Detection of early Alzheimer's disease in MCI patients by the combination of MMSE and an episodic memory test
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
BMC Neurology 2011, 11:78 doi:10.1186/1471-2377-11-78Published: 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.