Defining mild cognitive impairment: impact of varying decision criteria on neuropsychological diagnostic frequencies and correlates
Schinka JA, Loewenstein DA, Raj A, Schoenberg MR, Banko JL, Potter H, Duara R.. The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry, 2010-08-01
Topic: Risk, prevention and care in population studies
Objective To examine the impact of varying decision criteria on neuropsychological diagnostic frequencies and on their correlates. Design Descriptive and correlational study. Setting Florida Alzheimer's Disease Research Center. Participants A sample of 373 individuals with comprehensive baseline analyses participating in a longitudinal study of cognitive decline and early Alzheimer disease. Measurements Mild cognitive impairment (MCI) diagnoses were made on the basis of four sets of decision criteria created by crossing two approaches: varying the number of impaired test results required for a diagnosis within any domain (1 test versus 2) and varying the performance level required to determine impairment (1.5 or 2 standard deviations [SDs] below the normative mean) for any test. Results Under each criteria set, single-domain amnestic MCI was the most frequent MCI diagnosis. MCI global and subtype diagnosis frequencies were inversely related to the stringency of the criteria. The single test-1.5 SD criterion identified the largest number of cases as qualifying for an MCI diagnosis, and the two test-2.0 SD cutoff identified the fewest. Across all sets of criteria, the authors found significant positive associations between neuropsychological diagnoses and Clinical Dementia Rating score categories. Significant relationships between diagnoses and both apolipoprotein E (APOE) genotype and magnetic resonance imaging ratings of medial temporal atrophy (MTA) application were found only for the two test-1.5 SD and two test-2.0 SD cutoffs. Conclusion MCI diagnosis frequencies are substantively affected by the stringency of the criteria, but the relative rankings of MCI subtype diagnoses are fairly consistent regardless of the stringency of the criteria. Significant associations of neuropsychological diagnoses with independent markers such as APOE genotype and MTA are only found with more stringent criteria, suggesting that a coherent network of associations reflecting cognitive decline occurs with more restrictive definitions for impairment.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Schinka, J. A., Loewenstein, D. A., Raj, A., Schoenberg, M. R., Banko, J. L., Potter, H., et al. (2010). Defining mild cognitive impairment: impact of varying decision criteria on neuropsychological diagnostic frequencies and correlates. The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry. https://doi.org/10.1097/jgp.0b013e3181e56d5a
Vancouver
Schinka JA, Loewenstein DA, Raj A, Schoenberg MR, Banko JL, Potter H, et al. Defining mild cognitive impairment: impact of varying decision criteria on neuropsychological diagnostic frequencies and correlates. The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry. 2010. doi:10.1097/jgp.0b013e3181e56d5a. PMID: 21399729.
BibTeX
@article{schinka2010-21399729,
author = {Schinka, J. A. and Loewenstein, D. A. and Raj, A. and Schoenberg, M. R. and Banko, J. L. and Potter, H. and Duara, R.},
title = {{Defining mild cognitive impairment: impact of varying decision criteria on neuropsychological diagnostic frequencies and correlates}},
journal = {The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry},
year = {2010},
doi = {10.1097/jgp.0b013e3181e56d5a},
pmid = {21399729},
url = {https://doi.org/10.1097/jgp.0b013e3181e56d5a}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 7 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
Key findings
- Measurements Mild cognitive impairment (MCI) diagnoses were made on the basis of four sets of decision criteria created by crossing two approaches: varying the number of impaired test results required for a diagnosis within any domain (1 test versus 2) and varying the performance level required to determine impairment (1.5 or 2 standard deviations [SDs] below the normative mean) for any test.
- Results Under each criteria set, single-domain amnestic MCI was the most frequent MCI diagnosis.
- Across all sets of criteria, the authors found significant positive associations between neuropsychological diagnoses and Clinical Dementia Rating score categories.
- Significant relationships between diagnoses and both apolipoprotein E (APOE) genotype and magnetic resonance imaging ratings of medial temporal atrophy (MTA) application were found only for the two test-1.5 SD and two test-2.0 SD cutoffs.
- Significant associations of neuropsychological diagnoses with independent markers such as APOE genotype and MTA are only found with more stringent criteria, suggesting that a coherent network of associations reflecting cognitive decline occurs with more restrictive definitions for impairment.
Why it matters
This study showed that how strictly mild cognitive impairment is defined changes how many people are diagnosed and which factors, including APOE genotype, relate to the diagnosis. It highlights that diagnostic criteria matter for research and clinical practice, but it does not test any treatment or prevention.
New to this subject? Start with our plain-English guide: Genetics →
Study details
- Study designlongitudinal study
- Participants373
- Evidence strengthModerate
How this study scored 55/100
Published in a peer-reviewed journal, and it is a longitudinal study following the same people over time. Scored zero for effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry) |
| Journal's citation record | 2 / 4 | American Journal of Geriatric Psychiatry: journal h-index 178 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A longitudinal study following the same people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2010 — within 20 year(s) of the newest study here |
| Sample size | 2 / 4 | 373 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 117 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 6.5 citations a year over 18 year(s) since 2010 |
| Impact for its field and year | 3 / 6 | Cited 4.0× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 1 / 6 | Cited by 2 other studies in this library |
| Still being cited | 1 / 4 | Cited 10 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Ranjan Duara: h-index 99 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | University of Miami: institution h-index 998 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 4 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 21399729) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 55 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1097/jgp.0b013e3181e56d5a
- PubMed: 21399729
- Original source →
- Free full text: PubMed Central →
Full text: free to read — PubMed Central lists this copy as free to read: the link above (checked 10 Oct 2026).
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