Progression and predictors of mild cognitive impairment in Chinese elderly: A prospective follow-up in the Shanghai Aging Study

Ding Ding, Qianhua Zhao, Qihao Guo, Xiaoniu Liang, Jianfeng Luo, Lirong Yu, Li Zheng, Zhen Hong, Shanghai Aging Study (SAS), Ding Ding, Qianhua Zhao, Qihao Guo, Xiaoniu Liang, Jianfeng Luo, Lirong Yu, Li Zheng, Zhen Hong, Shanghai Aging Study (SAS)

Abstract

Introduction: The Shanghai Aging Study is a community-based study aiming to investigate the incidence and progression of cognitive decline in Chinese elderly, with the operational procedures and diagnostic criteria similar to cohort studies in developed countries.

Methods: We prospectively evaluated 362 individuals with mild cognitive impairment (MCI) diagnosed at baseline through a clinical and neuropsychological interview. Diagnoses of dementia and MCI were made using standard criteria via consensus diagnosis.

Results: The conversion rate to dementia was 6.0 per 100 person-years, while the reversion rate to cognitive normal was 7.8 per 100 person-years. Amnestic MCI multiple domains was the most risky type for dementia (conversion rate: 14.2 per 100 person-years). Older age (hazard ratio [HR] = 1.09), apolipoprotein E (APOE ε4) (HR = 2.15), and low MMSE score (HR = 1.18) were predictors for dementia.

Discussion: Approximately 6% of elderly with MCI progress to dementia annually. Prospective studies are needed to further examine risk and protective predictors and to seek proper interventions for cognitive decline.

Keywords: Aging; Conversion; Dementia; Mild cognitive impairment; Progression; Risk factor; prospective study.

Figures

Fig. 1
Fig. 1
Flow chart of the follow-up study for individuals with mild cognitive impairment diagnosed at the baseline. Abbreviations: MCI, mild cognitive impairment; aMCI, amnestic mild cognitive impairment; naMCI, nonamnestic mild cognitive impairment.
Fig. 2
Fig. 2
Annual conversion rate from MCI to dementia (A) and reversion rate from MCI to cognitive normal (B) in individuals with different age groups. Abbreviations: MCI, mild cognitive impairment; aMCI-SD, amnestic mild cognitive impairment single domain; aMCI-MD, amnestic mild cognitive impairment multiple domains; naMCI-SD, nonamnestic mild cognitive impairment single domain; naMCI-MD, nonamnestic mild cognitive impairment multiple domains.
Fig. 3
Fig. 3
Cumulative conversion rate from MCI to dementia (A) and cumulative reversion rate from MCI to cognitive normal (B) in individuals with 4 MCI subtypes. Abbreviations: MCI, mild cognitive impairment; aMCI-SD, amnestic mild cognitive impairment single domain; aMCI-MD, amnestic mild cognitive impairment multiple domains; naMCI-SD, nonamnestic mild cognitive impairment single domain; naMCI-MD, nonamnestic mild cognitive impairment multiple domains.

