Prevalence and Incidence of Mild Cognitive Impairment across Subtypes, Age, and Sex

2019 ◽  
Vol 47 (4-6) ◽  
pp. 219-232 ◽  
Author(s):  
Marieclaire Overton ◽  
Mats Pihlsgård ◽  
Sölve Elmståhl
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Age Groups ◽  
Population Based ◽  
Incidence Rates ◽  
Functional Abilities ◽  
Amnestic Mci ◽  
Cognitive Complaint ◽  
Prevalence Estimates

Objective: The purpose of this study was to report on the prevalence and incidence of mild cognitive impairment (MCI) across age, sex, and subtypes according to various criteria in a population-based sample. Methods: The sample was drawn from the Swedish Good Aging in Skåne (GÅS) population study, and data from 3,752 participants aged 60 years and more were used to calculate the MCI prevalence. The incidence was calculated using 2,093 participants with 6-year follow-up data. MCI was defined according to the expanded Mayo Clinic criteria: cognitive complaint, objective cognitive impairment (two different criteria depending on the severity of impairment), preserved functional abilities, and no dementia. Results: The prevalence estimates ranged from 5.13 to 29.9% depending on age and severity of impairment. The incidence rates of overall MCI were 22.6 (95% confidence interval [CI]: 19.6–25.9) and 8.67 (95% CI: 7.0–10.7) per 1,000 person-years for less severe and severe cognitive impairment, respectively. The highest prevalence and incidence estimates were found for “non-amnestic MCI single domain.” The older age groups had a higher prevalence, and no sex or age differences in MCI incidence were detected. Conclusion: Our findings concur with previous research advocating that MCI is a heterogeneous concept, since the prevalence and incidence estimates differed substantially according to age, MCI subtype, and severity of cognitive impairment.

Impairment in instrumental activities of daily living with high cognitive demand is an early marker of mild cognitive impairment: the Sydney Memory and Ageing Study

2013 ◽  
Vol 43 (11) ◽  
pp. 2437-2445 ◽  
Author(s):  
S. Reppermund ◽  
H. Brodaty ◽  
J. D. Crawford ◽  
N. A. Kochan ◽  
B. Draper ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Cognitive Demand ◽  
Functional Abilities ◽  
Amnestic Mci ◽  
Instrumental Activities ◽  
High Cognitive Demand

BackgroundCriteria for mild cognitive impairment (MCI) consider impairment in instrumental activities of daily living (IADL) as exclusionary, but cross-sectional studies suggest that some high-level functional deficits are present in MCI. This longitudinal study examines informant-rated IADL in MCI, compared with cognitively normal (CN) older individuals, and explores whether functional abilities, particularly those with high cognitive demand, are predictors of MCI and dementia over a 2-year period in individuals who were CN at baseline.MethodA sample of 602 non-demented community dwelling individuals (375 CN and 227 with MCI) aged 70–90 years underwent baseline and 24-month assessments that included cognitive and medical assessments and an interview with a knowledgeable informant on functional abilities with the Bayer Activities of Daily Living Scale.ResultsSignificantly more deficits in informant-reported IADL with high cognitive demand were present in MCI compared with CN individuals at baseline and 2-year follow-up. Functional ability in CN individuals at baseline, particularly in activities with high cognitive demand, predicted MCI and dementia at follow-up. Difficulties with highly cognitively demanding activities specifically predicted amnestic MCI but not non-amnestic MCI whereas those with low cognitive demand did not predict MCI or dementia. Age, depressive symptoms, cardiovascular risk factors and the sex of the informant did not contribute to the prediction.ConclusionsIADL are affected in individuals with MCI, and IADL with a high cognitive demand show impairment predating the diagnosis of MCI. Subtle cognitive impairment is therefore likely to be a major hidden burden in society.

Elucidating the risk factors for progression from amyloid-negative amnestic mild cognitive impairment to dementia

2020 ◽  
Vol 17 ◽  
Author(s):  
Hyung-Ji Kim ◽  
Jae-Hong Lee ◽  
E-nae Cheong ◽  
Sung-Eun Chung ◽  
Sungyang Jo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Amnestic Mild Cognitive Impairment ◽  
Amyloid Pet ◽  
Clinical Progression ◽  
Amnestic Mci

