scholarly journals Severity distribution of Alzheimer’s disease dementia and mild cognitive impairment in the Framingham Heart Study

2020 ◽  
Author(s):  
Jing Yuan ◽  
Nancy Maserejian ◽  
Yulin Liu ◽  
Sherral Devine ◽  
Cai Gillis ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Framingham Heart Study ◽  
Time Windows ◽  
Population Based ◽  
Clinical Syndrome ◽  
Mild Disease ◽  
Heart Study

Abstract Background: Studies providing Alzheimer’s disease (AD) prevalence data have largely neglected to characterize the proportion of AD that is mild, moderate or severe. Estimates of the severity distribution along the AD continuum, including the mild cognitive impairment (MCI) stage, are important to plan research and allocate future resources, particularly resources targeted at particular stages of disease. Methods: Participants (aged 50-94) with prevalent MCI or AD dementia clinical syndrome were cross-sectionally selected from three time-windows of the population-based Framingham Heart Study in 2004-2005 (n=381), 2006-2007 (n=422), and 2008-2009 (n=389). Summary estimates of the severity distribution were achieved by pooling results across time-windows. Diagnosis and severity were assessed by consensus dementia review. MCI-progressive was determined if the participant had documented progression to AD dementia clinical syndrome using longitudinal data.Results: Among AD dementia participants, the pooled percentages were 50.4% for mild, 30.3% for moderate, and 19.3% for severe. Among all MCI and AD participants, the pooled percentages were 29.5%, 19.6%, 25.7%, and 45.2% for MCI-not-progressive, MCI-progressive, mild AD dementia, and the combined group of MCI-progressive & mild AD dementia, respectively. Distributions by age and sex were presented.Conclusions: Heterogeneity in severity of the AD population exists. That half of prevalent cases have mild disease underscores the need for research and interventions to slow decline of this burdensome disease.Limitations: First, the FHS cohort participants were almost homogenously Caucasians and residents of a single city in MA, that limits the generalization of the results. Second, although FHS is a longitudinal study, the study population over the three time-windows would not be expected to be as dynamic as that of sampling participants from different geographic areas. Lastly, the study lacked AD biomarker confirmation (e.g., amyloid, tau, neurodegeneration), which would have increased the accuracy of case ascertainment.

scholarly journals Severity Distribution of Alzheimer’s Disease Dementia and Mild Cognitive Impairment in the Framingham Heart Study

2020 ◽  
pp. 1-11
Author(s):  
Jing Yuan ◽  
Nancy Maserejian ◽  
Yulin Liu ◽  
Sherral Devine ◽  
Cai Gillis ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Framingham Heart Study ◽  
Time Windows ◽  
Population Based ◽  
Clinical Syndrome ◽  
Mild Disease ◽  
Heart Study

Background: Studies providing Alzheimer’s disease (AD) prevalence data have largely neglected to characterize the proportion of AD that is mild, moderate, or severe. Estimates of the severity distribution along the AD continuum, including the mild cognitive impairment (MCI) stage, are important to plan research and allocate future resources, particularly resources targeted at particular stages of disease. Objective: To characterize the distribution of severity of AD dementia and MCI among prevalent cases in the population-based Framingham Heart Study. Methods: Participants (aged 50–94) with prevalent MCI or AD dementia clinical syndrome were cross-sectionally selected from three time-windows of the population-based Framingham Heart Study in 2004-2005 (n = 381), 2006-2007 (n = 422), and 2008-2009 (n = 389). Summary estimates of the severity distribution were achieved by pooling results across time-windows. Diagnosis and severity were assessed by consensus dementia review. MCI-progressive was determined if the participant had documented progression to AD dementia clinical syndrome using longitudinal data. Results: Among AD dementia participants, the pooled percentages were 50.4%for mild, 30.3%for moderate, and 19.3%for severe. Among all MCI and AD participants, the pooled percentages were 29.5%, 19.6%, 25.7%, and 45.2%for MCI-not-progressive, MCI-progressive, mild AD dementia, and the combined group of MCI-progressive and mild AD dementia, respectively. Distributions by age and sex were presented. Conclusion: The finding that half of the people living with AD have mild disease underscores the need for research and interventions to slow decline or prevent progression of this burdensome disease.

