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Home: Research: Forums: Live Discussions
What We Know, What We Don't Know
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What we know

What we don’t know

6.

60 percent of people diagnosed with MCI go on to be diagnosed with AD

Can those with AD be identified while still at the MCI stage?


Comments
  Comment by:  Jurgen Claassen (Disclosure)
Submitted 8 May 2007  |  Permalink Posted 1 June 2007

I would be more interested in the 40 percent who do not progress to clinical AD. What is the cause of their cognitive impairment if not AD? Or even more interesting, why did AD not progress from the MCI stage. Do these individuals have disease-limiting phenomena?

View all comments by Jurgen Claassen

  Comment by:  Alvin Lyckman
Submitted 8 April 2008  |  Permalink Posted 10 April 2008

This statistic is not meaningful without knowing what percentage of non-MCI people go on to develop AD in the same time frame.

View all comments by Alvin Lyckman

  Comment by:  Alvin Lyckman
Submitted 15 April 2008  |  Permalink Posted 22 April 2008

In addition, the significance of MCI to AD and age-related dementias in general requires knowing the prevalence of MCI. Since AD is clearly not inevitable, with or without prior MCI, I agree with Jurgen Classen that further distinguishing the non-progressors will provide critical insight. However, we have yet to establish the epidemiological relationships between sporadic AD and MCI versus non-pathologic aging.

View all comments by Alvin Lyckman

  Comment by:  Scott Weikart
Submitted 1 September 2009  |  Permalink Posted 1 September 2009

Ron Petersen (Mayo Clinic) has been active in defining and studying MCI (1).

Ron has a theoretical framework based on assumed etiology, with which he predicts (2) that:

  • single-domain amnestic MCI (aMCI), i.e., memory impairment only, will progress to pure AD (if not caused by depression);
  • multi-domain amnestic MCI will progress to AD plus vascular dementia (if not caused by depression);
  • non-amnestic MCI will progress to non-AD dementias.

Ron showed a graph on the slide "MCI: Conversion to Dementia" (3), which shows:

  • 35 percent of non-ApoE4 carriers will progress to dementia in three years;
  • 90+ percent of ApoE4 carriers will progress to dementia (still progressing at four years).

ADNI partners (and others) are researching biomarkers for earlier/better prediction of conversion (4-6). Various cerebrospinal fluid (CSF) biomarkers and changes in brain-region sizes from neuroimaging seem to have predictive power (7).

References:
1. Petersen, R. Mild Cognitive Impairment. CONTINUUM: Lifelong Learning in Neurology. Dementia. 13(2):15-38, April 2007. Abstract

2. Edited by Ronald C. Petersen. Mild Cognitive Impairment: Aging to Alzheimer's Disease. Oxford University Press, USA; first edition January 9, 2003.

3. Petersen, Ronald C. Mild Cognitive Impairment: The Current Status. Talk at 10th Annual Updates on Dementia conference, Stanford University, June 4, 2008.

4. Antecedent Biomarkers for the Early and Preclinical Detection of Alzheimer's Disease

5. ADNI: GWA Nearly Complete, Biomarker Analysis Update

6. ADNI: Mission Creep From Alzheimer Disease to Healthy Senior?

7. Beckett, Laurel, ADNI Biostatistics Core, director. Private communication.

View all comments by Scott Weikart

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