Journal of the International Neuropsychological Society

Research Articles

The Fate of the 0.5s: Predictors of 2-Year Outcome in Mild Cognitive Impairment

Eleni Aretoulia1, Ozioma C. Okonkwoa1a2, Jaclyn Sameka1 and Jason Brandta1a2a3 c1

a1 Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, Maryland

a2 Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, Maryland

a3 The Copper Ridge Institute, Sykesville, Maryland

Abstract

Impairments in executive cognition (EC) may be predictive of incident dementia in patients with mild cognitive impairment (MCI). The present study examined whether specific EC tests could predict which MCI individuals progress from a Clinical Dementia Rating (CDR) score of 0.5 to a score ≥1 over a 2-year period. Eighteen clinical and experimental EC measures were administered at baseline to 104 MCI patients (amnestic and non-amnestic, single- and multiple-domain) recruited from clinical and research settings. Demographic characteristics, screening cognitive measures and measures of everyday functioning at baseline were also considered as potential predictors. Over the 2-year period, 18% of the MCI individuals progressed to CDR ≥ 1, 73.1% remained stable (CDR = 0.5), and 4.5% reverted to normal (CDR = 0). Multiple-domain MCI participants had higher rates of progression to dementia than single-domain, but amnestic and non-amnestic MCIs had similar rates of conversion. Only three EC measures were predictive of subsequent cognitive and functional decline at the univariate level, but they failed to independently predict progression to dementia after adjusting for demographic, other cognitive characteristics, and measures of everyday functioning. Decline over 2 years was best predicted by informant ratings of subtle functional impairments and lower baseline scores on memory, category fluency, and constructional praxis. (JINS, 2011, 17, 277–288)

(Received July 15 2010)

(Revised November 23 2010)

(Accepted November 23 2010)

(Online publication December 21 2010)

Correspondence:

c1 Correspondence and reprint requests to: Jason Brandt, PhD, Department of Psychiatry and Behavioral Sciences, The Johns Hopkins Hospital, 600 N. Wolfe Street, Meyer 218, Baltimore, MD 21287-7218. E-mail: jbrandt1@jhmi.edu