Animal fluency improvements and confrontation naming declines over 6 months are associated with differential conversion from MCI to AD in ADNI

Background Not everyone with mild cognitive impairment (MCI) progresses to Alzheimer’s dementia (AD). Predicting who will decline is important. We previously reported that 6‐months change scores for language, but not for memory, executive functioning, or visuospatial functions, identified a high‐risk subgroup. Here we consider more specific language processes and consider AD fluid and imaging biomarkers. Methods We used longitudinal data from 764 ADNI participants enrolled with MCI and still had MCI at 6 months, which was our baseline for Cox proportional hazards modeling of conversion to AD. We derived scores for four aspects of language: confrontation naming, animal fluency, letter fluency tests, and other language tests. We evaluated changes from enrollment to month 6 for each of these scores. We also adjusted models for APOE genotype, entorhinal thickness and hippocampal volume, and CSF amyloid and tau biomarkers. Results The sample’s mean age was 73.2 years, and 59% were male. From over 2918 total follow‐up years (mean 3.8), there were 287 conversions to AD. Cox models controlling for demographic characteristics, showed improvements in animal fluency scores associated with lower risk (HR=0.58, p=.005), but declines in confrontation naming were associated with higher risk (HR=1.74, p