Cargando…

Predictors of Incident Mild Cognitive Impairment and Its Course in a Diverse Community-Based Population

BACKGROUND AND OBJECTIVES: To investigate sociodemographic and medical predictors of incident mild cognitive impairment (MCI) and subsequent course of MCI at follow-up, including sustained MCI diagnosis, classification as cognitively normal, and progression to dementia. METHODS: Within a community-b...

Descripción completa

Detalles Bibliográficos
Autores principales: Angevaare, Milou J., Vonk, Jet M.J., Bertola, Laiss, Zahodne, Laura, Watson, Caitlin Wei-Ming, Boehme, Amelia, Schupf, Nicole, Mayeux, Richard, Geerlings, Mirjam I., Manly, Jennifer J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8726570/
https://www.ncbi.nlm.nih.gov/pubmed/34853178
http://dx.doi.org/10.1212/WNL.0000000000013017
_version_ 1784626347414388736
author Angevaare, Milou J.
Vonk, Jet M.J.
Bertola, Laiss
Zahodne, Laura
Watson, Caitlin Wei-Ming
Boehme, Amelia
Schupf, Nicole
Mayeux, Richard
Geerlings, Mirjam I.
Manly, Jennifer J.
author_facet Angevaare, Milou J.
Vonk, Jet M.J.
Bertola, Laiss
Zahodne, Laura
Watson, Caitlin Wei-Ming
Boehme, Amelia
Schupf, Nicole
Mayeux, Richard
Geerlings, Mirjam I.
Manly, Jennifer J.
author_sort Angevaare, Milou J.
collection PubMed
description BACKGROUND AND OBJECTIVES: To investigate sociodemographic and medical predictors of incident mild cognitive impairment (MCI) and subsequent course of MCI at follow-up, including sustained MCI diagnosis, classification as cognitively normal, and progression to dementia. METHODS: Within a community-based cohort, diagnoses of MCI were made with a published algorithm. Diagnosis of dementia was based on clinical consensus. Cox regressions estimated hazard ratios of incident MCI associated with several predictors. Modified Poisson regressions estimated relative risks associated with predictors of diagnostic status at follow-up after incidence. RESULTS: Among 2,903 cognitively normal participants at baseline, 752 developed MCI over an average of 6.3 (SD 4.5) years (incidence rate 56 per 1,000 person-years). Presence of APOE ε4 and higher medical burden increased risk of incident MCI, while more years of education, more leisure activities, and higher income decreased this risk. Of the incident MCI cases, after an average of 2.4 years of follow-up, 12.9% progressed to dementia, 9.6% declined in functioning and did not meet the algorithmic criteria for MCI but did not meet the clinical criteria for dementia, 29.6% continued to meet MCI criteria, and 47.9% no longer met MCI criteria. Multidomain MCI, presence of APOE ε4, depressive symptoms, and antidepressant use increased the risk of progression to dementia. DISCUSSION: This community-based study showed that almost half of the individuals with incident MCI diagnoses were classified as cognitively normal at follow-up. Predictors of incident MCI demonstrably differed from those of subsequent MCI course; these findings can refine expectations for cognitive and functional course of those presenting with MCI.
format Online
Article
Text
id pubmed-8726570
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Lippincott Williams & Wilkins
record_format MEDLINE/PubMed
spelling pubmed-87265702022-01-13 Predictors of Incident Mild Cognitive Impairment and Its Course in a Diverse Community-Based Population Angevaare, Milou J. Vonk, Jet M.J. Bertola, Laiss Zahodne, Laura Watson, Caitlin Wei-Ming Boehme, Amelia Schupf, Nicole Mayeux, Richard Geerlings, Mirjam I. Manly, Jennifer J. Neurology Research Article BACKGROUND AND OBJECTIVES: To investigate sociodemographic and medical predictors of incident mild cognitive impairment (MCI) and subsequent course of MCI at follow-up, including sustained MCI diagnosis, classification as cognitively normal, and progression to dementia. METHODS: Within a community-based cohort, diagnoses of MCI were made with a published algorithm. Diagnosis of dementia was based on