Subclassifications for mild XXXX : prevalence and predictive validity.

@entity303 @entity73 @entity2730
BACKGROUND: Mild @entity73 ( @entity2730 ) is associated with an increased risk of developing @entity303 . Recently published results of the Current Concepts in @entity2730 Conference suggested subclassifications for @entity2730 ( @entity2730 , @entity2730 -multiple domains slightly impaired, @entity2730 -single nonmemory domain) based on the recognized heterogeneity in the use of the term. These subclassifications have not been empirically validated to date. METHOD: A community sample of 1045 @entity303 -free individuals aged 75 years and over was examined by neuropsychological testing in a three-wave longitudinal study. The prevalences and the predictive validities for the subclassifications of @entity2730 and their modifications (original criteria except for the report of subjective @entity73 ) were determined. RESULTS: The prevalence was 1 to 15% depending on the subset employed. Subjects with a diagnosis of @entity2730 progressed to @entity303 at a rate of 10 to 55% over 2.6 years, depending on the subset employed. @entity2730 achieved the highest positive predictive power (PPP). ROC curves of the subclassifications for @entity2730 indicate that all but one subset for @entity2730 failed to predict @entity303 ( @entity2730 -multiple domains slightly impaired-modified: AUC=0.585, P<0.01, 95% CI, 0.517-0.653). The use of modified criteria for @entity2730 (original criteria except for the report of subjective @entity73 ) is associated with a higher diagnostic sensitivity but also with a reduction in diagnostic specificity and PPP. CONCLUSIONS: Modified criteria should be applied if a concept for @entity2730 with a high sensitivity is required and the original criteria (including subjective @entity73 ) if a concept with high specificity and high PPP is required.
