Can neurocognitive assessment be a lower-cost substitute for biomarkers in predicting progression from mild cognitive impairment (MCI) to Alzheimer's disease (AD)? A narrative review

The challenge to find the best predictors of conversion from Mild Cognitive Impairment (MCI) to Alzheimer's disease (AD) has been ongoing at least for the last decade. Nonetheless, clinicians still lack, to date, a robust predictive tool for identifying individuals who will go through this conversion. In this narrative review, we reported the sensitivity and specificity of biomarkers and neurocognitive assessment in predicting the progression from MCI to AD. Given that biomarkers do not necessarily provide a better predictive accuracy as showcased by the numbers in this study, cognitive tests seem like a more cost-effective, less invasive, and easily accessible option. They also offer the added benefit of measuring functional cognitive impairment. However, it remains clear that efforts are still needed to come up with more accurate, sensitive, and specific predictors.