The prognosis of mild cognitive impairment in the elderly

Purpose: To determine whether or not subtypes of intellectual functioning are suitable to predict further cognitive decline in individuals with mild cognitive impairment. Design: naturalistic longitudinal study (mean interval 2.7 years). Patients: 41 subjects with mild cognitive impairment who attended a memory clinic. Methods: SIDAM, CT, SPECT, and ApoE genotype. Results: At follow-up, 8 out of 41 patients (19.5%) with MCI had progressed to dementia, 8 patients (19.5%) had improved to normal levels of cognitive functioning, 25 patients (61%) had remained stable within the MCI group. At baseline the two prognostic groups differed significantly with regard to age, memory functions. orientation, and the degree of atrophy of the left medial temporal lobe on CT scan. Conclusion: The majority of MCI patients in this study remained cognitively stable within the observation period. Patients with older age. poorer test performance on memory tasks and orientation deficits are at higher risk of progressive decline to dementia. CT measures of medial temporal lobe atrophy may be a sensitive parameter of group discrimination.