Objective: Although questionable dementia (QD) is generally known as high-risk condition for Alzheimer's disease (AD) or very mild AD, whether it is single diagnostic entity is still disputed. To investigate the question, we analyze the follow up data of QD subjects.
Design: Longitudinal follow up study.
Materials and Methods: 164 QD subjects, who were rated 0.5 on Clinical Dementia Rating (CDR) scale, were reevaluated between first to second years. Every subject was examined according to the protocol of the Korean Version of the CERAD clinical assessment battery and tested by the CERAD-K neuropsychological test battery (Lee et al., 2002). Diagnosis of dementia was made according to the criteria from DSM-IV and diagnosis of AD was made according to the criteria from NICDS-ADRDA. All subjects have above the score 2 on Modified Hachinski Ischemic Score (MHIS). Progression and improvement were defined by change of the score on CDR scale during follow up period.
Results: 19 subjects (11.6%) were progressed to mild AD and 45 subjects (27.4%) were improved to normal. Most subjects who progressed (18/19) and improved (44/45) were diagnosed as dementia and non-dementia at the baseline assessment, respectively. From the logistic regression analysis, score on CDR sum of box (CDR-SOB) and word list delayed recall test could predict the progression from CDR 0.5 to 1. Cut off point of CDR-SOB for prediction of progression is 1.5/2. Word list delayed recall and follow up period can predict the improvement from CDR 0.5 to 0.
Conclusion: Our results showed that questionable dementia was a heterogeneous condition, in which at least reversible mild cognitive impairment and very mild dementia were included. Progression and improvement of QD might be successfully predicted by clinical and neuropsychological assessment.
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