Mild Cognitive Impairment: Epidemiology and Dementia Risk in an Elderly Italian Population

Ravaglia, Giovanni; Forti, Paola; Montesi, Fausta; Lucicesare, Anna; Pisacane, Nicoletta; Rietti, Elisa; Dalmonte, E.; Bianchin, Marisa; Mecocci, Patrizia

doi:10.1111/j.1532-5415.2007.01503.x

Cited by 149 publications

(135 citation statements)

References 36 publications

Supporting

Mentioning

109

Contrasting

Order By: Relevance

“…MCI occupies a central location in the spectrum of cognitive aging, and its use as a diagnostic term has been criticized because of the heterogeneity of its prognosis. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] There are many reasons for the wide range of dementia risk in persons designated as MCI, but perhaps the most important one is that cognitive functioning that falls between the designations of "typical cognitive aging" and "definitely demented" is remarkably diverse. Changes in memory, attention, executive, language, and visuospatial domains, as well as the magnitude of those changes, have distinct implications for prognosis.…”

mentioning

confidence: 99%

Spectrum of cognition short of dementia

et al. 2015

View full text Add to dashboard Cite

Objective: To understand the neuropsychological basis of dementia risk among persons in the spectrum including cognitive normality and mild cognitive impairment. Methods:We quantitated risk of progression to dementia in elderly persons without dementia from 2 population-based studies, the Framingham Heart Study (FHS) and Mayo Clinic Study of Aging (MCSA), aged 70 to 89 years at enrollment. Baseline cognitive status was defined by performance in 4 domains derived from batteries of neuropsychological tests (that were similar but not identical for FHS and MCSA) at cut scores corresponding to SDs of #20.5, 21, 21.5, and 22 from normative means. Participants were characterized as having no cognitive impairment (reference group), or single or multiple amnestic or nonamnestic profiles at each cut score. Incident dementia over the following 6 years was determined by consensus committee at each study separately.Results: The pattern of hazard ratios for incident dementia, rates of incident dementia and positive predictive values across cognitive test cut scores, and number of affected domains was similar although not identical across the FHS and MCSA. Dementia risks were higher for amnestic profiles than for nonamnestic profiles, and for multidomain compared with single-domain profiles.Conclusions: Cognitive domain subtypes, defined by neuropsychologically derived cut scores and number of low-performing domains, differ substantially in prognosis in a conceptually logical manner that was consistent between FHS and MCSA. Neuropsychological characterization of elderly persons without dementia provides valuable information about prognosis. The heterogeneity of risk of dementia cannot be captured concisely with one test or a single definition or cutpoint. The wide variation in cognitive function in aging, both in levels of performance and rates of change over time, forces clinicians and lay people to focus on categorical descriptions. Labels such as cognitively normal, mild cognitive impairment (MCI), and dementia are applied as if they were discrete entities, but it is accepted that these terms represent demarcations of convenience along the continuum of cognition. MCI occupies a central location in the spectrum of cognitive aging, and its use as a diagnostic term has been criticized because of the heterogeneity of its prognosis. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] There are many reasons for the wide range of dementia risk in persons designated as MCI, but perhaps the most important one is that cognitive functioning that falls between the designations of "typical cognitive aging" and "definitely demented" is remarkably diverse. Changes in memory, attention, executive, language, and visuospatial domains, as well as the magnitude of those changes, have distinct implications for prognosis. The existing studies suggested to us that the diversity of affected domains and cutpoints, rather than a weakness, had

show abstract

mentioning

confidence: 99%

Spectrum of cognition short of dementia

et al. 2015

View full text Add to dashboard Cite

show abstract

“…For the naMCI subtypes, the incidence is 28 to 36.3 cases per 1,000 person-years. The factors that increase the risk for MCI are higher age, lower education, and hypertension (Busse et al, 2006;Caracciolo et al, 2008;Chaves, Camozzato, Godinho, Piazenski, & Kaye, 2009;Luck, Luppa, Briel, & Riedel-Heller, 2010;Manly et al, 2008;Ravaglia et al, 2007;Solfrizzi et al, 2004;Tervo et al, 2004;Verghese et al, 2006). Despite methodological diversity, epidemiological studies agree that individuals with MCI present a higher risk for developing dementia compared with the elderly population without cognitive impairment.…”

