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Mild cognitive impairment represents early-stage Alzheimer disease
Morris JC, Storandt M, Miller JP, McKeel DW, Price JL, Rubin EH, Berg L.. Archives of neurology, 2001-03-01
Topic: Risk, prevention and care in population studies
Background Mild cognitive impairment (MCI) is considered to be a transitional stage between aging and Alzheimer disease (AD). Objective To determine whether MCI represents early-stage AD by examining its natural history and neuropathologic basis. Design A prospective clinical and psychometric study of community-living elderly volunteers, both nondemented and minimally cognitively impaired, followed up for up to 9.5 years. Neuropathologic examinations were performed on participants who had undergone autopsy. Setting An AD research center. Participants All participants enrolled between July 1990 and June 1997 with Clinical Dementia Rating (CDR) scores of 0 (cognitively healthy; n = 177; mean age, 78.9 years) or 0.5 (equivalent to MCI; n = 277; mean age, 76.9 years). Based on the degree of clinical confidence that MCI represented dementia of the Alzheimer type (DAT), 3 subgroups of individuals with CDR scores of 0.5 were identified: CDR 0.5/DAT, CDR 0.5/incipient DAT, and CDR 0.5/uncertain dementia. Main outcome measure Progression to the stage of CDR 1, which characterizes mild definite DAT. Results Survival analysis showed that 100% of CDR 0.5/DAT participants progressed to greater dementia severity over a 9.5-year period. At 5 years, rates of progression to a score of CDR 1 (or greater) for DAT were 60.5% (95% confidence interval [CI], 50.2%-70.8%) for the CDR 0.5/DAT group, 35.7% (95% CI, 21.0%-50.3%) for the CDR 0.5/incipient DAT group, 19.9% (95% CI, 8.0%-31.8%) for the CDR 0.5/uncertain dementia group, and 6.8% (95% CI, 2.2%-11.3%) for CDR 0/controls. Progression to greater dementia severity correlated with degree of cognitive impairment at baseline. Twenty-four of the 25 participants with scores of CDR 0.5 had a neuropathologic dementing disorder, which was AD in 21 (84%). Conclusions Individuals currently characterized as having MCI progress steadily to greater stages of dementia severity at rates dependent on the level of cognitive impairment at entry and they almost always have the neuropathologic features of AD. We conclude that MCI generally represents early-stage AD.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Morris, J. C., Storandt, M., Miller, J. P., McKeel, D. W., Price, J. L., Rubin, E. H., et al. (2001). Mild cognitive impairment represents early-stage Alzheimer disease. Archives of neurology. https://doi.org/10.1001/archneur.58.3.397
Vancouver
Morris JC, Storandt M, Miller JP, McKeel DW, Price JL, Rubin EH, et al. Mild cognitive impairment represents early-stage Alzheimer disease. Archives of neurology. 2001. doi:10.1001/archneur.58.3.397. PMID: 11255443.
BibTeX
@article{morris2001-11255443,
author = {Morris, J. C. and Storandt, M. and Miller, J. P. and McKeel, D. W. and Price, J. L. and Rubin, E. H. and Berg, L.},
title = {{Mild cognitive impairment represents early-stage Alzheimer disease}},
journal = {Archives of neurology},
year = {2001},
doi = {10.1001/archneur.58.3.397},
pmid = {11255443},
url = {https://doi.org/10.1001/archneur.58.3.397}
}
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
- Results Survival analysis showed that 100% of CDR 0.5/DAT participants progressed to greater dementia severity over a 9.5-year period.
- We conclude that MCI generally represents early-stage AD.
Why it matters
Following 277 people rated as having mild cognitive impairment (CDR 0.5) and 177 healthy volunteers at one research centre for up to 9.5 years, this study found that within 5 years 60.5%, 35.7% and 19.9% of three MCI subgroups (graded by how confident clinicians were that Alzheimer-type dementia was present) had reached mild definite dementia, compared with 6.8% of controls. Of the 25 MCI participants examined after death, 21 (84%) had Alzheimer's disease, and the authors concluded that "MCI generally represents early-stage AD." It is an observational study of natural history and tested no treatment or prevention.
Study details
- Participants177
- Effect sizeor 0.5; 60.5%; 50.2%
- Evidence strengthLow
How this study scored 61/100
Published in a peer-reviewed journal. Scored zero for study design and randomised / blinded because the record does not state it. We have no data on senior author's track record, so that was left out: it earned 59 of the 96 points we could judge it on, which is 61 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Archives of neurology) |
| Journal's citation record | 3 / 4 | Archives of Neurology: journal h-index 353 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2001 — older than 20 years, still counted |
| Sample size | 2 / 4 | 177 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| 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 | 7 / 7 | Cited 1,859 times (OpenAlex, 2026-10-10) |
| Citations per year | 5 / 5 | 68.9 citations a year over 27 year(s) since 2001 |
| Impact for its field and year | 6 / 6 | Cited 44.3× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 5 / 6 | Cited by 158 other studies in this library |
| Still being cited | 3 / 4 | Cited 126 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | 2 / 3 | Washington University in St. Louis: institution h-index 1,962 (OpenAlex) |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 11255443) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 59 / 96 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 59 of the 96 points we could judge it on is 61 out of 100. |
| Total | 61 / 100 | — |
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