Subclassifications for mild cognitive impairment: prevalence and predictive validity

2003 ◽  
Vol 33 (6) ◽  
pp. 1029-1038 ◽  
Author(s):  
A. BUSSE ◽  
J. BISCHKOPF ◽  
S. G. RIEDEL-HELLER ◽  
M. C. ANGERMEYER
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Function ◽  
Community Sample ◽  
Neuropsychological Testing ◽  
High Sensitivity ◽  
High Specificity ◽  
Cognitive Complaint ◽  
Increased Risk ◽  
Multiple Domains

Background. Mild cognitive impairment (MCI) is associated with an increased risk of developing dementia. Recently published results of the Current Concepts in MCI Conference suggested subclassifications for MCI (MCI-amnestic, MCI-multiple domains slightly impaired, MCI-single nonmemory domain) based on the recognized heterogeneity in the use of the term. These subclassifications have not been empirically validated to date.Method. A community sample of 1045 dementia-free individuals aged 75 years and over was examined by neuropsychological testing in a three-wave longitudinal study. The prevalences and the predictive validities for the subclassifications of MCI and their modifications (original criteria except for the report of subjective decline in cognitive function) were determined.Results. The prevalence was 1 to 15% depending on the subset employed. Subjects with a diagnosis of MCI progressed to dementia at a rate of 10 to 55% over 2·6 years, depending on the subset employed. MCI-amnestic achieved the highest positive predictive power (PPP). ROC curves of the subclassifications for MCI indicate that all but one subset for MCI failed to predict dementia (MCI-multiple domains slightly impaired-modified: AUC=0·585, P<0·01, 95% CI, 0·517–0·653). The use of modified criteria for MCI (original criteria except for the report of subjective decline in cognitive function) is associated with a higher diagnostic sensitivity but also with a reduction in diagnostic specificity and PPP.Conclusions. Modified criteria should be applied if a concept for MCI with a high sensitivity is required and the original criteria (including subjective cognitive complaint) if a concept with high specificity and high PPP is required.

scholarly journals Mild cognitive impairment: prevalence and incidence according to different diagnostic criteria

2003 ◽  
Vol 182 (5) ◽  
pp. 449-454 ◽  
Author(s):  
Anja Busse ◽  
Jeannette Bischkopf ◽  
Steffi G. Riedel-Heller ◽  
Matthias C. Angermeyer
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Longitudinal Study ◽  
Diagnostic Criteria ◽  
Community Sample ◽  
Neuropsychological Testing ◽  
Incidence Rates ◽  
Prevalence Rates ◽  
Case Definitions ◽  
Increased Risk

BackgroundAlthough mild cognitive impairment is associated with an increased risk of developing dementia, there has been little work on its incidence and prevalence.AimsTo report age-specific prevalence, incidence and predictive validities for four diagnostic concepts of mild cognitive impairment.MethodA community sample of 1045 dementia-free individuals aged 75 years and over was examined by neuropsychological testing in a three-wave longitudinal study.ResultsPrevalence rates ranged from 3% to 20%, depending on the concept applied. The annual incidence rates applying different case definitions varied from 8 to 77 per 1000 person-years. Rates of conversion to dementia over 2.6 years ranged from 23% to 47%.ConclusionsMild cognitive impairment is frequent in older people. Prevalence, incidence and predictive validities are highly dependent on the diagnostic criteria applied.

Association of Circulating Cholesterol Level with Cognitive Function and Mild Cognitive Impairment in the Elderly: A Community-based Population Study

2020 ◽  
Vol 17 (6) ◽  
pp. 556-565
Author(s):  
Yujie Guo ◽  
Pengfei Li ◽  
Xiaojun Ma ◽  
Xiaochen Huang ◽  
Zhuoheng Liu ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Function ◽  
Cholesterol Level ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Cross Sectional ◽  
Increased Risk ◽  
Aging Adults ◽  
Female Subjects