Background: Amyloid PET allows for the assessment of amyloid β status in the brain, distinguishing true Alzheimer’s disease from Alzheimer’s disease-mimicking conditions. Around 15–20% of patients with clinically probable Alzheimer’s disease have been found to have no significant Alzheimer’s pathology on amyloid PET. However, a limited number of studies had been conducted this subpopulation in terms of clinical progression. Objective: We investigated the risk factors that could affect the progression to dementia in patients with amyloid-negative amnestic mild cognitive impairment (MCI). Methods: This study was a single-institutional, retrospective cohort study of patients over the age of 50 with amyloidnegative amnestic MCI who visited the memory clinic of Asan Medical Center with a follow-up period of more than 36 months. All participants underwent brain magnetic resonance imaging (MRI), detailed neuropsychological testing, and fluorine-18[F18]-florbetaben amyloid PET. Results: During the follow-up period, 39 of 107 patients progressed to dementia from amnestic MCI. In comparison with the stationary group, the progressed group had a more severe impairment in verbal and visual episodic memory function and hippocampal atrophy, which showed an Alzheimer’s disease-like pattern despite the lack of evidence for significant Alzheimer’s disease pathology. Voxel-based morphometric MRI analysis revealed that the progressed group had a reduced gray matter volume in the bilateral cerebellar cortices, right temporal cortex, and bilateral insular cortices. Conclusion: Considering the lack of evidence of amyloid pathology, clinical progression of these subpopulation may be caused by other neuropathologies such as TDP-43, abnormal tau or alpha synuclein that lead to neurodegeneration independent of amyloid-driven pathway. Further prospective studies incorporating biomarkers of Alzheimer’s diseasemimicking dementia are warranted.

Longitudinal Magnetic Resonance Spectroscopy as Marker of Cognitive Deterioration in Mild Cognitive Impairment

2011 ◽  
Vol 26 (8) ◽  
pp. 631-636 ◽  
Author(s):  
Pedro J. Modrego ◽  
Nicolás Fayed
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Magnetic Resonance ◽  
Magnetic Resonance Spectroscopy ◽  
Parietal Cortex ◽  
Surrogate Marker ◽  
Resonance Spectroscopy ◽  
Cognitive Changes ◽  
Amnestic Mci

Objective: Amnestic mild cognitive impairment (MCI) is highly predictive of Alzheimer’s disease but the pace of deterioration varies across patients. We hypothesize that magnetic resonance spectroscopy (MRS) could be a useful surrogate marker to monitor progression of cognitive impairment in patients with amnestic MCI. Methods. A cohort of patients with amnestic MCI underwent single-voxel 1H-MRS at baseline and at 2-year follow-up. We included 16 patients who converted to dementia of Alzheimer type and other 16 who did not. Changes in cognitive function were compared with the changes in the metabolite levels assessed in vivo. Results. At baseline the converters had lower mean N-acetyl-aspartate (NAA)/creatine (Cr) ratios in the posteromedial parietal cortex (1.41) than nonconverters (1.47). Most patients tended to lose points in the Mini-Mental test after 2-year follow-up in parallel with decreases in NAA levels ( r = .53; P = .002) in the posteromedial parietal cortex as well. The converters showed significant decreases in NAA levels and Cr ratios, whereas the nonconverters did not ( P = .001 and .02, respectively) in this area. Conclusion. We conclude that MRS is a technique sensitive enough to monitor cognitive changes and progression to dementia in patients with amnestic MCI.

Progression of mild cognitive impairment to dementia in German specialist practices

Dementia ◽  
2016 ◽  
Vol 18 (1) ◽  
pp. 380-390 ◽  
Author(s):  
Jens Bohlken ◽  
Louis Jacob ◽  
Karel Kostev
Keyword(s):  
Cognitive Impairment ◽  
Health Insurance ◽  
Mild Cognitive Impairment ◽  
Cox Regression ◽  
Insurance Coverage ◽  
Age Groups ◽  
Health Insurance Coverage ◽  
Hazard Ratio ◽  
Age Group

The goal of this study was to estimate the rate of the progression of mild cognitive impairment to dementia and identify the potential risk factors in German specialist practices from 2005 to 2015. This study included 4633 patients aged 40 years and over from 203 neuropsychiatric practices, who were initially diagnosed with mild cognitive impairment between 2005 and 2013. The primary outcome was diagnosis of all-cause dementia recorded in the database until the end of the five-year follow-up period. Cox regression models were used to examine mild cognitive impairment progression to dementia when adjusted for confounders (age, sex, and health-insurance type). The mean age was 68.9 years and 46.6% were men. After the five-year follow-up period, 38.1% of women and 30.4% of men had been diagnosed with dementia ( p < 0.001). The share of subjects with dementia increased with age, rising from 6.6% in the age group of ≤ 60 years to 64.7% in the age group of > 80 years ( p < 0.001). Men were at a lower risk of being diagnosed with dementia than women (hazard ratio = 0.86). Patients in the age groups 61–70, 71–80, and > 80 years also had a higher risk of developing this psychiatric disorder, with hazard ratios ranging from 3.50 to 11.71. Finally, mild cognitive impairment was less likely to progress to dementia in people with private health-insurance coverage than in people with public health-insurance coverage (hazard ratio = 0.69). Around one in three patients developed dementia in the five years following mild cognitive impairment diagnosis. Sex, age, and type of health insurance were associated with this risk.

scholarly journals DEFINITIONS MATTER WHEN DIAGNOSING MILD COGNITIVE IMPAIRMENT

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S115-S115
Author(s):  
Carol Derby ◽  
Charles B Hall ◽  
Mindy Katz
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Incidence Rate ◽  
Population Based ◽  
Study Cohort ◽  
Dramatic Reduction ◽  
Cognitively Normal ◽  
Aging Study ◽  
Normal Cognition

