Document Detail


Outcomes of mild cognitive impairment by definition: a population study.
MedLine Citation:
PMID:  21670400     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Mild cognitive impairment (MCI) has been defined in several ways.
OBJECTIVE: To determine the 1-year outcomes of MCI by different definitions at the population level.
DESIGN: Inception cohort with 1-year follow-up. Participants were classified as having MCI using the following definitions operationalized for this study: amnestic MCI by Mayo criteria, expanded MCI by International Working Group criteria, Clinical Dementia Rating (CDR) = 0.5, and a purely cognitive classification into amnestic and nonamnestic MCI.
SETTING: General community.
PARTICIPANTS: Stratified random population-based sample of 1982 individuals 65 years and older.
MAIN OUTCOME MEASURES: For each MCI definition, there were 3 possible outcomes: worsening (progression to dementia [CDR ≥ 1] or severe cognitive impairment), improvement (reversion to CDR = 0 or normal cognition), and stability (unchanged CDR or cognitive status).
RESULTS: Regardless of MCI definition, over 1 year, a small proportion of participants progressed to CDR > 1 (range, 0%-3%) or severe cognitive impairment (0%-20%) at rates higher than their cognitively normal peers. Somewhat larger proportions of participants improved or reverted to normal (6%-53%). Most participants remained stable (29%-92%). Where definitions focused on memory impairment and on multiple cognitive domains, higher proportions progressed and lower proportions reverted on the CDR.
CONCLUSIONS: As ascertained by several operational definitions, MCI is a heterogeneous entity at the population level but progresses to dementia at rates higher than in normal elderly individuals. Proportions of participants progressing to dementia are lower and proportions reverting to normal are higher than in clinical populations. Memory impairments and impairments in multiple domains lead to greater progression and lesser improvement. Research criteria may benefit from validation at the community level before incorporation into clinical practice.
Authors:
Mary Ganguli; Beth E Snitz; Judith A Saxton; Chung-Chou H Chang; Ching-Wen Lee; Joni Vander Bilt; Tiffany F Hughes; David A Loewenstein; Frederick W Unverzagt; Ronald C Petersen
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Archives of neurology     Volume:  68     ISSN:  1538-3687     ISO Abbreviation:  Arch. Neurol.     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-06-14     Completed Date:  2011-08-12     Revised Date:  2013-02-13    
Medline Journal Info:
Nlm Unique ID:  0372436     Medline TA:  Arch Neurol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  761-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA. gangulim@upmc.edu
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MeSH Terms
Descriptor/Qualifier:
Age Distribution
Aged
Aged, 80 and over
Amnesia / diagnosis,  epidemiology*
Cognition Disorders / classification*,  diagnosis,  epidemiology*
Cohort Studies
Dementia / diagnosis,  epidemiology*
Disability Evaluation
Disease Progression
Female
Humans
Incidence
Longitudinal Studies
Male
Neuropsychological Tests / standards
Prevalence
Severity of Illness Index
Time Factors
Grant Support
ID/Acronym/Agency:
K23 AG038479/AG/NIA NIH HHS; K23 AG038479-01/AG/NIA NIH HHS; K23 AG038479-02/AG/NIA NIH HHS; K24 AG022035/AG/NIA NIH HHS; K24 AG022035-09/AG/NIA NIH HHS; K24AG022035/AG/NIA NIH HHS; P30AG005133/AG/NIA NIH HHS; R01 AG023651/AG/NIA NIH HHS; R01 AG023651-05/AG/NIA NIH HHS; R01AG023651/AG/NIA NIH HHS

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