Simone Galati, Michele Rossi, Federica Del Signore, Giulia Locatelli, Antonio Guaita, Elena Rolandi
Golgi Cenci Foundation, Corso San Martino 10, 20081, Abbiategrasso (MI), Italy.
Department of Psychology, University of Milan-Bicocca, Milan, Italy.
Sci Rep. 2025 Jun 5;15(1):19827. doi: 10.1038/s41598-025-04275-y.
Making early and informative diagnoses of mild cognitive impairment (MCI) is highly important for planning timely and appropriate interventions aimed at dementia risk reduction. However, there is currently no agreement on the MCI criteria, leading to wide heterogeneity in the prognosis of MCI patients and high reversion rates. Our study aimed to compare the prognostic value of Conventional (Petersen/Winblad) and Neuropsychological (Jak/Bondi) criteria for the diagnosis of MCI. We directly compared the ability of each classification method to predict progression to dementia and the stability of the diagnosis over 12 years in a population-based sample of 1021 older adults without dementia. The relative impact of subjective complaints and objective impairment on clinical progression was further evaluated. Baseline MCI diagnosis with the Neuropsychological and Conventional criteria was associated with a comparable risk of dementia over time. Across the study period, the Neuropsychological criteria led to more consistent diagnoses (63.2% vs. 43.2%). The copresence of subjective memory complaints and objective impairment at baseline was associated with increased dementia risk within both diagnostic frameworks. These results further support the use of comprehensive neuropsychological assessment to make timely and appropriate MCI diagnoses and show the added prognostic value of subjective complaints.
对轻度认知障碍(MCI)进行早期且信息丰富的诊断对于制定旨在降低痴呆风险的及时且恰当的干预措施极为重要。然而,目前对于MCI的诊断标准尚无共识,这导致MCI患者的预后存在广泛异质性且逆转率很高。我们的研究旨在比较传统(彼得森/温布拉德)和神经心理学(雅克/邦迪)标准对MCI诊断的预后价值。我们在1021名无痴呆的老年人的基于人群的样本中,直接比较了每种分类方法预测进展为痴呆的能力以及12年间诊断的稳定性。进一步评估了主观主诉和客观损害对临床进展的相对影响。随着时间的推移,采用神经心理学和传统标准进行的基线MCI诊断与痴呆风险相当。在整个研究期间,神经心理学标准导致的诊断更一致(63.2%对43.2%)。在两种诊断框架内,基线时主观记忆主诉和客观损害同时存在与痴呆风险增加相关。这些结果进一步支持使用综合神经心理学评估来及时且恰当地进行MCI诊断,并显示了主观主诉的额外预后价值。