Section: Mild Cognitive Impairmentmentioning

confidence: 94%

“…The clinical concepts of MCI that show higher conversion rates for AD probably are those that are more restrictive and include elderly persons with episodic memory deficits (Bäckman, Jones, Berger, Laukka, & Small, 2005;Bozoki, Giordani, Heidebrink, Berent, & Foster, 2001;Ravaglia et al, 2007;Tierney et al, 1996). Typically, aMCI shows a higher probability of conversion to AD and, to a lesser degree, vascular dementia, whereas naMCI is likely to show far more variability in terms of progression to various forms of dementia (e.g., frontotemporal dementia and primary progressive aphasia; Busse et al, 2006;Fischer et al, 2007;Yaffe et al, 2006;Yaffe et al, 2011a;Petersen, 2004).…”

Section: Mild Cognitive Impairmentmentioning

confidence: 99%

Neuropsychological and neurobiological markers of the preclinical stage of Alzheimer’s disease.

Fichman

Oliveira

Fernandes

2011

Psychology & Neuroscience

View full text Add to dashboard Cite

Dementia, especially Alzheimer's disease, has a high prevalence in the elderly population. Therefore, identifying individuals who are at a high risk for early diagnosis is crucial to allow both pharmacological and behavioral therapeutic interventions, which in some cases can delay the progression of dementia. This paper describes neuropsychological and neurobiological markers for the early diagnosis of Alzheimer's disease and presents the main risk factors, including neuropathological, neuroanatomical, neurofunctional, genetic, and neuropsychological. The literature shows that the combination of these markers is the best method for predicting Alzheimer's disease, years before its clinical manifestation. The most prevalent neurobiological and neuropsychological risk factors include (1) senile plaques and neurofibrillary tangles in the medial temporal lobe and cortical regions, (2) low concentrations of Aβ1-42 peptide and high concentrations of total tau protein and phosphorylated tau protein in cerebrospinal fluid, (3) reduced global cerebral volume, increased ventricular volume, and atrophy in the hippocampal formation and entorhinal cortex, (4) global reductions in cerebral metabolism and perfusion in the temporoparietal junction, temporal, parietal, and frontal lobes, hippocampal formation, and posterior cingulate cortex, (5) the presence of the apolipoprotein E ε4 allele, and (6) verbal anterograde episodic long-term memory impairment and executive dysfunction. The present review discusses the evidence for markers that identify individuals who are at a high risk of developing Alzheimer's disease and the importance of longitudinal studies in this context.

show abstract

“…Available evidence indicates that the prevalence of MCI ranges from 7.7% to 42.0% depending on the age groups under consideration, the country where the study was conducted, and the diagnostic criteria used to make the diagnosis [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] (Table 1). The data from these studies indicate that MCI commonly occurs in older adults across different cultures, races, and ethnicities.…”

Section: Epidemiologymentioning

confidence: 99%

Mild cognitive impairment: A comprehensive review

2015

Healthy Aging Res

View full text Add to dashboard Cite

Mild cognitive impairment (MCI) represents an intermediate stage between normal cognitive changes associated with aging and dementia. Individuals with MCI have been identified as having a faster rate of progression to dementias. Risk factors for progression include greater cognitive deficits at baseline, ApoE4 carrier status, brain volume changes, cerebrospinal fluid (CSF) changes, and the presence of behavioral and psychological symptoms. Refinements in the diagnostic criteria for MCI and the identification of biomarkers to predict the progression to dementias have resulted in the appropriate diagnosis of this condition being made and the development of possible prevention and treatment strategies. Available data indicate that cognitive and physical training appears to slow the progression of the disease process. Studies of pharmacotherapeutic agents do not indicate benefit for cholinesterase inhibitors, the anti-inflammatory drug rofecoxib, or antioxidants in slowing the progression of MCI to dementias.

show abstract

Mild Cognitive Impairment: Epidemiology and Dementia Risk in an Elderly Italian Population

Abstract: MCI occurs often in this elderly Italian cohort and is associated with greater risk of AD, but only when the impairment involves the memory domain. However, a substantial proportion of MCI cases with memory impairment do not progress to dementia.

Cited by 149 publications

References 36 publications

Spectrum of cognition short of dementia

Spectrum of cognition short of dementia

Neuropsychological and neurobiological markers of the preclinical stage of Alzheimer’s disease.

Mild cognitive impairment: A comprehensive review

Contact Info

Product

Resources

About