The UK ADC longitudinal research program follows 500 subjects with normal cognition who undergo annual medical, neurological and neuropsychological examination (table 1 ) [16 (link)]. All subjects presented here were required to have undergone a previous examination, with a consensus diagnosis of ‘normal’. All subjects transitioning from normal cognition to MCI in the period from July 1, 2005, to December 31, 2006 (n = 48) were included in the analysis. The diagnosis of MCI in this study was based on the examining physician’s review of each case, including all available current and longitudinal data.
Subjects given the diagnosis of MCI were contacted by a study physician who conveyed this diagnosis to each participant using a standardized protocol. This communication included disclosure of the diagnosis, as well as a systematic explanation of its prognostic value for predicting future cognitive decline and the possible development of a degenerative dementia. All subjects were invited and encouraged to undergo a medical workup for reversible causes of cognitive decline according to the American Academy of Neurology practice parameter on the initial diagnosis and workup of dementia [17 (link)].
Demographic variables recorded included: age, education, gender, duration of MCI (<1 year in all cases) and willingness to undergo diagnostic medical workup for reversible causes of memory decline. Clinical variables included: laboratory testing (complete blood count; comprehensive metabolic panel including electrolytes, glucose, liver and renal functions; rapid plasma reagent; sensitive thyroid-stimulating hormone; vitamin B12, andfolate), MRI or CT scan of the brain (including semiquantitative estimates of hippocampal and cortical atrophy [18 (link), 19 (link)]), cognitive domain involvement (memory, attention, language, executive and visuospatial), Folstein Mini-Mental State Examination (MMSE) [20 (link), 21 (link)], and Clinical Dementia Rating scale (CDR) global and sum-of-boxes (CDR-SOB) scores [22 (link)].
Subjects given the diagnosis of MCI were contacted by a study physician who conveyed this diagnosis to each participant using a standardized protocol. This communication included disclosure of the diagnosis, as well as a systematic explanation of its prognostic value for predicting future cognitive decline and the possible development of a degenerative dementia. All subjects were invited and encouraged to undergo a medical workup for reversible causes of cognitive decline according to the American Academy of Neurology practice parameter on the initial diagnosis and workup of dementia [17 (link)].
Demographic variables recorded included: age, education, gender, duration of MCI (<1 year in all cases) and willingness to undergo diagnostic medical workup for reversible causes of memory decline. Clinical variables included: laboratory testing (complete blood count; comprehensive metabolic panel including electrolytes, glucose, liver and renal functions; rapid plasma reagent; sensitive thyroid-stimulating hormone; vitamin B12, andfolate), MRI or CT scan of the brain (including semiquantitative estimates of hippocampal and cortical atrophy [18 (link), 19 (link)]), cognitive domain involvement (memory, attention, language, executive and visuospatial), Folstein Mini-Mental State Examination (MMSE) [20 (link), 21 (link)], and Clinical Dementia Rating scale (CDR) global and sum-of-boxes (CDR-SOB) scores [22 (link)].
