Diagnostic criteria and prevalence of mild cognitive impairment in older adults living in the community: a systematic review and meta-analysis

Pessoa, Rebeca Mendes P.; Bomfim, Ana Julia de Lima; Ferreira, Bianca Letícia Cavalmoretti; Chagas, Marcos Hortes Nisihara

doi:10.1590/0101-60830000000197

Cited by 24 publications

(14 citation statements)

References 46 publications

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“…Similar variability was seen across studies using the IWG Criteria for aMCI (range 4.5% [48] to 18.3% [58]) and IWG criteria for all-MCI (range 30.4% [55] to 6.1% [50]). These results are in line with previous systematic reviews of MCI incorporating studies predominately from high-income countries [111]. Variability in prevalence is likely due to differences in sample characteristics (e.g.…”

Section: Discussionsupporting

confidence: 92%

Prevalence and Risk of Mild Cognitive Impairment in Low and Middle-Income Countries: A Systematic Review

McGrattan

Zhu

Richardson

et al. 2021

JAD

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Background: Mild cognitive impairment (MCI) is a cognitive state associated with increased risk of dementia. Little research on MCI exists from low-and middle-income countries (LMICs), despite high prevalence of dementia in these settings. Objective: This systematic review aimed to review epidemiological reports to determine the prevalence of MCI and its associated risk factors in LMICs. Methods: Medline, Embase, and PsycINFO were searched from inception until November 2019. Eligible articles reported on MCI in population or community-based studies from LMICs and were included as long as MCI was clearly defined. Results: 5,568 articles were screened, and 78 retained. In total, n = 23 different LMICs were represented; mostly from China (n = 55 studies). Few studies were from countries defined as lower-middle income (n = 14), low income (n = 4), or from population representative samples (n = 4). There was large heterogeneity in how MCI was diagnosed; with Petersen criteria the most commonly applied (n = 26). Prevalence of amnesic MCI (aMCI) (Petersen criteria) ranged from 0.6%to 22.3%. Similar variability existed across studies using the International Working Group Criteria for aMCI (range 4.5%to 18.3%) and all-MCI (range 6.1%to 30.4%). Risk of MCI was associated with demographic (e.g., age), health (e.g., cardio-metabolic disease), and lifestyle (e.g., social isolation, smoking, diet and physical activity) factors. Conclusion: Outside of China, few MCI studies have been conducted in LMIC settings. There is an urgent need for population representative epidemiological studies to determine MCI prevalence in LMICs. MCI diagnostic methodology also needs to be standardized. This will allow for cross-study comparison and future resource planning.

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Section: Discussionsupporting

confidence: 92%

Prevalence and Risk of Mild Cognitive Impairment in Low and Middle-Income Countries: A Systematic Review

McGrattan

Zhu

Richardson

et al. 2021

JAD

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“…In particular, prestroke cognitive impairment affected a high percentage of patients (14.3% with dementia and 26.5% with MCI) according to our diagnostic criteria. Our findings about prestroke dementia are in line with the results of a meta‐analysis published in 2009 28 (reporting 14.4% of dementia in hospital‐based studies), whereas the prevalence of prestroke MCI is largely variable in the literature according to the characteristics of the studies, such as cognitive tests used, diagnostic criteria, and operationalization of these criteria 29,30 . Methods to assess prestroke cognitive impairment varied from interviews with caregivers, review of medical files in retrospective studies 28 or, more commonly, use of questionnaires (eg, Blessed Dementia Rating Scale 6 ; Informant Questionnaire on Cognitive Decline in the Elderly, IQCODE) 7 that were, however, originally designed to discriminate between dementia and normal cognition.…”

