Clinical Question: Does cognitive performance predict the subsequent development of Alzheimer’s disease?

Setting: Outpatient (specialty)

Study Design: Cohort (prospective)

Synopsis: The authors recruited 102 patients with and without cognitive complaints and monitored them until they died. At baseline, all patients completed a variety of neuropsychiatric tests, including the age- and education-adjusted Mayo Cognitive Factor Scales (MCFS). The clinical diagnosis of dementia was made according to the most recent Diagnostic and Statistical Manual of Mental Disorders. However, the authors did not report if this assessment was made with the knowledge of baseline MCFS results.

The main outcome was a neuropathologic diagnosis of Alzheimer’s disease, which the authors report was not influenced by the initial neuropsychiatric testing. Patients had an average follow-up of nearly six years. The MCFS detected 75 percent of patients with a neuropathologic diagnosis of Alzheimer’s disease and was 73.9 percent specific (positive likelihood ratio = 2.9; negative likelihood ratio = 0.34). These numbers suggest that the MCFS is of limited use in ruling out or ruling in Alzheimer’s disease.

Bottom Line: Baseline scores on the MCFS are somewhat predictive of developing Alzheimer’s disease after six years. (Level of evidence: 2b)