Dataset Information

Study of the Risk and Preventive Factors for Progress of Mild Cognitive Impairment to Dementia.

ABSTRACT:

Objective

To evaluate the risk factors for progress of mild cognitive impairment to dementia.

Methods

This study was based on the epidemiological survey in 2011 (No. PKJ2010-Y26) and contained 441 MCI individuals. Cognitive function was measured by the Mini-Mental Status Examination, clinical dementia rating, and montreal cognitive assessment. The association between demographic characteristics and MCI outcomes were evaluated using single-and multifactor ordered logistic regression analysis models.

Results

Of the 441 MCI, 77 progressed to dementia (MCIp: 17.5%, 95% CI: 14.4%-21.6%), 356 remained stable (MCIs: 80.7%, 95% CI: 77.0%-88.4%), and 8 reverted to normal cognition (MCIr: 1.8%, 95% CI: 0.6%-3.0%) at follow-up in 2017. Univariate ordinal regression analysis showed that diabetes (P = .052), marriage (P = .028), worker (P = .069), and manager (P = .075) may be the risk factor for the status of MCI. Multiple ordinal regression results showed that diabetes (P = .049) and marriage (P = .04) significantly affected the cognitive function changes in the MCI patients.

Conclusion

Nondiabetics and being married may prevent the progression from MCI to dementia.

SUBMITTER: Hu C

PROVIDER: S-EPMC10624080 | biostudies-literature | 2020 Jan-Dec

REPOSITORIES: biostudies-literature

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Publications

Study of the Risk and Preventive Factors for Progress of Mild Cognitive Impairment to Dementia.

Hu Chengping C Wang Ling L Guo Yi Y Cao Zhicheng Z Lu Ying Y Qin Hongyun H Qin Hongyun H

American journal of Alzheimer's disease and other dementias 20200101

<h4>Objective</h4>To evaluate the risk factors for progress of mild cognitive impairment to dementia.<h4>Methods</h4>This study was based on the epidemiological survey in 2011 (No. PKJ2010-Y26) and contained 441 MCI individuals. Cognitive function was measured by the Mini-Mental Status Examination, clinical dementia rating, and montreal cognitive assessment. The association between demographic characteristics and MCI outcomes were evaluated using single-and multifactor ordered logistic regressio ...[more]

PMID: 32567328

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Project description:Background/objectiveIn population studies, most individuals with mild cognitive impairment (MCI) do not progress to dementia in the near term, but rather remain stable MCI or revert to normal cognition. Here, we characterized MCI subgroups with different outcomes over 5 years.Setting/participantsA population-based cohort (N=1603).MeasurementsClinical Dementia Rating (CDR); self-reported medical conditions, subjective cognitive concerns, self-rated health, depressive symptoms, blood pressure, medications, blood pressure, APOE genotype, cognitive domain composite scores.DesignWe compared 3 MCI subgroups who progressed to dementia (n=86), stabilized at MCI (n=384), or reverted to normal (n=252), to those who remained consistently normal (n=881), defining MCI as CDR = 0.5 and dementia as CDR≥1. Using multinomial logistic regression models adjusted for demographics, we examined the associations of each group with selected baseline characteristics.ResultsWith the normal group for reference, worse subjective cognitive concerns, functional impairments, self-rated health, and depressive symptoms were associated with being in any MCI group. Taking more prescription medications was associated with being in the stable MCI and reverter groups; diabetes and low diastolic blood pressure were associated with stable MCI. The APOE4 genotype was associated with stable and progressive MCI; stroke was associated with progressive MCI. All MCI subgroups were likely to have lower mean composite scores in all cognitive domains and more operationally defined impairments in attention, language, and executive function; reverters were more likely to lack memory and visuospatial impairments.ConclusionsMCI subgroups with different 5-year outcomes had some distinct characteristics suggesting different underlying causes. The progressors, unlike the reverters, had a profile broadly typical of Alzheimer's disease; the stable MCIs had other, including vascular, morbidity. These data shed light on the heterogeneity of MCI in the population. J Am Geriatr Soc 67:232-238, 2019.

