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Conversion from subtypes of mild cognitive impairment to Alzheimer dementia

From the Ludwig Boltzmann Institute of Aging Research (P.F., S.J., S.W., K.H.T.), Department of General Psychiatry (P.F.), Medical University Vienna, Section for Medical Statistics (S.Z.), Medical University Vienna, Department of Pathology (S.H.), Danube Hospital Vienna, Institute of Neurology (E.G.), Medical University Vienna, and Ludwig Boltzmann Institute of Digital Radiology and Interventional Radiology (W.K.), Vienna, Austria.

Address correspondence and reprint requests to Dr. P. Fischer, Psychiatrische Klinik AKH, Waehringer Guertel 18-20, A-1090 Wien/Vienna, Austria; e-mail: Peter.Fischer{at}meduniwien.ac.at

Objective: To compare the rates of conversion to Alzheimer dementia (AD) between subtypes of mild cognitive impairment (MCI) in a community-based birth cohort investigated at age 75 and followed up after 30 months.

Methods: The Vienna Trans-Danube Aging Study investigated every inhabitant of the area on the left shore of the river Danube who was born between May 1925 and June 1926. With use of the official voting registry, 1505 subjects were contacted and 697 participated. Data refer to the cohort of 581 nondemented individuals who completed extensive neuropsychological examination at baseline. Follow-up after 30 months was possible in 476 probands (35 deceased).

Results: The 141 patients with MCI at baseline were classified into two subtypes. At follow-up, 41 of these patients with MCI were diagnosed with AD. Conversion rates to AD were 48.7% (CI: 32.4 to 65.2) for amnestic MCI and 26.8% (CI: 17.6 to 37.8) for nonamnestic MCI. Another 49 AD cases originated from cognitive health at baseline (12.6%; CI: 9.4 to 16.3).

Conclusions: Patients with mild cognitive impairment (MCI) showed a high probability to be diagnosed with Alzheimer dementia (AD) after 30 months. Subtypes of MCI were not useful in defining early stages of various types of dementia: Not only amnestic MCI but also nonamnestic MCI converted frequently to AD, and conversion to vascular dementia and dementia with Lewy bodies was not restricted to nonamnestic MCI.

Supported by the Ludwig Boltzmann Society, Ludwig Boltzmann Institute of Aging Research. Peter Fischer had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Neuropathologic analyses are supported by the Lord Mayor's Medicoscientific Fund of the City of Vienna.

Disclosure: The authors report no conflicts of interest.

Received March 10, 2006. Accepted in final form October 6, 2006.

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