Performance on Neuropsychological Assessment and Progression to Dementia: A Meta-Analysis

This meta-analysis examined how performance on various cognitive domains of neuropsychological functioning can contribute to predicting progression to dementia from mild cognitive impairment (MCI) or subjective memory complaints. Studies performed between the years of 1997 and 2018 were identified through a search of the electronic databases Medline and PsycINFO. Data from the articles identified were pooled to determine standardized mean differences, calculated as Hedges g, using a random-effects model. Twenty-four studies were included in the analysis. The majority of studies examined the progression of amnestic mild cognitive impairment (aMCI) to Alzheimer's disease (AD). Nonprogressors performed significantly better than did progressors in the domains of divided attention, executive function, expressive language, immediate recall, processing speed, delayed recall, visuospatial/constructional ability, working memory, and sustained attention. These findings indicate that individuals with MCI or subjective memory complaints who do not progress to dementia, perform better at baseline as compared with individuals that progress to dementia on a range of neuropsychological measures, and lends further support to the contention that neuropsychological assessment can make important contributions to predicting progression to dementia while individuals are still in the MCI or subjective memory complaint stage.