Project description:BackgroundMild cognitive impairment and cognitive impairment, no dementia, are emerging terms that encompass the clinical state between normal cognition and dementia in elderly people. Controversy surrounds their characterization, definition and application in clinical practice. In this article, we provide physicians with practical guidance on the definition, diagnosis and treatment of mild cognitive impairment and cognitive impairment, no dementia, based on recommendations from the Third Canadian Consensus Conference on the Diagnosis and Treatment of Dementia, held in March 2006.MethodsWe developed evidence-based guidelines using systematic literature searches, with specific criteria for study selection and quality assessment, and a clear and transparent decision-making process. We selected studies published from January 1996 to December 2005 that had mild cognitive impairment or cognitive impairment, no dementia, as the outcome. Subsequent to the conference, we searched for additional articles published between January 2006 and January 2008. We graded the strength of evidence using the criteria of the Canadian Task Force on Preventive Health Care.ResultsWe identified 2483 articles, of which 314 were considered to be relevant and of good or fair quality. From a synthesis of the evidence in these studies, we made 16 recommendations. In brief, family physicians should be aware that most types of dementia are preceded by a recognizable phase of mild cognitive decline. They should be familiar with the concepts of mild cognitive impairment and of cognitive impairment, no dementia. Patients with these conditions should be closely monitored because of their increased risk for dementia. Leisure activities, cognitive stimulation and physical activity could be promoted as part of a healthy lifestyle in elderly people and those with mild cognitive impairment. Vascular risk factors should be treated optimally. No other specific therapies can yet be recommended.InterpretationPhysicians will increasingly see elderly patients with mild memory loss, and learning an approach to diagnosing states such as mild cognitive impairment is now warranted. Close monitoring for progression to dementia, promotion of a healthy lifestyle and treatment of vascular risk factors are recommended for the management of patients with mild cognitive impairment.

Project description:BackgroundSubjective cognitive decline (SCD) and anxiety symptoms both predict neurocognitive disorders, but the two correlate strongly with each other. It is unclear whether they reflect two independent disease processes in the development of neurocognitive disorders and hence deserve separate attention. This cohort study examined whether SCD and anxiety symptoms demonstrate independent risks of mild cognitive disorder and dementia (MCI/dementia).MethodsThe study included 14,066 participants aged ≥ 50 years and diagnosed with normal cognition at baseline, recruited from Alzheimer's Disease Centers across the USA. The participants were evaluated for SCD and anxiety symptoms at baseline and followed up almost annually for incident MCI/dementia (median follow-up 4.5 years; interquartile range 2.2-7.7 years). SCD and anxiety symptoms were included in Cox regression to investigate their independent risks of MCI/dementia.ResultsSCD and anxiety symptoms demonstrated independent risks of MCI/dementia, with HR 1.9 (95% CI 1.7-2.1) and 1.3 (95% CI 1.2-1.5), respectively. Co-occurring SCD and anxiety symptoms demonstrated the highest risk (HR 2.4, 95% CI 1.9-2.9)-participants in this group had a 25% probability of developing MCI/dementia by 3.1 years (95% 2.4-3.7), compared to 8.2 years among those without SCD or anxiety (95% CI 7.9-8.6). The results remained robust even in the sensitivity analyses that took into account symptom severity and consistency of symptoms in the first 2 annual visits.ConclusionsThe findings suggest that clinicians should not dismiss one over the other when patients present with both SCD and anxiety and that both constructs may potentially be useful to identify high-risk populations for preventive interventions and trials. The findings also point to the need for further research to clarify on the neurobiological distinctions between SCD and anxiety symptoms, which may potentially enrich our understanding on the pathogenesis of neurocognitive disorders.

Project description:BackgroundIn cognitively normal individuals, subjective cognitive decline (SCD) has been reported to predict MCI and dementia (MCI/dementia). However, prior studies mostly captured SCD at single time-points without considering the longitudinal course of SCD. This study examined whether the trajectories of SCD provide any added information-beyond one-time assessments of SCD-on the risk of MCI/dementia.MethodsThis cohort study included 5661 participants from the Alzheimer's Disease Centers across the USA, who were ≥ 50 years and had normal cognition in the first-four annual visits (year 1 to year 4). The participants were evaluated for SCD in the first-four annual visits (year 1 to year 4), and followed-up almost annually (year 4 up to year 14) for incident MCI/dementia. SCD trajectories (as identified from latent-class-growth-curve-analysis) were included in Cox regression to estimate their risks of MCI/dementia, with analyses further stratified by age (< 75 years versus ≥ 75 years; based on median-split).ResultsCompared to those without SCD (in the first-four annual visits), Intermittent SCD (i.e., reported in 1-2 of the first-four annual visits) predicted a higher risk (HR 1.4) and Persistent SCD (i.e., reported in 3-4 of the first-four annual visits) predicted the highest risk (HR 2.2), with the results remaining significant even after adjusting for baseline SCD. Age-stratified analysis revealed that the risk associated with Intermittent SCD was only present in older individuals, while risk related to Persistent SCD was consistently present across the younger and older age groups. Age compounded the effects of the trajectories, whereby older individuals with Persistent SCD had > 75% probability of developing MCI/dementia by 10 years, in contrast to < 25% probability by 10 years in younger individuals with No SCD.ConclusionsThe findings demonstrate the utility of SCD trajectories-especially when used in combination with age strata-in identifying high-risk populations for preventive interventions and trials. They also suggest a potential modification in the current SCD criteria, with the inclusion of "persistent SCD over several years" as a feature of SCD plus.

Dataset Information

Study of the Risk and Preventive Factors for Progress of Mild Cognitive Impairment to Dementia.

Objective

Methods

Results

Conclusion

Publications

Study of the Risk and Preventive Factors for Progress of Mild Cognitive Impairment to Dementia.

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