Evidence map›Paper›PMID 34376506›Full record

ArticleNeurology2021

Data-Driven vs Consensus Diagnosis of MCI: Enhanced Sensitivity for Detection of Clinical, Biomarker, and Neuropathologic Outcomes.

Emily C Edmonds, Denis S Smirnov, Kelsey R Thomas, Lisa V Graves, Katherine J Bangen, Lisa Delano-Wood, Douglas R Galasko, David P Salmon, Mark W Bondi

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In one paragraph

Article in Neurology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers.

0numbers the graph read from it
0cells of the map it votes in
30citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

30 citing papers in PubMed.

  1. Article
  2. Article
  3. [Progress on prognostic assessment methods for mild cognitive impairment].Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences · 2026
    Review
  4. Review
  5. Article
  6. Article
  7. Article
  8. Neuropsychiatric symptom phenotypes for early detection of risk in older adults.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025
    Article
  9. Dementia prevalence in the Wisconsin Longitudinal Study.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025
    Article
  10. Review
  11. Article
  12. Article
  13. Article
  14. Sex- and region-dependent neuroinflammation in Alzheimer's disease.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025
    Article
  15. Article
  16. Article
  17. Article
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Emily C EdmondsFrom the Veterans Affairs San Diego Healthcare System (E.C.E., K.R.T., L.V.G., K.J.B., L.D.-W., D.R.G., M.W.B.); and Departments of Psychiatry (E.C.E., K.R.T., L.V.G., K.J.B., L.D.-W., M.W.B.) and Neurosciences (D.S.S., D.R.G., D.P.S.), University of California San Diego, La Jolla. ecedmonds@ucsd.edu.
Denis S SmirnovFrom the Veterans Affairs San Diego Healthcare System (E.C.E., K.R.T., L.V.G., K.J.B., L.D.-W., D.R.G., M.W.B.); and Departments of Psychiatry (E.C.E., K.R.T., L.V.G., K.J.B., L.D.-W., M.W.B.) and Neurosciences (D.S.S., D.R.G., D.P.S.), University of California San Diego, La Jolla.
Kelsey R ThomasFrom the Veterans Affairs San Diego Healthcare System (E.C.E., K.R.T., L.V.G., K.J.B., L.D.-W., D.R.G., M.W.B.); and Departments of Psychiatry (E.C.E., K.R.T., L.V.G., K.J.B., L.D.-W., M.W.B.) and Neurosciences (D.S.S., D.R.G., D.P.S.), University of California San Diego, La Jolla.
Lisa V GravesFrom the Veterans Affairs San Diego Healthcare System (E.C.E., K.R.T., L.V.G., K.J.B., L.D.-W., D.R.G., M.W.B.); and Departments of Psychiatry (E.C.E., K.R.T., L.V.G., K.J.B., L.D.-W., M.W.B.) and Neurosciences (D.S.S., D.R.G., D.P.S.), University of California San Diego, La Jolla.
Katherine J BangenFrom the Veterans Affairs San Diego Healthcare System (E.C.E., K.R.T., L.V.G., K.J.B., L.D.-W., D.R.G., M.W.B.); and Departments of Psychiatry (E.C.E., K.R.T., L.V.G., K.J.B., L.D.-W., M.W.B.) and Neurosciences (D.S.S., D.R.G., D.P.S.), University of California San Diego, La Jolla.
Lisa Delano-WoodFrom the Veterans Affairs San Diego Healthcare System (E.C.E., K.R.T., L.V.G., K.J.B., L.D.-W., D.R.G., M.W.B.); and Departments of Psychiatry (E.C.E., K.R.T., L.V.G., K.J.B., L.D.-W., M.W.B.) and Neurosciences (D.S.S., D.R.G., D.P.S.), University of California San Diego, La Jolla.
Douglas R GalaskoFrom the Veterans Affairs San Diego Healthcare System (E.C.E., K.R.T., L.V.G., K.J.B., L.D.-W., D.R.G., M.W.B.); and Departments of Psychiatry (E.C.E., K.R.T., L.V.G., K.J.B., L.D.-W., M.W.B.) and Neurosciences (D.S.S., D.R.G., D.P.S.), University of California San Diego, La Jolla.
David P SalmonFrom the Veterans Affairs San Diego Healthcare System (E.C.E., K.R.T., L.V.G., K.J.B., L.D.-W., D.R.G., M.W.B.); and Departments of Psychiatry (E.C.E., K.R.T., L.V.G., K.J.B., L.D.-W., M.W.B.) and Neurosciences (D.S.S., D.R.G., D.P.S.), University of California San Diego, La Jolla.
Mark W BondiFrom the Veterans Affairs San Diego Healthcare System (E.C.E., K.R.T., L.V.G., K.J.B., L.D.-W., D.R.G., M.W.B.); and Departments of Psychiatry (E.C.E., K.R.T., L.V.G., K.J.B., L.D.-W., M.W.B.) and Neurosciences (D.S.S., D.R.G., D.P.S.), University of California San Diego, La Jolla.

