APH 2009, 67, 7-14:

Progression and improvement after mild cognitive impairment

F. Buntinx, L. Paquay, M. Ylieff, J. De Lepeleire

Objective: We studied progression to dementia and improvement rates of mild cognitive impairment (MCI) to help clinicians decide whether or not to screen older people for MCI.

Method: Prospective cohort study in which 156 vulnerable patients with (n=24) and without (n=132) MCI are followed and reassessed after two years with MMSE and Camdex.

Results: Nine (38%) out of 24 patients initially diagnosed with MCI and 20 (15%) out of 132 considered normal or depressed progressed to dementia within two years. This results in a relative risk of progression of 2.48 (95% confidence interval=1.29-4.77), a sensitivity of 31%
(95%CI=16-51) and a predictive value of 38% (95%CI=20-59). Out of 24 people with MCI at baseline, 8 (33%; 95%CI=16-55) had improved at follow-up.

Conclusion: The low sensitivity of MCI for subsequent occurrence of dementia and the high improvement rate found in our study as well as by others, and the absence of a proven therapy, provide cumulative evidence against screening for MCI.