Background: The present study was designed to examine the association of circulating cholesterol with cognitive function in non-demented community aging adults. Methods: This was a cross-sectional study including 1754 Chinese adults aged 55-80 years. The association between serum cholesterol levels and cognitive function was examined. Participants were categorized into four groups according to the quartile of circulating TC (total cholesterol), High Density Lipoprotein Cholesterol (HDL-c), Low Density Lipoprotein Cholesterol (LDL-c) levels and HDLc/ LDL-c ratio. The difference in cognitive performance among the groups was compared. Logistic regression model was used to determine the association of circulating cholesterol level with the risk of Mild Cognitive Impairment (MCI). Results: Mild increase of serum LDL-c level correlated with better visual and executive, language, memory and delayed recall abilities. Higher circulating TC and HDL-c levels were found to be associated with poorer cognitive function, especially in aging female subjects. Higher circulating TC, HDL-c and HDL/LDL ratio indicated an increased risk of MCI, especially in female subjects. Conclusion: Slight increase in circulating LDL-c level might benefit cognitive function in aging adults. However, higher circulating TC and HDL-c levels might indicate a decline of cognitive function, especially in aging female subjects.

scholarly journals Progression of mild cognitive impairment to dementia: a challenge to current thinking

2006 ◽  
Vol 189 (5) ◽  
pp. 399-404 ◽  
Author(s):  
Anja Busse ◽  
Matthias C. Angermeyer ◽  
Steffi G. Riedel-Heller
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Community Sample ◽  
Neuropsychological Testing ◽  
Time Dependent ◽  
Current Thinking ◽  
Conversion Rates ◽  
Over Time ◽  
Long Term Studies

BackgroundStudies of conversion from mild cognitive impairment to dementia suggest a linear progression over time. Conversion rates during lifetime may extend to 80–90%.AimsThis study examines the time-dependent evolution from mild cognitive impairment to dementia. Current assumptions regarding yearly and lifetime conversion rates are challenged.MethodA community sample of 1045 dementia-free individuals aged 75 years and over was examined by neuropsychological testing based on 6 years of observation.ResultsApproximately 60–65% of people with mild cognitive impairment develop clinical dementia during their life. Progression from mild cognitive impairment to dementia appears to be time dependent, occurring primarily within the initial 18 months.ConclusionsFurther long-term studies are needed to examine the time-dependent evolution from mild cognitive impairment to dementia and to establish age-specific conversion rates during lifetime.

scholarly journals Association Between Gamma-Glutamyl Transferase and Mild Cognitive Impairment in Chinese Women

2021 ◽  
Vol 13 ◽  
Author(s):  
Zhaoyang Tang ◽  
Xueyu Chen ◽  
Wenran Zhang ◽  
Xiangfu Sun ◽  
Qingzhi Hou ◽  
...  
Keyword(s):  
Uric Acid ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Function ◽  
Chinese Women ◽  
Gamma Glutamyl Transferase ◽  
Gamma Glutamyl ◽  
Increased Risk ◽  
Glutamyl Transferase ◽  
The Relationship

Background: Dementia, as a global public health problem, is becoming increasingly serious. As a precursor of dementia, mild cognitive impairment (MCI) plays an important role in the diagnosis and prevention of dementia. Recent studies have found a correlation between gamma-glutamyl transferase (GGT) levels and cognitive function in men. The relationship between GGT levels and cognitive function in women remains unclear because GGT activity and expression differ between the sexes.Method: We recruited a total of 2,943 Chinese women from Jidong and Taian in 2019. We grouped the participants according to GGT levels, diagnosed MCI using the Montreal Cognitive Assessment (MOCA) scale, and modeled the study outcomes using logistic regression to explore the relationship between GGT level and MCI. We also analyzed the interaction of obesity, sleep duration, and hyperuricemia with GGT in the development of MCI.Results: The prevalence of MCI increased with increasing GGT level, from the lowest quartile to the highest quartile of GGT: 8.4% (66/786), 14.2% (119/840), 17.6% (108/613), and 21.4% (151/704), respectively. At the same time, as GGT levels increased, so did the risk of MCI. In the fully adjusted model, compared with those for participants in the lowest GGT quartiles, the odds ratios (ORs), and 95% confidence intervals (CIs) for MCI for participants in the second, third, and fourth GGT quartiles were 1.49 (1.04–2.12), 1.53(1.06–2.21), and 1.88 (1.33–2.65), respectively. The risk of developing MCI was further increased in people with high GGT levels who were obese (OR = 1.96, 95% CI: 1.39–2.76, P &lt; 0.001), slept less (OR = 1.91, 95% CI: 1.35–2.71, P &lt; 0.001), had high levels of uric acid (OR = 1.55, 95% CI: 1.03–2.32, P &lt; 0.001), or after menopause (OR = 2.92, 95% CI: 2.07–4.12, P &lt; 0.001).Conclusion: We found that MCI is more common in women with elevated GGT levels, so GGT could be a potential diagnostic marker for MCI. Meanwhile, our findings indicated that women with high GGT levels had an increased risk of MCI when they were obese, sleep deprived, had high serum uric acid (SUA) levels or underwent menopause.