Funding

UCSD Shiley-Marcos Alzheimer's Disease Research Center P30P30AG062429 · NIA · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI DOUGLAS R GALASKO · 2019 to 2026
$34.9M
Intracranial arterial compliance, cerebral blood flow, and dementia risk in older adults with type 2 diabetesR01AG063782 · NIA · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI BANGEN, KATHERINE · 2020 to 2024
$3.7M
Re-visiting Methods for MCI Diagnosis to Improve Biomarker and Trial FindingsR01AG049810 · NIA · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI BONDI, MARK W, EDLAND, STEVEN DYAL · 2016 to 2020
$3.7M
Identifying best methods for the detection of subtle cognitive declineR03AG070435 · NIA · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI THOMAS, KELSEY R · 2021 to 2022
$316k
Cognitive and Biomarker Profiles of Accurate and Inaccurate MCI DiagnosisIK2CX001415 · VA · VA SAN DIEGO HEALTHCARE SYSTEM · PI EDMONDS, EMILY CHARLOTTE · 2017 to 2021
–
CSRD VA IK2 CX001415CSRD VA IK2 CX001865NIA NIH HHS P30 AG062429NIA NIH HHS R01 AG049810NIA NIH HHS R01 AG063782NIA NIH HHS R03 AG070435
6 · The paper itself

Abstract

BACKGROUND AND

objectivesGiven prior work demonstrating that mild cognitive impairment (MCI) can be empirically differentiated into meaningful cognitive subtypes, we applied actuarial methods to comprehensive neuropsychological data from the University of California San Diego Alzheimer's Disease Research Center (ADRC) in order to identify cognitive subgroups within ADRC participants without dementia and to examine cognitive, biomarker, and neuropathologic trajectories.

methodsCluster analysis was performed on baseline neuropsychological data (n = 738; mean age 71.8). Survival analysis examined progression to dementia (mean follow-up 5.9 years). CSF Alzheimer disease (AD) biomarker status and neuropathologic findings at follow-up were examined in a subset with available data.

resultsFive clusters were identified: optimal cognitively normal (CN; n = 130) with above-average cognition, typical CN (n = 204) with average cognition, nonamnestic MCI (naMCI; n = 104), amnestic MCI (aMCI; n = 216), and mixed MCI (mMCI; n = 84). Progression to dementia differed across MCI subtypes (mMCI > aMCI > naMCI), with the mMCI group demonstrating the highest rate of CSF biomarker positivity and AD pathology at autopsy. Actuarial methods classified 29.5% more of the sample with MCI and outperformed consensus diagnoses in capturing those who had abnormal biomarkers, progressed to dementia, or had AD pathology at autopsy. DISCUSSION: We identified subtypes of MCI and CN with differing cognitive profiles, clinical outcomes, CSF AD biomarkers, and neuropathologic findings over more than 10 years of follow-up. Results demonstrate that actuarial methods produce reliable cognitive phenotypes, with data from a subset suggesting unique biological and neuropathologic signatures. Findings indicate that data-driven algorithms enhance diagnostic sensitivity relative to consensus diagnosis for identifying older adults at risk for cognitive decline.

Indexed as

AgedAged, 80 and overAlzheimer DiseaseAmyloid beta-PeptidesBiomarkersBrainCognitive DysfunctionConsensusDisease ProgressionFemaleHumansMaletau ProteinsAmyloid beta-PeptidesBiomarkersMAPT protein, humantau Proteins

Identifiers

PMID34376506
PMCPMC8480404

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.