Predictors of Reversion from Mild Cognitive Impairment to Normal Cognition

Abstract

Background/Aims: Few studies have examined predictors of reversion from mild cognitive impairment (MCI) to normal cognition. We sought to identify baseline predictors of reversion, using the National Alzheimer's Coordinating Center Uniform Data Set, by comparing MCI individuals who reverted to normal cognition to those who progressed to dementia. Methods: Participants (n = 1,208) meeting MCI criteria were evaluated at the baseline visit and 3 subsequent annual visits. Clusters of baseline predictors of MCI reversion included demographic/genetic data, global functioning, neuropsychological functioning, medical health/dementia risk score, and neuropsychiatric symptoms. Stepwise logistic regression models identified predictors of MCI reversion per cluster, which were then entered into a final comprehensive model to find overall predictor(s). Results: At 2 years, 175 (14%) reverted to normal cognition, 612 (51%) remained MCI, and 421 (35%) progressed to dementia, with sustained diagnoses at 3 years. Significant variables associated with MCI reversion were younger age, being unmarried, absence of APOE ε4 allele, lower CDR-SOB score, and higher memory/language test scores. Conclusion: A relatively sizable proportion of MCI individuals reverted to normal cognition, which is associated with multiple factors previously noted. Findings may enhance MCI prognostic accuracy and increase precision of early intervention studies of dementia.

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

“…In neuroimaging studies, medial temporal and global cortical atrophy and rate of volume loss predict progression to dementia . Studies of reverters show the converse …”

“…With regard to established risk factors or markers of AD, our results validate those of several previous community‐based studies. Older age, amnestic MCI, poorer memory performance, worse overall cognitive function, APOE4 genotype, and stroke are consistent predictors of MCI progression to dementia . In neuroimaging studies, medial temporal and global cortical atrophy and rate of volume loss predict progression to dementia .…”

Factors affecting reversion from mild cognitive impairment to normal cognition in midlife to later life in Korea: A national population study

“…In midlife, the MCI reversion rate was 52.0%, but it was just 26.6% in later life. This high reversion rate in midlife emphasizes that younger participants with MCI were more likely to revert to NC . The difference in results between the groups seems to be due to age.…”

“…With increasing interest in MCI reversion, numerous studies have attempted to find the factors affecting MCI reversion. Several factors have been identified as contributing to MCI reversion, including young, male, more educated, currently married, high physical function, few chronic diseases, high cognitive function, fewer depressive symptoms and participation in leisure activities . Furthermore, several biomarkers were associated with MCI reversion, such as higher levels of amyloid beta and lower levels of tau proteins in cerebrospinal fluid of patients with Alzheimer's disease .…”

“…Few studies, however, have examined multiple factors together that are associated with MCI reversion, including demographic, physical, psychological, social and genetic variables. Most studies have only analyzed fragmentary variables in medical/genetic aspects, making it difficult to identify the integrated factors in various aspects of physical, psychological and social domains . In addition, the rate of MCI reversion has varied in these studies depending on the age of the study population .…”