A Cochrane review [Abstract] 1 included 11 studies with a total of 1569 patients with mild cognitive impairment (MCI) followed for conversion to dementia. Four studies assessed the role of baseline scores of the Mini-Mental State Examination (MMSE) in conversion from MCI to all-cause dementia and 8 studies assessed this test in conversion from MCI to Alzheimer´s disease dementia. Only one study provided information about the MMSE and conversion from MCI to vascular dementia. For conversion from MCI to dementia in general, the accuracy of baseline MMSE scores ranged from sensitivities of 23% to 76% and specificities from 40% to 94%. In relationship to conversion from MCI to Alzheimer's disease dementia, the accuracy of baseline MMSE scores ranged from sensitivities of 27% to 89% and specificities from 32% to 90%. Only one study provided information about conversion from MCI to vascular dementia, presenting a sensitivity of 36% and a specificity of 80% with an incidence of vascular dementia of 6.2%.
Comment: The quality of evidence is downgraded by indirectness (only one time point used for assessment) and inconsistency (heterogeneity in sensitivity and specificity due to the lack of pre-specified thresholds).
Primary/Secondary Keywords