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Reversion from mild cognitive impairment to normal or near-normal cognition: risk factors and prognosis
Koepsell TD, Monsell SE.. Neurology, 2012-09-26
Topic: Risk, prevention and care in population studies
Objectives We sought to identify characteristics of individuals with mild cognitive impairment (MCI) that are associated with a relatively high probability of reverting back to normal cognition, and to estimate the risk of future cognitive decline among those who revert. Methods We first studied 3,020 individuals diagnosed with MCI on at least 1 visit to an Alzheimer's Disease Center in the United States. All underwent standardized Uniform Data Set evaluations at their first visit with an MCI diagnosis and on a subsequent visit, about 1 year later, at which cognitive status was reassessed. Multiple logistic regression was used to identify predictors of reverting from MCI back to normal cognition. We then estimated the risk of developing MCI or dementia over the next 3 years among those who had reverted, compared with individuals who had not had a study visit with MCI. Results About 16% of subjects diagnosed with MCI reverted back to normal or near-normal cognition approximately 1 year later. Five characteristics assessed at the first MCI visit contributed significantly to a model predicting a return to normal cognition: Mini-Mental State Examination (MMSE) score, Clinical Dementia Rating (CDR) score, MCI type, Functional Activities Questionnaire (FAQ) score, and APOE ε4 status. Survival analysis showed that the risk of retransitioning to MCI or dementia over the next 3 years was sharply elevated among those who had MCI and then improved, compared with individuals with no history of MCI. Conclusions Even in a cohort of patients seen at dementia research centers, reversion from MCI was fairly common. Nonetheless, those who reverted remained at increased risk for future cognitive decline.
Key findings
- Objectives We sought to identify characteristics of individuals with mild cognitive impairment (MCI) that are associated with a relatively high probability of reverting back to normal cognition, and to estimate the risk of future cognitive decline among those who revert.
- We then estimated the risk of developing MCI or dementia over the next 3 years among those who had reverted, compared with individuals who had not had a study visit with MCI.
- Results About 16% of subjects diagnosed with MCI reverted back to normal or near-normal cognition approximately 1 year later.
- Five characteristics assessed at the first MCI visit contributed significantly to a model predicting a return to normal cognition: Mini-Mental State Examination (MMSE) score, Clinical Dementia Rating (CDR) score, MCI type, Functional Activities Questionnaire (FAQ) score, and APOE ε4 status.
- Survival analysis showed that the risk of retransitioning to MCI or dementia over the next 3 years was sharply elevated among those who had MCI and then improved, compared with individuals with no history of MCI.
Why it matters
Among 3,020 people diagnosed with mild cognitive impairment at US Alzheimer's Disease Centers, about 16% were back to normal or near-normal cognition roughly a year later, and five things measured at the first MCI visit (MMSE score, CDR score, MCI type, FAQ score and APOE ε4 status) helped predict who reverted. But those who reverted had a "sharply elevated" risk of going back to MCI or dementia over the next 3 years compared with people with no history of MCI. The study observed people rather than testing a treatment, so it does not show how to cure or prevent Alzheimer's, and improving on a test is not the same as being in the clear.
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Study details
- Participants3,020
- Evidence strengthModerate
How this study scored 62/100
Published in a leading specialty journal. Scored zero for study design, effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Neurology) |
| Journal's citation record | 4 / 4 | Neurology: journal h-index 525 (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 | 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 | 2012 — within 20 year(s) of the newest study here |
| Sample size | 3 / 4 | 3,020 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 | 6 / 7 | Cited 371 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 23.2 citations a year over 16 year(s) since 2012 |
| Impact for its field and year | 4 / 6 | Cited 11.1× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 4 / 6 | Cited by 38 other studies in this library |
| Still being cited | 3 / 4 | Cited 90 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Sarah E. Monsell: h-index 33 (OpenAlex, whole career) |
| Institution's track record | 3 / 3 | University of Washington: institution h-index 3,540 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 2 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 23019264) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 62 / 100 | — |
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Read the original
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Koepsell, T. D., & Monsell, S. E. (2012). Reversion from mild cognitive impairment to normal or near-normal cognition: risk factors and prognosis. Neurology. https://doi.org/10.1212/wnl.0b013e31826e26b7
Vancouver
Koepsell TD, Monsell SE. Reversion from mild cognitive impairment to normal or near-normal cognition: risk factors and prognosis. Neurology. 2012. doi:10.1212/wnl.0b013e31826e26b7. PMID: 23019264.
BibTeX
@article{koepsell2012-23019264,
author = {Koepsell, T. D. and Monsell, S. E.},
title = {{Reversion from mild cognitive impairment to normal or near-normal cognition: risk factors and prognosis}},
journal = {Neurology},
year = {2012},
doi = {10.1212/wnl.0b013e31826e26b7},
pmid = {23019264},
url = {https://doi.org/10.1212/wnl.0b013e31826e26b7}
}
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