scholarly journals Functional Connectivity Variations in Mild Cognitive Impairment: Associations with Cognitive Function

2011 ◽  
Vol 18 (1) ◽  
pp. 39-48 ◽  
Author(s):  
S. Duke Han ◽  
Konstantinos Arfanakis ◽  
Debra A. Fleischman ◽  
Sue E. Leurgans ◽  
Elizabeth R. Tuminello ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Function ◽  
Functional Connectivity ◽  
Processing Speed ◽  
Resting State Fmri ◽  
Posterior Cingulate Cortex ◽  
Community Based ◽  
Posterior Cingulate ◽  
Increased Risk

AbstractParticipants with mild cognitive impairment (MCI) have a higher likelihood of developing Alzheimer's disease (AD) compared to those without MCI, and functional magnetic resonance neuroimaging (fMRI) used with MCI participants may prove to be an important tool in identifying early biomarkers for AD. We tested the hypothesis that functional connectivity differences exist between older adults with and without MCI using resting-state fMRI. Data were collected on over 200 participants of the Rush Memory and Aging Project, a community-based, clinical-pathological cohort study of aging. From the cohort, 40 participants were identified as having MCI, and were compared to 40 demographically matched participants without cognitive impairment. MCI participants showed lesser functional connectivity between the posterior cingulate cortex and right and left orbital frontal, right middle frontal, left putamen, right caudate, left superior temporal, and right posterior cingulate regions; and greater connectivity with right inferior frontal, left fusiform, left rectal, and left precentral regions. Furthermore, in an alternate sample of 113, connectivity values in regions of difference correlated with episodic memory and processing speed. Results suggest functional connectivity values in regions of difference are associated with cognitive function and may reflect the presence of AD pathology and increased risk of developing clinical AD. (JINS, 2012, 18, 39–48)

scholarly journals The Possible Link Between Serum Lipocalin-2 Level and Mild Cognitive Impairment in Adults With Metabolic Syndrome

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A420-A421
Author(s):  
Kanokporn Pinyopornpanish ◽  
Arintaya Phrommintikul ◽  
Chaisiri Angkurawaranon ◽  
Sirinart Kumfu ◽  
Nipon Chattipakorn ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Function ◽  
Demographic Data ◽  
Lipocalin 2 ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Inflammatory Protein ◽  
Increased Risk ◽  
Neutrophil Gelatinase

Abstract Introduction: Metabolic syndrome (MetS) is associated with an increased risk of cognitive impairment. Lipocalin-2 (LCN2) or neutrophil gelatinase-associated lipocalin (NGAL), is an inflammatory protein, and participates in the innate immune response. LCN2 significantly decreased in the cerebrospinal fluid of individuals with mild cognitive impairment. A recent study reported that circulating lipocalin-2 is involved in early AD pathogenesis. However, the association of LCN2 and cognition in MetS patients are still unclear. Then, the present study aims to evaluate whether serum LCN2 levels are associated with the alteration of cognitive function in MetS subjects. Methods: Participants with MetS, but without dementia or prior psychiatric problems, were enrolled to the study. The demographic data and physical examination were assembled. Blood samples were collected to evaluate the metabolic parameters. Levels of serum LCN2 were determined with ELISA assay. The global score of the Thai version of Montreal cognitive assessment (MoCA) was used to assess cognitive function. Multivariable regression analysis was used to determine the associations. Results: Among 202 MetS participants, 111 (54.95 %) were female, and average age was 64.6 (SD 8.6). Mean serum LCN2 and MoCA score were 30.7 ng/ml (SD 17.6) and 19.3 (SD 4.8), respectively. Serum LCN2 levels were negatively associated with the MoCA scores in crude analysis (B=-0.053; 95%CI -0.090, -0.015; p 0.006). After adjustment for sex, age, waist circumference, and creatinine levels, there was an association between the higher serum LCN2 levels and the lower MoCA scores (B=-0.049; 95%CI -0.090, -0.008; p 0.019). Conclusion: These findings suggest the association between serum LCN2 levels and MCI in MetS subjects. However, further longitudinal study should be investigated to support the link between serum LCN2 levels and cognitive impairment.

