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One of the critical elements for visual <jats:styled-content style=\"fixed-case\">MTA<\/jats:styled-content> assessment is the cut\u2010off score that determines deviation from normality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this study, we assessed the sensitivity and specificity of different <jats:styled-content style=\"fixed-case\">MTA<\/jats:styled-content> cut\u2010off scores to classify control subjects, individuals with mild cognitive impairment (<jats:styled-content style=\"fixed-case\">MCI<\/jats:styled-content>) and <jats:styled-content style=\"fixed-case\">AD<\/jats:styled-content> patients from two large independent cohorts, AddNeuroMed and Alzheimer's Disease Neuroimaging Initiative. Of note, we evaluated the effects of clinical, demographic and genetic variables on the classification performance according to the different cut\u2010offs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A cut\u2010off of \u22651.5 based on the mean <jats:styled-content style=\"fixed-case\">MTA<\/jats:styled-content> scores of both hemispheres showed higher sensitivity in classifying patients with <jats:styled-content style=\"fixed-case\">AD<\/jats:styled-content> (84.5%) and <jats:styled-content style=\"fixed-case\">MCI<\/jats:styled-content> subjects (75.8%) who converted to dementia compared to an age\u2010dependent cut\u2010off. The age\u2010dependent cut\u2010off showed higher specificity or ability to correctly identify control subjects (83.2%) and those with <jats:styled-content style=\"fixed-case\">MCI<\/jats:styled-content> who remained stable (65.5%). Increasing age, early\u2010onset disease and absence of the <jats:italic>ApoE<\/jats:italic> \u03b54 allele had a stronger influence on classifications using the \u22651.5 cut\u2010off. Above 75\u00a0years of age, an alternative cut\u2010off of \u22652.0 should be applied to achieve a classification accuracy for both patients with <jats:styled-content style=\"fixed-case\">AD<\/jats:styled-content> and control subjects that is clinically useful.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Clinical, demographic and genetic variables can influence the classification of <jats:styled-content style=\"fixed-case\">MTA<\/jats:styled-content> cut\u2010off scores, leading to misdiagnosis in some cases. These variables, in addition to the differential sensitivity and specificity of each cut\u2010off, should be carefully considered when performing visual <jats:styled-content style=\"fixed-case\">MTA<\/jats:styled-content> assessment.<\/jats:p><\/jats:sec>","DOI":"10.1111\/joim.12148","type":"journal-article","created":{"date-parts":[[2013,10,14]],"date-time":"2013-10-14T11:42:57Z","timestamp":1381750977000},"page":"317-330","source":"Crossref","is-referenced-by-count":70,"title":["Influence of age, disease onset and <i>ApoE4<\/i> on visual medial temporal lobe atrophy cut\u2010offs"],"prefix":"10.1111","volume":"275","author":[{"given":"J. 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