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Open Access Highly Accessed Research article

Detection of early Alzheimer's disease in MCI patients by the combination of MMSE and an episodic memory test

Ana Pozueta1, Eloy Rodríguez-Rodríguez1, José Luis Vazquez-Higuera1, Ignacio Mateo1, Pascual Sánchez-Juan1, Soraya González-Perez2, José Berciano1 and Onofre Combarros1*

Author Affiliations

1 Neurology Service, IFIMAV and CIBERNED, "Marqués de Valdecilla" University Hospital (University of Cantabria), Avda Valdecilla s/n, 39008-Santander, Spain

2 AFAC (Alzheimer's Disease Association), Rosario de Acuña 7-bajo, 39008-Santander, Spain

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BMC Neurology 2011, 11:78  doi:10.1186/1471-2377-11-78

Published: 24 June 2011



Mild cognitive impairment (MCI) is a heterogeneous clinical entity that comprises the prodromal phase of Alzheimer's disease (Pr-AD). New biomarkers are useful in detecting Pr-AD, but they are not universally available. We aimed to investigate baseline clinical and neuropsychological variables that might predict progression from MCI to AD dementia.


All patients underwent a complete clinical and neuropsychological evaluation at baseline and every 6 months during a two-year follow-up period, with 54 out of 109 MCI patients progressing to dementia (50 of them progressed to AD dementia), and 55 remaining as stable MCI (S-MCI).


A combination of MMSE and California Verbal Learning Test Long Delayed Total Recall (CVLT-LDTR) constituted the best predictive model: subjects scoring above 26/30 on MMSE and 4/16 on CVLT-LDTR had a negative predictive value of 93.93% at 2 years, whereas those subjects scoring below both of these cut-off scores had a positive predictive value of 80.95%.


Pr-AD might be distinguished from S-MCI at baseline using the combination of MMSE and CVLT-LDTR. These two neuropsychological predictors are relatively brief and may be readily completed in non-specialist clinical settings.