Natural course of mild cognitive impairment in Parkinson disease

Neurology ◽  
2017 ◽  
Vol 88 (8) ◽  
pp. 767-774 ◽  
Author(s):  
Kenn Freddy Pedersen ◽  
Jan Petter Larsen ◽  
Ole-Bjørn Tysnes ◽  
Guido Alves
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Confidence Interval ◽  
Parkinson Disease ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Neuropsychological Testing ◽  
Increased Risk ◽  
Normal Cognition

Objective:To examine the incidence, progression, and reversion of mild cognitive impairment in patients with Parkinson disease (PD-MCI) over 5 years.Methods:A population-based cohort of patients with incident PD underwent repeated neuropsychological testing of attention, executive function, memory, and visuospatial abilities at baseline (n = 178), 1 year (n = 175), 3 years (n = 163), and 5 years (n = 150). Patients were classified as PD-MCI and diagnosed with dementia according to published criteria.Results:Thirty-six patients (20.2%) fulfilled criteria for PD-MCI at baseline. Among those with normal cognition at baseline (n = 142), the cumulative incidence of PD-MCI was 9.9% after 1 year, 23.2% after 3 years, and 28.9% after 5 years of follow-up. Overall, 39.1% of patients with baseline or incident PD-MCI progressed to dementia during the 5-year study period. The conversion rate to dementia was 59.1% in patients with persistent PD-MCI at 1 year vs 7.2% in those with normal cognition during the first year (adjusted odds ratio 16.6, 95% confidence interval 5.1–54.7, p < 0.001). A total of 27.8% of patients with baseline PD-MCI and 24.2% of those with incident PD-MCI had reverted to normal cognition at study end, but the reversion rate decreased to 9.4% in those with persistent PD-MCI at 2 consecutive visits. Compared with cognitively normal patients, PD-MCI reverters within the first 3 years of follow-up were at increased risk of subsequently developing dementia (adjusted odds ratio 10.7, 95% confidence interval 1.5–78.5, p = 0.019).Conclusions:Early PD-MCI, regardless of persistence or reversion to normal cognition, has prognostic value for predicting dementia in patients with PD.

scholarly journals Apathy as a Risky Neuropsychiatric Syndrome of Progression From Normal Aging to Mild Cognitive Impairment and Dementia: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Zili Fan ◽  
Luchun Wang ◽  
Haifeng Zhang ◽  
Xiaozhen Lv ◽  
Lihui Tu ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Function ◽  
Normal Population ◽  
Meta Analysis ◽  
Cognitively Normal ◽  
Random Effects Models ◽  
Increased Risk ◽  
Normal Cognitive Function

Background: Apathy has been suggested as a potential predictor of mild cognitive impairment (MCI) progression to dementia. Whether it might predict the transition from normal cognitive function to cognitive impairment has been less studied. The current study aimed to provide a comprehensive summary of the evidence on the association between apathy and the transition from normal cognitive function to cognitive impairment.Methods: We searched the PubMed, Embase, and Web of Science databases for longitudinal prospective cohort studies that evaluated apathy at baseline in the cognitively normal population and had cognitive impairment as the outcome. Random effects models were used, and heterogeneity was explored with stratification. The stability of the synthesized result was indicated using sensitivity analysis by excluding one study each time and recalculating the overall effect.Results: Ten studies comprising 26,195 participants were included. Apathy status was available for 22,101 participants. Apathy was present in 1,803 of 22,101 participants (8.16%). Follow-up ranged from 1 to 13 years. The combined odds ratio (OR) of cognitive impairment for patients with apathy was 2.07 (95% CI: 1.43–2.99; I2 = 86%), and the combined hazard ratio was 2.70 (95% CI: 1.38–5.27; I2 = 94%). The OR meta-analyses for different conversion outcomes were MCI (OR = 3.38, 95% CI: 1.57–7.28; I2 =71%), cognitive decline (OR = 1.27, 95% CI: 0.81–2.00; I2 = 64%) and dementia (OR = 2.12, 95% CI: 1.32–3.41; I2 = 86%). Subgroup analysis suggested that the association between apathy and cognitive impairment changed with age, depression adjustments, apathy measurement, and follow-up time.Conclusions: Apathy was associated with a greater than 2-fold increased risk of progression to cognitive impairment in the cognitively normal population. Future interventions targeting apathy management in the general population may reduce the risk of cognitive impairment.