Apolipoprotein E allele 4 is not a sufficient or a necessary predictor of the development of Mild Cognitive Impairment

2010 ◽  
Vol 25 (1) ◽  
pp. 15-18 ◽  
Author(s):  
R. Heun ◽  
U. Gühne ◽  
T. Luck ◽  
M.C. Angermeyer ◽  
U. Ueberham ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Apolipoprotein E ◽  
Target Population ◽  
Population Based ◽  
Initial Development ◽  
Apoe Ε4 ◽  
Ε4 Allele

AbstractThe presence of Mild Cognitive Impairment (MCI) and of an apolipoprotein E (apoE) ε4 allele both predict the development of Alzheimer's disease. However, the extent to which this allele also predicts the development of MCI is unclear even though MCI is an early transitional stage in the development of Alzheimer's disease. The present study investigates the prevalence of the apoE ε4 allele in incipient MCI. Participants were recruited from the population-based Leipzig Longitudinal Study of the Aged (LEILA75+). All subjects who were initially cognitively healthy, i.e. did not meet MCI criteria described by Petersen [Petersen RC. Mild cognitive impairment. J Intern Med 2004; 256(3): 183–94], and whose apoE status could be determined were followed-up. After 4.5 years, 15.5% of the cognitively healthy target population had developed MCI. The frequencies of the apoE ε4 genotype did not differ between individuals with incipient MCI (12.9%) and individuals who remained cognitively healthy during the study (18.4%, p > 0.5). Consequently, the apoE ε4 genotype is not a necessary or sufficient risk factor for MCI. Further studies need to investigate the influence of the whole range of genetic and environmental risk factors on the course of Alzheimer's disease including the initial development of MCI and the later conversion to Alzheimer's disease.

Estimation of the risk of conversion of mild cognitive impairment of Alzheimer type to Alzheimer's disease in a south Brazilian population-based elderly cohort: the PALA study

2011 ◽  
Vol 24 (4) ◽  
pp. 674-681 ◽  
Author(s):  
Cláudia Godinho ◽  
Ana Luiza Camozzato ◽  
Diego Onyszko ◽  
Márcia Lorena Chaves
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Population Based ◽  
Alzheimer Type ◽  
Risk Of Progression ◽  
Elderly Cohort ◽  
The Impact ◽  
Cognitively Intact

ABSTRACTBackground: Higher mild cognitive impairment (MCI) prognostic variability has been related to sample characteristics (community-based or specialized clinic) and to diverse operationalization criteria. The aim of the study was to evaluate the trajectory of MCI of Alzheimer type in a population-based elderly cohort in Southern Brazil. We also estimated the risk for the development of probable Alzheimer's disease (AD) in comparison with healthy subjects.Methods: Data were derived from a population-based cohort (the PALA study). MCI outcomes were sub-classified into three categories: conversion, stabilization, and reconversion. The risk of progression to dementia was compared between MCI and normal participants. The analysis was based on 21 MCI subjects and 220 cognitively intact participants (N = 241).Results: Of the 21 MCI subjects, 38% developed dementia, 24% remained stable and 38% improved. The MCI annual conversion rate to AD was 8.5%. MCI was associated with significantly higher risk of conversion to AD (HR = 49.83, p = 0.004), after adjustment for age, education, sex and Mini-Mental State Examination score.Conclusions: Independent of the heterogeneity of the outcomes, MCI of the Alzheimer type participants showed significantly higher risk of developing probable AD, demonstrating the impact of the use of these MCI criteria that emphasize long-term episodic memory impairment.

Sign in / Sign up

Export Citation Format

Share Document