016/j.neulet.2009.10.014 · Cited by 13
Therapeutic Use and Chronic Abuse of CNS Stimulants and Anabolic Drugs
Coliță, D., Coliță, C.-I., Hermann, D. M., Coliță, E., Doeppner, T. R., Udriștoiu, I., & Popa‐Wagner, A. (2022) · Current Issues in Molecular Biology · doi:10.3390/cimb44100333 · Cited by 13
“Moreover, between 10 and 20% of individuals above the age of 65 are diagnosed with mild cognitive impairment (MCI) [4], and of these, 10% will progress to AD [5].”
Background
Patient, Family Caregiver, and Provider Perceptions on Self-Assessment Screening for Cognitive Impairment in Primary Care: Findings From a Qualitative Study
Bandini, J. I., Schulson, L., Ahluwalia, S. C., Harrison, J. M., Chen, E. K., Lai, J., & Edelen, M. O. (2022) · Gerontology and Geriatric Medicine · doi:10.1177/23337214221131403 · Cited by 16
“CI is characterized by a decline in cognition greater than expected for an individual’s age and education level but without significant interference in everyday activities (Mitchell & Shiri-Feshki, 2009; Panegyres et al., 2016).”
Background
Effectiveness of an Individualized Exergame-Based Motor-Cognitive Training Concept Targeted to Improve Cognitive Functioning in Older Adults With Mild Neurocognitive Disorder: Study Protocol for a Randomized Controlled Trial
Manser, P., Michels, L., Schmidt, A., Barinka, F., & de Bruin, E. D. (2023) · JMIR Research Protocols · doi:10.2196/41173 · Cited by 14
“The annual conversion rate of mNCD to MNCD is approximately 4.9 in community settings and 9.6 in specialist clinical settings [31].”
Influential
Compensatory Mechanisms in Early Alzheimer’s Disease and Clinical Setting: The Need for Novel Neuropsychological Strategies
Torrealba, E., Aguilar-Zerpa, N., Garcia-Morales, P., & Díaz, M. L. (2023) · Journal of Alzheimer s Disease Reports · doi:10.3233/adr-220116 · Cited by 15
“In addition, a recent meta-analysis have concluded that the rate of conversion of MCI to dementia is approximately 5% to 10% over a period of 10 years [4].”
Background
Long-term beneficial impact of the randomised trial ‘Train the Brain’, a motor/cognitive intervention in mild cognitive impairment people: effects at the 14-month follow-up
Sale, A., Noale, M., Cintoli, S., Tognoni, G., Braschi, C., Berardi, N., Maggi, S., Maffei, L., Maffei, L., Picano, E., et al. (2023) · Age and Ageing · doi:10.1093/ageing/afad067 · Cited by 14
Advances in diagnosing mild cognitive impairment and Alzheimer’s disease using 11C-PIB- PET/CT and common neuropsychological tests
Zhao, Q. X., Du, X., Chen, W., Zhang, T., & Xu, Z. (2023) · Frontiers in Neuroscience · doi:10.3389/fnins.2023.1216215 · Cited by 17
Cognitive Impairment in Cardiovascular Patients after Myocardial Infarction: Prospective Clinical Study
Kasprzak, D., Kaczmarek‐Majer, K., Rzeźniczak, J., Klamecka-Pohl, K., Ganowicz-Kaatz, T., Słomczyński, M., Budzianowski, J., Pieszko, K., Hiczkiewicz, J., Tykarski, A., et al. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12154954 · Cited by 15
“However, it is associated with an increased risk of developing dementia, with an annual progression rate of between 5 and 10% [3].”
Background
Results of the Italian RESILIEN-T Pilot Study: A Mobile Health Tool to Support Older People with Mild Cognitive Impairment
Bevilacqua, R., Felici, E., Cucchieri, G., Amabili, G., Margaritini, A., Franceschetti, C., Barboni, I., Paolini, S., Civerchia, P., Raccichini, A., et al. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12196129 · Cited by 13
“, while in the evening it was asked ‘How much MCI are often not included in the research in the technological ﬁeld while public and patient involvement, especially in an interdisciplinary design and health-care context, is important to bring together, adapt and develop acceptable and usable technologies.”
BackgroundInfluential
Improvement of working memory in older adults with mild cognitive impairment after repetitive transcranial magnetic stimulation – a randomized controlled pilot study
Senczyszyn, A., Szcześniak, D., Wieczorek, T., Maciaszek, J., Malecka, M., Bogudzińska, B., Zimny, A., Fila-Pawłowska, K., & Rymaszewska, J. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1196478 · Cited by 15
A qualitative study of informal caregiver perceptions of the benefits of an early dementia diagnosis
Couch, E., Co, M., Albertyn, C. P., Prina, M. A., & Lawrence, V. C. (2024) · BMC Health Services Research · doi:10.1186/s12913-024-10957-6 · Cited by 13
“MCI is a significant predictor of future dementia, with approximately 7% of people with MCI developing dementia annually [7, 8].”
Background
Predictive Models for the Transition from Mild Neurocognitive Disorder to Major Neurocognitive Disorder: Insights from Clinical, Demographic, and Neuropsychological Data
Tsiakiri, A., Bakirtzis, C., Plakias, S., Vlotinou, P., Vadikolias, Κ., Terzoudi, A., & Christidi, F. (2024) · Biomedicines · doi:10.3390/biomedicines12061232 · Cited by 13
“Progression from minor to major NCD varies widely, typically occurring within 3 to 5 years, and is influenced by factors such as age, genetics, and comorbid conditions [13].”
Background
An fNIRS representation and fNIRS-scales multimodal fusion method for auxiliary diagnosis of amnestic mild cognitive impairment
Cheng, S., Shang, P., Zhang, Y., Guan, J., Chen, Y., Lv, Z., Huang, S., Liu, Y., & Xie, H. (2024) · Biomedical Signal Processing and Control · doi:10.1016/j.bspc.2024.106646 · Cited by 13

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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