Mild cognitive impairment and dementia in primary care: the value of medical history

Olazarán, Javier; Torrero, Pedro; Cruz, Isabel Cristina Fonseca da; Aparicio, Esperanza; Sanz, A. Castrillo; Mula, Nieves; Marzana, Garbiñe; Cabezón, Dionisio; Begué, Concepción

doi:10.1093/fampra/cmr005

Cited by 50 publications

(59 citation statements)

References 31 publications

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“…Besides the MCI subtype, fewer chronic medical conditions and younger age predict reversion to normal cognition. 32 The only factors associated with fluctuating or stable MCI so far investigated are the different MCI subtypes, as discussed above. We investigated determinants for a more severe course of MCI considering the 4 courses ranked in order of severity.…”

Section: Prognosis Of MCImentioning

confidence: 99%

Prognosis of Mild Cognitive Impairment in General Practice: Results of the German AgeCoDe Study

Kaduszkiewicz

Eisele

Wiese

et al. 2014

The Annals of Family Medicine

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PURPOSEThe concept of mild cognitive impairment (MCI) has recently been introduced into the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as mild neurocognitive disorder, making it a formal diagnosis. We investigated the prognostic value of such a diagnosis and analyzed the determinants of the future course of MCI in the AgeCoDe study (German Study on Ageing, Cognition, and Dementia in Primary Care Patients). METHODSWe recruited 357 patients with MCI aged 75 years or older from primary care practices and conducted follow-up with interviews for 3 years. Depending on the course of impairment over time, the patients were retrospectively split into 4 groups representing remittent, fluctuating, stable, and progressive courses of MCI. We performed ordinal logistic regression analysis and classification and regression tree (CART) analysis.RESULTS Overall, 41.5% of the patients had remission of symptoms with normal cognitive function 1.5 and 3 years later, 21.3% showed a fluctuating course, 14.8% had stable symptoms, and 22.4% had progression to dementia. Patients were at higher risk for advancing from one course to the next along this spectrum if they had symptoms of depression, impairment in more than 1 cognitive domain, or more severe cognitive impairment, or were older. The result on a test of the ability to learn and reproduce new material 10 minutes later was the best indicator at baseline for differentiating between remittent and progressive MCI. Symptoms of depression modified the prognosis. CONCLUSIONSIn primary care, about one-quarter of patients with MCI have progression to dementia within the next 3 years. Assessments of memory function and depressive symptoms are helpful in predicting a progressive vs a remittent course. When transferring the concept of MCI into clinical diagnostic algorithms (eg,, however, we should not forget that three-quarters of patients with MCI stayed cognitively stable or even improved within 3 years. They should not be alarmed unnecessarily by receiving such a diagnosis. 2014;158-165. doi:10.1370/afm.1596. Ann Fam Med INTRODUCTION Mild cognitive impairment (MCI) is a common condition in the elderly with a prevalence of 16.0% in individuals without dementia 1 and an incidence rate of 63.6 (per 1,000 person-years). 2 It is considered to be a transitional state between normal and pathologic cognitive decline. MCI is defined by a cognitive performance below that expected for age and educational attainment, but above a pathologic level as in early dementia. Patients show essentially normal functional activities.Winblad et al 3 classified the clinical presentations of MCI into subtypes according to the impaired cognitive domains, such as memory, orientation, intellectual abilities, and higher cortical functioning. Taking into account memory deficits and the number of cognitive domains impaired, MCI subtypes have been classified as follows: amnestic single domain (impairment of memory only), amnestic multidomain (impairment of memory and 1 or more o...

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Section: Prognosis Of MCImentioning

confidence: 99%

Prognosis of Mild Cognitive Impairment in General Practice: Results of the German AgeCoDe Study

Kaduszkiewicz

Eisele

Wiese

et al. 2014

The Annals of Family Medicine

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“…The results are supported by findings from other investigators who demonstrated that most diagnostic information in primary care was gained from age, functional assessment, 34 and the clock drawing test (AUC 0.92). 35 The diagnostic utility of an abnormal neurological examination 36 and urinary incontinence 37 were examined, which have been shown previously to be associated with dementia. Items on everyday maths, personal finances, and reasoning were all derived from IQCODE, 26 and were previously found to have modest utility (AUC 0.85, 0.82, 0.82, respectively) in a case-control study in secondary care.…”

Section: Comparison With Existing Literaturementioning

confidence: 99%

Clinical history for diagnosis of dementia in men: Caerphilly Prospective Study

Creavin¹,

Fish

Gallacher

et al. 2015

Br J Gen Pract

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“…지장애의 유병률 경도인지장애 발생 관련요인 에 대한 [5,8], [9] 횡단적 연구뿐만 아니라 경도인지장애에서 치매 또는 정상인 , 지로의 진행률 및 관련요인 에 대한 종단적 연구도 활 [7,[10][11][12] 발히 진행되어 왔다 이에 비하여 국내에서는 아직까지 경도 .…”

Section: 경도인지장애에 대한 관심이 커지면서 국외에서는 경도인unclassified

Reversion to Normal Cognition and Its Correlates among the Community-dwelling Elderly with Mild Cognitive Impairment: the Longitudinal Cohort Study

Kang

Whang

Park

2015

Korean J Adult Nurs

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Mild cognitive impairment and dementia in primary care: the value of medical history

Abstract: Clinical data usually collected on medical history by PCP are useful to detect patients with MCI and dementia and also to predict MCI outcome.

Cited by 50 publications

References 31 publications

Prognosis of Mild Cognitive Impairment in General Practice: Results of the German AgeCoDe Study

Prognosis of Mild Cognitive Impairment in General Practice: Results of the German AgeCoDe Study

Clinical history for diagnosis of dementia in men: Caerphilly Prospective Study

Reversion to Normal Cognition and Its Correlates among the Community-dwelling Elderly with Mild Cognitive Impairment: the Longitudinal Cohort Study

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