Five-Year Follow-up of Cognitive Impairment With No Dementia

Tuokko, Holly; Frerichs, Robert J.; Graham, Janice E.; Rockwood, Kenneth; Kristjansson, Betsy; Fisk, John D.; Bergman, Howard; Kozma, Al; McDowell, Ian

doi:10.1001/archneur.60.4.577

Cited by 184 publications

(148 citation statements)

References 21 publications

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“…We observed a conversion rate from CIND to dementia of 12% per year, similar to the rates observed in prior studies 14 . We did not observe similar associations for conversion from aMCI to dementia.…”

Section: Discussionsupporting

confidence: 90%

Neuropsychiatric Symptoms as Risk Factors for Progression From CIND to Dementia: The Cache County Study

Peters¹,

Rosenberg²,

Steinberg³

et al. 2013

The American Journal of Geriatric Psychiatry

133

104

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Objectives To examine the association of neuropsychiatric symptom (NPS) severity with risk of transition to all-cause dementia, Alzheimer's disease (AD), and vascular dementia (VaD). Design Survival analysis of time to dementia, AD, or VaD onset. Setting Population-based study. Participants 230 participants diagnosed with cognitive impairment, no dementia (CIND) from the Cache County Study of Memory Health and Aging were followed for a mean of 3.3 years. Measurements The Neuropsychiatric Inventory (NPI) was used to quantify the presence, frequency, and severity of NPS. Chi-square statistics, t-tests, and Cox proportional hazard ratios were used to assess associations. Results The conversion rate from CIND to all-cause dementia was 12% per year, with risk factors including an APOE ε4 allele, lower MMSE, lower 3MS, and higher CDR sum-of-boxes. The presence of at least one NPS was a risk factor for all-cause dementia, as was the presence of NPS with mild severity. Nighttime behaviors were a risk factor for all-cause dementia and of AD, while hallucinations were a risk factor for VaD. Conclusions These data confirm that NPS are risk factors for conversion from CIND to dementia. Of special interest is that even NPS of mild severity are a risk for all-cause dementia or AD.

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Section: Discussionsupporting

confidence: 90%

Neuropsychiatric Symptoms as Risk Factors for Progression From CIND to Dementia: The Cache County Study

Peters¹,

Rosenberg²,

Steinberg³

et al. 2013

The American Journal of Geriatric Psychiatry

133

104

View full text Add to dashboard Cite

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“…The risk factor profile for cognitive impairment without dementia differed from that for dementia, and incident CVD was associated with the former but not the latter. Cognitive impairment without dementia, as defined in the present study, is a broad classification [41] with a high prevalence in diabetes [42]. Mild cognitive impairment is a more restrictive category with a high rate of transition to dementia, but it has recently been shown that the subgroup of mild cognitive impairment associated with CVD is less likely to progress to dementia [43].…”

Section: Discussionmentioning

confidence: 61%

Predictors of cognitive impairment and dementia in older people with diabetes

et al. 2007

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Aims/hypothesis Diabetes is associated with an increased risk of dementia but the reasons for this association are unclear because there are many potential mechanisms. We explored the relative contribution of diabetes-related variables as predictors of dementia in older individuals with diabetes. Methods Survivors, aged ≥70 or more, were recruited from an existing observational cohort study 7.6±1.0 years after baseline, when they underwent a comprehensive assessment of diabetes, complications and cardiovascular risk factors. Dementia, probable Alzheimer's disease and cognitive impairment without dementia were diagnosed clinically. Logistic regression modelling determined independent predictors of cognitive diagnoses. Results Of 302 participants, aged 75.7±4.6 years, 28 (9.3%) had dementia (16 with probable Alzheimer's disease) and 60 (19.9%) had cognitive impairment without dementia. The major independent longitudinal predictors of dementia were older age (per decade; odds ratio 4.0, 95% CI 1.59-10.10), diabetes duration (for each 5 years; odds ratio 1.69, 95% CI 1.24-2.32), peripheral arterial disease (odds ratio 5.35, 95% CI 2.08-13.72) and exercise (which was protective; odds ratio 0.26, 95% CI 0.09-0.73). For Alzheimer's disease, diabetes duration was an independent predictor in addition to age and diastolic blood pressure. The results of the cross-sectional analyses were similar with respect to diabetes duration and peripheral arterial disease. Conclusions/interpretation Peripheral arterial disease is a strong independent risk factor for dementia in diabetes. After adjustment for a wide range of potential risk factors, diabetes duration remains independently associated with dementia and probable Alzheimer's disease, indicating that factors not measured in this study may be important in the pathogenesis of dementia in diabetes.

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“…Mild cognitive decline is observed in about 25% of the population aged 65 or over (1) and, although this status may be an expression of normal physiological aging (2), it is also the typical presentation of the early phases of degenerative dementia (3). Epidemiological studies have linked cognitive impairment to a higher risk of dementia, institutionalization and mortality (4).…”

Section: Introductionmentioning

confidence: 99%