clinical consensus. Cox regressions estimated hazard ratios of incident MCI associated with several predictors. Modified Poisson regressions estimated relative risks associated with predictors of diagnostic status at follow-up after incidence. RESULTS: Among 2,903 cognitively normal participants at baseline, 752 developed MCI over an average of 6.3 (SD 4.5) years (incidence rate 56 per 1,000 person-years). Presence of APOE ε4 and higher medical burden increased risk of incident MCI, while more years of education, more leisure activities, and higher income decreased this risk. Of the incident MCI cases, after an average of 2.4 years of follow-up, 12.9% progressed to dementia, 9.6% declined in functioning and did not meet the algorithmic criteria for MCI but did not meet the clinical criteria for dementia, 29.6% continued to meet MCI criteria, and 47.9% no longer met MCI criteria. Multidomain MCI, presence of APOE ε4, depressive symptoms, and antidepressant use increased the risk of progression to dementia. DISCUSSION: This community-based study showed that almost half of the individuals with incident MCI diagnoses were classified as cognitively normal at follow-up. Predictors of incident MCI demonstrably differed from those of subsequent MCI course; these findings can refine expectations for cognitive and functional course of those presenting with MCI. Lippincott Williams & Wilkins 2022-01-04 /pmc/articles/PMC8726570/ /pubmed/34853178 http://dx.doi.org/10.1212/WNL.0000000000013017 Text en Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License 4.0 (CC BY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) , which permits downloading and sharing the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Research Article
Angevaare, Milou J.
Vonk, Jet M.J.
Bertola, Laiss
Zahodne, Laura
Watson, Caitlin Wei-Ming
Boehme, Amelia
Schupf, Nicole
Mayeux, Richard
Geerlings, Mirjam I.
Manly, Jennifer J.
Predictors of Incident Mild Cognitive Impairment and Its Course in a Diverse Community-Based Population
title Predictors of Incident Mild Cognitive Impairment and Its Course in a Diverse Community-Based Population
title_full Predictors of Incident Mild Cognitive Impairment and Its Course in a Diverse Community-Based Population
title_fullStr Predictors of Incident Mild Cognitive Impairment and Its Course in a Diverse Community-Based Population
title_full_unstemmed Predictors of Incident Mild Cognitive Impairment and Its Course in a Diverse Community-Based Population
title_short Predictors of Incident Mild Cognitive Impairment and Its Course in a Diverse Community-Based Population
title_sort predictors of incident mild cognitive impairment and its course in a diverse community-based population
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8726570/
https://www.ncbi.nlm.nih.gov/pubmed/34853178
http://dx.doi.org/10.1212/WNL.0000000000013017
work_keys_str_mv AT angevaaremilouj predictorsofincidentmildcognitiveimpairmentanditscourseinadiversecommunitybasedpopulation
AT vonkjetmj predictorsofincidentmildcognitiveimpairmentanditscourseinadiversecommunitybasedpopulation
AT bertolalaiss predictorsofincidentmildcognitiveimpairmentanditscourseinadiversecommunitybasedpopulation
AT zahodnelaura predictorsofincidentmildcognitiveimpairmentanditscourseinadiversecommunitybasedpopulation
AT watsoncaitlinweiming predictorsofincidentmildcognitiveimpairmentanditscourseinadiversecommunitybasedpopulation
AT boehmeamelia predictorsofincidentmildcognitiveimpairmentanditscourseinadiversecommunitybasedpopulation
AT schupfnicole predictorsofincidentmildcognitiveimpairmentanditscourseinadiversecommunitybasedpopulation
AT mayeuxrichard predictorsofincidentmildcognitiveimpairmentanditscourseinadiversecommunitybasedpopulation
AT geerlingsmirjami predictorsofincidentmildcognitiveimpairmentanditscourseinadiversecommunitybasedpopulation
AT manlyjenniferj predictorsofincidentmildcognitiveimpairmentanditscourseinadiversecommunitybasedpopulation