Mild Cognitive Impairment that Does Not Progress to Dementia: A Population‐Based Study

Abstract

Background/Objective In population studies, most individuals with mild cognitive impairment (MCI) do not progress to dementia in the near term, but rather remain stable MCI or revert to normal cognition. Here, we characterized MCI subgroups with different outcomes over 5 years. Setting/Participants A population‐based cohort (N=1603). Measurements Clinical Dementia Rating (CDR); self‐reported medical conditions, subjective cognitive concerns, self‐rated health, depressive symptoms, blood pressure, medications, blood pressure, APOE genotype, cognitive domain composite scores. Design We compared 3 MCI subgroups who progressed to dementia (n=86), stabilized at MCI (n=384), or reverted to normal (n=252), to those who remained consistently normal (n=881), defining MCI as CDR = 0.5 and dementia as CDR≥1. Using multinomial logistic regression models adjusted for demographics, we examined the associations of each group with selected baseline characteristics. Results With the normal group for reference, worse subjective cognitive concerns, functional impairments, self‐rated health, and depressive symptoms were associated with being in any MCI group. Taking more prescription medications was associated with being in the stable MCI and reverter groups; diabetes and low diastolic blood pressure were associated with stable MCI. The APOE4 genotype was associated with stable and progressive MCI; stroke was associated with progressive MCI. All MCI subgroups were likely to have lower mean composite scores in all cognitive domains and more operationally defined impairments in attention, language, and executive function; reverters were more likely to lack memory and visuospatial impairments. Conclusions MCI subgroups with different 5‐year outcomes had some distinct characteristics suggesting different underlying causes. The progressors, unlike the reverters, had a profile broadly typical of Alzheimer's disease; the stable MCIs had other, including vascular, morbidity. These data shed light on the heterogeneity of MCI in the population. J Am Geriatr Soc 67:232–238, 2019.

Lifestyle changes and outcomes of elderly people with mild cognitive impairment: a 4-year longitudinal study

“…The MCI to NC reversion rate has been reported to range from 10-50%, although it varies depending on the follow-up period and MCI subtype [3,4]. In a previous study with the study population similar to ours and follow-up, the reversion rate was 35% [22], which is similar to the rate of 33.3% in our study [22].…”

“…Longitudinal studies have shown that mild cognitive impairment (MCI), which has clinical significance as a precursor of dementia, reverts to normal cognition (NC) function [3,4]. In previous studies investigating factors related to reversion from MCI to NC function, modifiable factors, such as memory, visual spatial cognitive function, neuropsychological function, personality, and lifestyle, have been reported [5][6][7].…”

Memory improvement in African Americans with amnestic mild cognitive impairment

“…33 African Americans are less likely than whites to enroll in clinical trials that use biomarkers to improve diagnostic accuracy of aMCI. 35 Our study suggests that by demonstrating memory deficits on more than one memory test or test occasion, false-positive diagnoses of aMCI may be avoided. 35 Our study suggests that by demonstrating memory deficits on more than one memory test or test occasion, false-positive diagnoses of aMCI may be avoided.…”

“…34 Therefore, community studies are still needed to validate diagnostic criteria in this underrepresented population. 35 Our study suggests that by demonstrating memory deficits on more than one memory test or test occasion, false-positive diagnoses of aMCI may be avoided. This is particularly important to ensure that all persons who are assessed for MCI, particularly those in minority groups who may be vulnerable to false-positive and false-negative diagnoses, receive appropriate treatment.…”

Modifiable Risk Factor Possession Patterns of Dementia in Elderly with MCI: A 4-Year Repeated Measures Study

“…Additionally, in previous MCI longitudinal studies, many MCI cases did not develop dementia but reverted to normal cognition (NC) [12,13]. Cognitive function, demographics, genetic data, personality, and lifestyle activities have been reported as factors associated with recovery from MCI to NC [13][14][15][16][17]. A meta-analysis reveals that factors such as young age, high educational level, and Mini-Mental State Examination (MMSE) score are more likely to revert from MCI to NC without APOEe4 allele, hypertension, and stroke.…”