A Critical Review of Neuropsychological Actuarial Criteria for Mild Cognitive Impairment

Background: The concept of mild cognitive impairment (MCI) has evolved since its original conception. So, too, have MCI diagnostic methods, all of which have varying degrees of success in identifying individuals at risk of conversion to dementia. The neuropsychological actuarial method is a straightforward diagnostic approach that has shown promise in large datasets in identifying individuals with MCI who are likely to have progressive courses. This method has been increasingly applied in various iterations and samples, raising questions of how best to apply this method and when caution should be used. Objective: Our objective was to review the literature investigating use of the neuropsychological actuarial method to diagnose MCI to identify strengths and weaknesses of this approach, as well as highlight areas for further research. Methods: Databases PubMed and PsychInfo were systematically searched for studies that compared the neuropsychological actuarial method to some other diagnostic method. Results: We identified 13 articles and extracted relevant study characteristics and findings. Existing literature was reviewed and integrated, with focus on the neuropsychological actuarial method's performance relative to existing diagnostic methods/criteria as well as associations with longitudinal outcomes and biomarkers. Tables with pertinent methodological information and general findings are also provided. Conclusion: The neuropsychological actuarial method to diagnose MCI has shown utility some in large-scale homogenous databases compared to research criteria. However, its standing relative to consensus diagnostic methods is unclear, and emerging evidence suggests the neuropsychological actuarial method may be more prone to diagnostic errors in more demographically diverse populations.