scholarly journals Influence of Different Cut-Off Values on the Diagnosis of Mild Cognitive Impairment in Parkinson's Disease

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Inga Liepelt-Scarfone ◽  
Susanne Graeber ◽  
Anne Feseker ◽  
Gülsüm Baysal ◽  
Jana Godau ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Predictive Accuracy ◽  
Neuropsychological Testing ◽  
Population Based ◽  
Healthy Population ◽  
Increased Risk ◽  
Definition Of

Comparable to Alzheimer's disease, mild cognitive impairment in Parkinson's disease (PD-MCI) is associated with an increased risk for dementia. However different definitions of PD-MCI may have varying predictive accuracy for dementia. In a cohort of 101 nondemented Parkinson patients who underwent neuropsychological testing, the frequency of PD-MCI subjects and PD-MCI subtypes (i.e., amnestic/nonamnestic) was determined by use of varying healthy population-based cut-off values. We also investigated the association between defined PD-MCI groups and ADL scales. Varying cut-off values for the definition of PD-MCI were found to affect frequency of PD-MCI subjects (9.9%–92.1%) and, maybe more important, lead to a “shift” of proportion of detected PD-MCI subtypes especially within the amnestic single-domain subtype. Models using a strict cut-off value were significantly associated with lower ADL scores. Thus, the use of defined cut-off values for the definition of PD-MCI is highly relevant for comparison purposes. Strict cut-off values may have a higher predictive value for dementia.

Association of Neutrophil-Lymphocyte Ratio with Mild Cognitive Impairment in Elderly Chinese Adults: A Case-control Study

2020 ◽  
Vol 16 (14) ◽  
pp. 1309-1315
Author(s):  
Peilin An ◽  
Xuan Zhou ◽  
Yue Du ◽  
Jiangang Zhao ◽  
Aili Song ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Function ◽  
Predictive Values ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Elderly Chinese ◽  
Normal Cognitive Function ◽  
The Absolute

Background: Inflammation plays a significant role in the pathophysiology of cognitive impairment in previous studies. Neutrophil-lymphocyte ratio (NLR) is a reliable measure of systemic inflammation. Objective: The aim of this study was to investigate the association between NLR and mild cognitive impairment (MCI), and further to explore the diagnostic potential of the inflammatory markers NLR for the diagnosis of MCI in elderly Chinese individuals. Methods: 186 MCI subjects and 153 subjects with normal cognitive function were evaluated consecutively in this study. Neutrophil (NEUT) count and Lymphocyte (LYM) count were measured in fasting blood samples. The NLR was calculated by dividing the absolute NEUT count by the absolute LYM count. Multivariable logistic regression was used to evaluate the potential association between NLR and MCI. NLR for predicting MCI was analyzed using Receiver Operating Characteristic (ROC) curve analysis. Results: The NLR of MCI group was significantly higher than that of subjects with normal cognitive function (2.39 ± 0.55 vs. 1.94 ± 0.51, P < 0.001). Logistic regression analysis showed that higher NLR was an independent risk factor for MCI (OR: 4.549, 95% CI: 2.623-7.889, P < 0.001). ROC analysis suggested that the optimum NLR cut-off point for MCI was 2.07 with 73.66% sensitivity, 69.28% specificity, 74.48% Positive Predictive Values (PPV) and 68.36% negative predictive values (NPV). Subjects with NLR ≥ 2.07 showed higher risk relative to NLR < 2.07 (OR: 5.933, 95% CI: 3.467-10.155, P < 0.001). Conclusion: The elevated NLR is significantly associated with increased risk of MCI. In particular, NLR level higher than the threshold of 2.07 was significantly associated with the probability of MCI.

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