Visual memory tests enhance the identification of amnestic MCI cases at greater risk of Alzheimer's disease

Javier Oltra-Cucarella, Miriam Sánchez-Sansegundo, Darren M. Lipnicki, John D. Crawford, Richard B. Lipton, Mindy J. Katz, Andrea R. Zammit, Nikolaos Scarmeas, Efthimios Dardiotis, Mary H. Kosmidis, Antonio Guaita, Roberta Vaccaro, Ki Woong Kim, Ji Won Han, Nicole A. Kochan, Henry Brodaty, José A. Pérez-Vicente, Luis Cabello-Rodríguez, Perminder S. Sachdev, Rosario Ferrer-Cascales

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Objectives: To investigate whether amnestic mild cognitive impairment (aMCI) identified with visual memory tests conveys an increased risk of Alzheimer's disease (risk-AD) and if the risk-AD differs from that associated with aMCI based on verbal memory tests.Participants: 4,771 participants aged 70.76 (SD = 6.74, 45.4% females) from five community-based studies, each a member of the international COSMIC consortium and from a different country, were classified as having normal cognition (NC) or one of visual, verbal, or combined (visual and verbal) aMCI using international criteria and followed for an average of 2.48 years. Hazard ratios (HR) and individual patient data (IPD) meta-analysis analyzed the risk-AD with age, sex, education, single/multiple domain aMCI, and Mini-Mental State Examination (MMSE) scores as covariates.Results: All aMCI groups (n = 760) had a greater risk-AD than NC (n = 4,011; HR range = 3.66-9.25). The risk-AD was not different between visual (n = 208, 17 converters) and verbal aMCI (n = 449, 29 converters, HR = 1.70, 95%CI: 0.88, 3.27, p = 0.111). Combined aMCI (n = 103, 12 converters, HR = 2.34, 95%CI: 1.13, 4.84, p = 0.023) had a higher risk-AD than verbal aMCI. Age and MMSE scores were related to the risk-AD. The IPD meta-analyses replicated these results, though with slightly lower HR estimates (HR range = 3.68, 7.43) for aMCI vs. NC.Conclusions: Although verbal aMCI was most common, a significant proportion of participants had visual-only or combined visual and verbal aMCI. Compared with verbal aMCI, the risk-AD was the same for visual aMCI and higher for combined aMCI. Our results highlight the importance of including both verbal and visual memory tests in neuropsychological assessments to more reliably identify aMCI.

Original languageEnglish (US)
Pages (from-to)997-1006
Number of pages10
JournalInternational Psychogeriatrics
Issue number7
StatePublished - Jul 1 2019


  • Alzheimer's disease
  • memory
  • mild cognitive impairment
  • progression

ASJC Scopus subject areas

  • Clinical Psychology
  • Gerontology
  • Geriatrics and Gerontology
  • Psychiatry and Mental health


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