Section: Discussionsupporting

confidence: 89%

Neuropsychological screening in the acute phase of cerebrovascular diseases

et al. 2020

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Introduction Cognitive impairment is a common and disabling consequence of stroke. Its prevalence, the best way to screen for it in the acute setting, and its relation with premorbid status have not been thoroughly clarified. Materials and methods Ischemic and hemorrhagic stroke patients admitted to our stroke unit underwent a baseline assessment that included a clinical and neuroimaging assessment, two cognitive tests (clock‐drawing test, CDT; Montreal Cognitive Assessment‐Basic, MoCA‐B) and measures of premorbid function (including the Clinical Dementia Rating Scale). A follow‐up examination was repeated 3‐4 months after the acute event. Results Two hundred and twenty‐three patients (52.5% women, mean age ± SD 75.8 years ± 12.3) were evaluated. Prestroke cognitive impairment was present in 91 patients (40.8%). At follow‐up, the prevalence of cognitive impairment was 49%, while its incidence among patients who did not have any prestroke cognitive impairment was 38.8%. Of the originally admitted 223 patients (71 were lost to follow‐up), only 60 (26.9%) were still cognitively intact at follow‐up. On regression analysis, age and baseline CDT were associated with worsening of cognitive status at follow‐up. In patients without cognitive impairment at baseline, a cutoff of 23 for MoCA‐B and of 8.7 for CDT scores predicted the diagnosis of post‐stroke cognitive impairment with sufficient accuracy. Discussion and conclusion Prestroke and post‐stroke cognitive impairment affect a large proportion of patients with stroke. Our findings suggest that a neuropsychological screening during the acute phase might be predictive of the development of post‐stroke cognitive impairment.

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“…While there was a higher prevalence of dementia in older age groups among those living at home (p < 0.001), there was a lower prevalence of dementia in older age groups among nursing home residents (p = 0.006). Table 6 our study is lower than in other studies [52], which and that the pooled prevalence was 17.5% [53]. several previous studies, whereas other studies fail to 581 find a sex difference [54].…”

Section: Participantscontrasting

confidence: 58%

Current and Future Prevalence Estimates of Mild Cognitive Impairment, Dementia, and Its Subtypes in a Population-Based Sample of People 70 Years and Older in Norway: The HUNT Study

Gjøra

Strand

Bergh

et al. 2021

JAD

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Background: Having accurate, up-to-date information on the epidemiology of mild cognitive impairment (MCI) and dementia is imperative. Objective: To determine the prevalence of MCI and dementia in Norway using data from a large population-based study. Methods: All people 70 + years of age, n = 19,403, in the fourth wave of the Trøndelag Health Study (HUNT4) were invited to participate in the study HUNT4 70 + . Trained health personnel assessed participants using cognitive tests at a field station, at homes, or at their nursing home. Interviewers also completed a structured carer questionnaire in regard to participants suspected of having dementia. Clinical experts made diagnoses according to DSM-5 criteria. We calculated prevalence weighing the data to ensure population representativeness. Results: A total of 9,930 (51.2%) of the possible 19,403 people participated, and 9,663 of these had sufficient information for analysis. Standardized prevalence of dementia and MCI was 14.6% (95% confidence interval (CI) 13.9–15.4) and 35.3% (95% CI 34.3–36.4), respectively. Dementia was more prevalent in women and MCI more prevalent in men. The most prevalent dementia subtype was Alzheimer’s disease (57%). By adding data collected from a study of persons < 70 years in the same region, we estimate that there are 101,118 persons with dementia in Norway in 2020, and this is projected to increase to 236,789 and 380,134 in 2050 and 2100, respectively. Conclusion: We found a higher prevalence of dementia and MCI than most previous studies. The present prevalence and future projections are vital for preparing for future challenges to the healthcare system and the entire society.

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Diagnostic criteria and prevalence of mild cognitive impairment in older adults living in the community: a systematic review and meta-analysis

Cited by 24 publications

References 46 publications

Prevalence and Risk of Mild Cognitive Impairment in Low and Middle-Income Countries: A Systematic Review

Prevalence and Risk of Mild Cognitive Impairment in Low and Middle-Income Countries: A Systematic Review

Neuropsychological screening in the acute phase of cerebrovascular diseases

Current and Future Prevalence Estimates of Mild Cognitive Impairment, Dementia, and Its Subtypes in a Population-Based Sample of People 70 Years and Older in Norway: The HUNT Study

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