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Ninety subjects with Mild Cognitive Impairment were followed for mean 39 months as part of the McGill University Study of Mild Memory Loss in the Elderly. Multiple measures were assessed at study entry and each year, to determine which measures would serve to predict decline to dementia. At the end of the study, 51 of the group had progressed to dementia (all with Alzheimer's Disease). No clinical markers were found to be predictive aside from age. APO-E genotype was similarly not useful. An algorithm of 7 measures was constructed using subject age, Mini-mental state exam score, two scores of delayed verbal memory, the lexical decision reaction time, a working memory score (Brown Peterson test), and a measure of hippocampal atrophy on MRI scanning. Using these seven measures, a group with 0% progression to dementia, and a group with 100% progression to dementia (four or more points out of seven on the scale) could be delineated. Once validated prospectively, accurate prediction of dementia risk will aid in construction of future therapy trials in MCI subjects.
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