Abstract Prior studies have shown that when standard diagnostic criteria are applied, the majority of individuals diagnosed with aMCI do not progress to clinical dementia, with a much larger proportion reverting to normal cognition. This suggests that a prospective confirmation of aMCI diagnosis may improve the specificity of the classification. We examined the rates of aMCI reversion using two definitions: one based on a single annual assessment, and one requiring a diagnosis over two consecutive annual assessments within the population based Einstein Aging Study Cohort. Using the definition that used a single annual assessment resulted in 224 incident aMCI cases in 5,321 person years of follow-up, for an incidence rate of 4.21 cases per 100 person years. Requiring the confirmatory diagnosis resulted in only 94 incident aMCI cases in 5736 person years of follow-up, for an incidence rate of 1.64 cases per 100 person years. 41% of the persons diagnosed with aMCI using the single annual assessment were cognitively normal at the next follow-up. Only 14% of the persons diagnosed with incident aMCI using the definition requiring later confirmation ever returned to being cognitively normal. When the aMCI definition that required confirmation was used, a dramatic reduction in the incidence rate of aMCI was observed in persons born after 1930, similar to what has been reported in the same cohort for dementia, but there was no such difference for the definition based on a single annual assessment.

scholarly journals Can Clinical Data Predict Progression to Dementia in Amnestic Mild Cognitive Impairment?

2008 ◽  
Vol 35 (3) ◽  
pp. 314-322 ◽  
Author(s):  
Lesley Fellows ◽  
Howard Bergman ◽  
Christina Wolfson ◽  
Howard Chertkow
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Clinical Data ◽  
Symptom Onset ◽  
Amnestic Mild Cognitive Impairment ◽  
Elderly Subjects ◽  
Prospective Longitudinal Study ◽  
Amnestic Mci ◽  
Prospective Longitudinal

Background:To determine whether clinical data obtained by history and physical examination can predict eventual progression to dementia in a cohort of elderly people with mild cognitive impairment.Methods:A prospective, longitudinal study of a cohort of elderly subjects with amnestic Mild Cognitive Impairment (MCI). Ninety subjects meeting the criteria for amnestic MCI were recruited and followed annually for an average of 3.3 years. Main outcome measure was the development of dementia determined by clinical assessment with confirmatory neuropsychological evaluation.Results:Fifty patients (56%) developed dementia on follow-up. They were older, had lower Mini-mental status exam (MMSE) scores and a shorter duration of symptoms at the time of first assessment. Multivariate logistic regression analysis identified age at symptom onset as the only clinical parameter which distinguished the group that deteriorated to dementia from the group that did not. The odds ratio for age was 1.1 (confidence interval 1.04 - 1.18).Conclusions:Patients presenting with amnestic MCI insufficient for the diagnosis of dementia are at high risk of developing dementia on follow-up. In our cohort, 56% were diagnosed with dementia over an average period of 5.9 years from symptom onset. The only clinical predictor for the eventual development of dementia was older age at symptom onset. Clinical features alone were insufficient to predict development of dementia.

scholarly journals Later-Onset Hypertension Is Associated With Higher Risk of Dementia in Mild Cognitive Impairment

2020 ◽  
Vol 11 ◽  
Author(s):  
Hongyun Qin ◽  
Binggen Zhu ◽  
Chengping Hu ◽  
Xudong Zhao
Keyword(s):  
Diabetes Mellitus ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Old Age ◽  
Pulse Pressure ◽  
Population Based ◽  
Proportional Hazard ◽  
Cox Proportional Hazard ◽  
Hypertension Development

To investigate the correlation between hypertension development and the progression of mild cognitive impairment (MCI) to dementia in middle-aged and elderly people. A population-based longitudinal cognition survey of people aged 55+ was conducted. The hypertension onset age was estimated by self-reported information and medical insurance card records. To study the effect of later-onset hypertension on dementia, the incidence of dementia was compared between the two groups. Of 277 hypertensive MCI participants without dementia, 56 (20.22%) progressed to dementia (MCIp) over the 6-year follow-up. The proportion of MCIp participants in the old-age-onset hypertension group (≥65 years) was higher than that in the middle-age-onset hypertension group (27.0 vs. 15.4%, respectively; X2 = 5.538, P = 0.019). In the old-age-onset hypertension group, the proportion of MCIp without diabetes mellitus was higher than those with diabetes mellitus (24.7 vs. 12.6%, respectively; X2 = 5.321, P = 0.021) and those with increased pulse pressure was higher than those without increased pulse pressure (33.3 vs. 15.4%, respectively; X2 = 3.902, P = 0.048). However, the cox proportional hazard showed that older age was the only risk factor for MCIp (HR = 0.618, p = 0.000). These results suggest that individuals with later-onset hypertension may have greater cognition decline, even with blood pressure maintained at 130/80 mmHg with antihypertensive management.

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