References

    1. Petersen R.C., Smith G.E., Waring S.C., Ivnik R.J., Tangalos E.G., Kokmen E. Mild cognitive impairment. Arch Neurol. 1999;56:303–308.
    1. Petersen R.C., Stevens J.C., Ganguli M., Tangalos E.G., Cummings J.L., DeKosky S.T. Practice parameter: early detection of dementia: mild cognitive impairment (an evidence- based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2001;56:1133–1142.
    1. Winblad B., Palmer K., Kivipelto M., Jelic V., Fratiglioni L., Wahlund L.O. Mild cognitive impairment-beyond controversies, towards a consensus: report of the International Working Group on Mild Cognitive Impairment. J Intern Med. 2004;256:240–246.
    1. Bruscoli M., Lovestone S. Is MCI really just early dementia? A systematic review of conversion studies. Int Psychogeriatr. 2004;16:129–140.
    1. Mitchell A.J., Shiri-Feshki M. Rate of progression of mild cognitive impairment to dementia - meta-analysis of 41 robust inception cohort studies. Acta Psychiatr Scand. 2009;119:252–265.
    1. Ward A., Tardiff S., Dye C., Arrighi H.M. Rate of Conversion from Prodromal Alzheimer's Disease to Alzheimer's Dementia: A Systematic Review of the Literature. Dement Geriatr Cogn Dis Extra. 2013;3:320–332.
    1. Peterson R.C., Aisen P.S., Beckett L.A., Donohue M.C., Gamst A.C., Harvey D.J. Alzheimer's Disease Neruoimaging Initiative (ADNI): clinical characterization. Neurology. 2010;74:201–209.
    1. Chan W.C., Lam L.C., Tam C.W., Lui V.W., Leung G.T., Lee A.T. Neuropsychiatric symptoms are associated with increased risks of progression to dementia: a 2-year prospective study of 321 Chinese older persons with mild cognitive impairment. Age Ageing. 2011;40:30–35.
    1. Ma F., Wu T., Miao R., Xiao Y., Zhang W., Huang G. Conversion of mild cognitive impairment to dementia among subjects with diabetes: a population-based study of incidence and risk factors with five years of follow-up. J Alzheimers Dis. 2015;43:1441–1449.
    1. Inselberg R., Massarwa M., Schechtman E., Strugatsky R., Farrer L.A., Friedland R.P. Estimating the risk for conversion from mild cognitive impairment to Alzheimer's disease in an elderly Arab community. J Alzheimers Dis. 2015;45:865–871.
    1. Busse A., Hensel A., Guhne U., Angermeyer M.C., Riedel-Heller S.G. Mild cognitive impairment: long-term course of four clinical subtypes. Neurology. 2006;67:2176–2185.
    1. Manly J.J., Tang M.X., Schupf N., Stern Y., Vonsattel J.P., Mayeux R. Frequency and course of mild cognitive impairment in a multiethnic community. Ann Neurol. 2008;63:494–506.
    1. Ganguli M., Snitz B.E., Saxton J.A., Chang C.H., Lee C.W., Bilt J.V. Outcomes of mild cognitive impairment by definition, a population study. Arch Neurol. 2011;68:761–767.
    1. Brodaty H., Heffernan M., Kochan N.A., Draper B., Trollor J.N., Reppermund S. Mild cognitive impairment in a community sample: the Sydney Memory and Ageing Study. Alzheimers Dement. 2013;9:310–317.
    1. Population of over-60-yr-olds reaches 212 million. 2015. Available at: Accessed January 13, 2016.
    1. More measures sought for aiding elderly population, China daily. 2012. Available at: Accessed February 10, 2014.
    1. Ding D., Zhao Q., Guo Q., Meng H., Wang B., Luo J. Prevalence of mild cognitive impairment in an urban community in China: a cross-sectional analysis of the Shanghai Aging Study. Alzheimers Dement. 2015;11:300–309.
    1. Ding D., Zhao Q., Guo Q., Meng H., Wang B., Luo J. The Shanghai Aging Study: study design, baseline characteristics, and prevalence of dementia. Neuroepidemiology. 2014;43:114–122.
    1. Lawton M.P., Brody E.M. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist. 1969;9:179–186.
    1. American Psychiatric Association . 4th ed. American Psychiatric Association; Washington: 1994. Diagnostic and Statistical Manual of Mental Disorders; pp. 143–147.
    1. Petersen R.C. Mild cognitive impairment as a diagnostic entity. J Intern Med. 2004;25:183–194.
    1. Solfrizzi V., Panza F., Colacicco A.M., D'Introno A., Capurso C., Torres F., for the Italian Longitudinal Study on Aging Working Group Vascular risk factors, incidence of MCI, and rates of progression to dementia. Neurology. 2004;63:1882–1891.
    1. Ganguli M., Dodge H.H., Shen C., DeKosky S.T. Mild cognitive impairment, amnestic type: an epidemiologic study. Neurology. 2004;63:115–121.
    1. Knopman D.S., Beiser A., Machulda M.M., Fields J., Roberts R.O., Pankratz V.S. Spectrum of cognition short of dementia. Framingham Heart Study and Mayo Clinic Study of Aging. Neurology. 2015;85:1712–1721.
    1. Lin K.A., Choudhury K.R., Rathakrishnan B.G., Marks D.M., Petrella J.R., Doraiswamy P.M., for the Alzheimer's Disease Neuroimaging Initiative Marked gender differences in progression of mild cognitive impairment over 8 years. Alzheimers Dement. 2015;1:103–110.
    1. Wang P.N., Lirng J.F., Lin K.N., Chang F.C., Liu H.C. Prediction of Alzheimer's disease in mild cognitive impairment: A prospective study in Taiwan. Neurobiol Aging. 2006;27:1797–1806.
    1. Nolze-Charron G., Mouiha A., Duchesne S., Bocti C., for the Alzheimer's Disease Neuroimaging Initiative1 White matter hyperintensities in mild cognitive impairment and lower risk of cognitive decline. J Alzheimers Dis. 2015;46:855–862.
    1. Osone A., Arai R., Hakamada R., Shimoda K. Impact of lifestyle-related disease on conversion and reversion in patients with mild cognitive impairment: after 12 months of follow-up. Int J Geriatr Psychiatry. 2015;14:639–653.
    1. Xu G., Zhou Z., Zhu W., Fan X., Liu X. Plasma C-reactive protein is related to cognitive deterioration and dementia in patients with mild cognitive impairment. J Neurol Sci. 2009;284:77–80.
    1. Hayakawa T., McGarrigle C.A., Coen R.F., Soraghan C.J., Foran T., Lawlor B.A. Orthostatic blood pressure behavior in people with mild cognitive impairment predicts conversion to dementia. J Am Geriatr Soc. 2015;63:1868–1873.
    1. Ye B.S., Jang E.Y., Kim S.Y., Kim E., Park S.A., Lee Y. Unstable body mass index and progression to probable Alzheimer's disease dementia in patients with amnestic mild cognitive impairment. J Alzheimers Dis. 2016;49:483–491.
    1. Comparison of population with various education attainments per 100,000 persons by region. China Statistical Yearbook 2011. Available at: . Accessed February 10, 2014.

Source: PubMed

스폰서 및 공동 작업자

건강 상태

약물 개입

3
구독하다