Title | Prognostic Significance of Mild Cognitive Impairment Subtypes for Dementia and Mortality: Data from the NEDICES Cohort. |
Publication Type | Journal Article |
Year of Publication | 2016 |
Authors | Bermejo-Pareja, F, Contador, I, Trincado, R, Lora, D, Sánchez-Ferro, Á, Mitchell, AJ, Boycheva, E, Herrero, A, Hernández-Gallego, J, Llamas, S, Galende, AVillarejo, Benito-León, J |
Journal | J Alzheimers Dis |
Volume | 50 |
Issue | 3 |
Pagination | 719-31 |
Date Published | 2016 |
ISSN | 1875-8908 |
Keywords | Aged, Aged, 80 and over, Algorithms, Cognitive Dysfunction, Cohort Studies, Dementia, Female, Humans, Male, Mental Status Schedule, Neuropsychological Tests, Predictive Value of Tests, Prognosis, Proportional Hazards Models, Spain |
Abstract | BACKGROUND: The predictive value of diverse subtypes of mild cognitive impairment (MCI) for dementia and death is highly variable. OBJECTIVE: To compare the predictive value of several MCI subtypes in progression to dementia and/or mortality in the NEDICES (Neurological Disorders in Central Spain) elderly cohort. METHODS: Retrospect algorithmic MCI subgroups were established in a non-dementia baseline NEDICES cohort using Spanish adaptations of the original Mini-Mental State Examination (MMSE-37) and Pfeffer's Functional Activities Questionnaire (Pfeffer-11). The presence of MCI was defined according two cognitive criteria: using two cut-offs points on the total MMSE-37 score. Five cognitive domains were used to establish the MCI subtypes. Functional capacity (Pfeffer-11) was preserved or minimally impaired in all MCI participants. The incident dementia diagnoses were established by specialists and the mortality data obtained from Spanish official registries. RESULTS: 3,411 participants without dementia were assessed in 1994-5. The baseline prevalence of MCI varied according to the MCI definition (4.3%-31.8%). The follow-up was a mean of 3.2 years (1997-8). The dementia incidence varied between 14.9 and 71.8 per 1,000/person-years. The dementia conversion rate was increased in almost all MCI subgroups (p > 0.01), and mortality rate was raised only in four MCI subtypes. The amnestic-multi-domain MCI (aMd-MCI) had the best dementia predictive accuracy (highest positive likelihood ratio and highest clinical utility when negative). CONCLUSIONS: Those with aMd-MCI were at greatest risk of progression to dementia, as in other surveys and might be explored with increased attention in MCI research and in dementia preventive trials. |
DOI | 10.3233/JAD-150625 |
Alternate Journal | J. Alzheimers Dis. |
PubMed ID | 26757038 |