Background: Identifying and classifying individuals with Cognitive Impairment-No Dementia
(CIND) has further challenged diagnostic methods, since varying the cutoffs for objective impairment
as well as the neuropsychological tests considered can significantly affect diagnosis. Therefore, we
investigated the applicability of an actuarial neuropsychological approach for clinical subdivision of
CIND and quantified the variability in diagnostic outcomes that results from diverse neuropsychologically
derived definition of objective cognitive impairment.
Methods: 1459 non-demented, clinic-based individuals were recruited from a monocentric memory
clinic from 1/1/2016/ to 1/1/2018 and classified as Cognitively Normal (NC), Slight Cognitive Symptom
(SCS), SSubtle Cognitive Decline (SCD) or Mild Cognitive Impairment (MCI) via different diagnostic
strategies, which varied the composition of objective cognitive assessments involved in the diagnostic
Results: We compared two methods of criteria proposed by Jak/Bondi and Petersen/Winblad to classify
individuals with CIND. A substantial range of differences in the percentages recognized as NC, SCS,
SCD, and MCI was presented, depending on the classification criteria adopted. Our data revealed that
the application of a set of six neuropsychological scores dividing CIND into 4 subgroups (NC, SCS,
SCD, and MCI) was able to classify all non-demented individuals without overlap or omission.
Conclusion: Our study provided clinical support for an operational framework of the CIND classification
system and underlined the value of applying comprehensive neuropsychological assessments for
definition. The concept of SCS, considered appropriate for a preclinical stage, was proposed as the
symptomatic definition for early intervention.