Conversion of mild cognitive impairment to dementia in elderly subjects: A preliminary study in a memory and cognitive disorder unit

Maioli, Fabiola; Coveri, Maura; Pagni, Paola; Chiandetti, Cinzia; Marchetti, C.; Ciarrocchi, R.; Ruggero, Camilo J.; Nativio, Valeria; Onesti, A.; D’Anastasio, C.; Pedone, Vincenzo

doi:10.1016/j.archger.2007.01.032

Cited by 112 publications

(82 citation statements)

References 26 publications

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“…However, our results are comparable to the conversion rate of other memory clinics, 38,39 whereas the conversion rate reported by Petersen et al 1 was found in a general community setting.…”

Section: Discussionsupporting

confidence: 72%

Progression of Mild Cognitive Impairment to Dementia

Staekenborg

Koedam

Henneman

et al. 2009

Stroke

123

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Background and Purpose-We sought to determine the predictive value of magnetic resonance imaging measures of vascular disease (white matter hyperintensities [WMHs], lacunes, microbleeds, and infarcts) compared with atrophy on the progression of mild cognitive impairment to dementia. Methods-We included 152 consecutive patients with mild cognitive impairment. Baseline magnetic resonance imaging was used to determine the presence of medial temporal lobe atrophy and vascular disease (presence of lacunes, microbleeds, and infarcts was determined, and WMHs were rated on a semiquantitative scale). Patients were followed up for 2Ϯ1 years. Results-Seventy-two (47%) patients progressed to dementia during follow-up. Of these, 56 (37%) patients were diagnosed with Alzheimer's disease, and 16 (10%) patients were diagnosed with a non-Alzheimer dementia (including vascular dementia, frontotemporal lobar degeneration, and Parkinson dementia). Converters were older and had a lower Mini-Mental State Examination score at baseline. On baseline magnetic resonance imaging, patients who progressed to a non-Alzheimer dementia showed more severe WMHs and had a higher prevalence of lacunes in the basal ganglia and microbleeds compared with nonconverters. Cox proportional-hazard models showed that, adjusted for age and sex, baseline medial temporal lobe atrophy (hazard ratioϭ2.9; 95% CI, 1.7 to 5.3), but not vascular disease, was associated with progression to Alzheimer's disease. By contrast, deep WMHs (hazard ratioϭ5.7; 95% CI, 1.2 to 26.7) and periventricular hyperintensities (hazard ratioϭ6.5; 95% CI, 1.4 to 29.8) predicted progression to non-Alzheimer dementia. Furthermore, microbleeds (hazard ratioϭ2.6; 95% CI, 0.9 to 7.5) yielded a Ͼ2-fold increased, though nonsignificant, risk of non-Alzheimer dementia. Conclusion-Medial

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Section: Discussionsupporting

confidence: 72%

Progression of Mild Cognitive Impairment to Dementia

Staekenborg

Koedam

Henneman

et al. 2009

Stroke

123

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“…MCI has been defined as both subjective and objective cognitive impairment in patients without dementia (Petersen et al, 2014). The risk for converting to dementia from SCI or MCI has been estimated to 10% and 25-40% respectively, depending on study design, duration of the follow up, and population type (clinic-based or general population) (Maioli et al, 2007) (Jessen et al, 2014b) (Mitchell et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

CAIDE Dementia Risk Score and biomarkers of neurodegeneration in memory clinic patients without dementia

Enache

Solomon

Cavallin

et al. 2016

Neurobiology of Aging

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PostprintThis is the accepted version of a paper published in Neurobiology of Aging. This paper has been peerreviewed but does not include the final publisher proof-corrections or journal pagination. Citation for the original published paper (version of record):Enache, D., Solomon, A., Cavallin, L., Kåreholt, I., Kramberger, M G. et al. (2016) CAIDE Dementia Risk Score and biomarkers of neurodegeneration in memory clinic patients without dementia. Neurobiology of Aging AbstractThe aim of this study was to explore cross-sectional associations between CAIDE Dementia Risk Score and dementia-related CSF and neuroimaging biomarkers in 724 memory clinic patients without dementia from the Memory Clinic at Karolinska University Hospital Huddinge, Sweden. We additionally evaluated the score's capacity to predict dementia. Two risk score versions were calculated: one including age, gender, obesity, hyperlipidaemia, and hypertension; and one additionally including APOE ε4 carrier status. CSF was analysed for amyloid β (Aβ), total tau (t-tau), and phosphorylated tau (p-tau). Visual assessments of medial temporal lobe atrophy (MTA), global cortical atrophy-frontal subscale (GCA-F) and Fazekas scale for white matter changes (WMC) were performed. Higher CAIDE Dementia Risk Score (version without APOE) was significantly associated with higher t-tau, more severe MTA, WMC and GCA-F. Higher CAIDE Dementia Risk Score (version with APOE) was associated with reduced Aβ, more severe MTA and WMC. CAIDE Dementia Risk Score version with APOE seemed to predict dementia better in this memory clinic population with short follow-up than the version without APOE.3

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“…In two epidemiological studies, one of which was higher quality 25;26 , hypercholesterolemia did not predict dementia in people with all type MCI [pooled unadjusted OR from 3 studies A clinical study found that people with all type MCI who had cholesterol levels in the highest quartile (>250mg/dL) were less likely to develop dementia than those with lower levels 27 , although serum HDL and LDL levels did not predict conversion in the same study 34 . Two other clinical studies found that serum LDL 35 , HDL and cholesterol levels 24 did not predict conversion from aMCI to dementia.…”

mentioning

confidence: 99%

Modifiable Predictors of Dementia in Mild Cognitive Impairment: A Systematic Review and Meta-Analysis

Cooper¹,

Sommerlad²,

Lyketsos³

et al. 2015

AJP

439

314

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Objectives: Public health campaigns encouraging early help-seeking have increased rates of Mild Cognitive Impairment (MCI) diagnosis in Western countries, but we know little about how to treat or prognosticate dementia outcomes in persons with MCI. Method: We searched electronic databases and references for longitudinal studies reporting potentially modifiable risk factors for incident dementia after MCI. Two authors independently evaluated study quality using a checklist. We meta-analysed findings from three or more studies. Results: We identified 76 eligible papers. Diabetes and prediabetes increased risk of conversion from amnestic MCI (aMCI) to Alzheimer's Dementia (AD); risk in treated versus untreated diabetes was lower in one study. Diabetes was also associated with increased risk of conversion from any type or non-amnestic MCI to all cause dementia. Metabolic syndrome and pre-diabetes predicted all cause dementia in people with aMCI and any type MCI respectively. Mediterranean diet decreased risk of conversion from aMCI to AD. Presence of neuropsychiatric symptoms or lower serum folate levels predicted conversion from any type MCI to all cause dementia, but less formal education did not. Depressive symptoms predicted conversion from any type MCI to dementia in epidemiological, but not clinical studies. Conclusions: Diabetes increased the risk of conversion to dementia. Other prognostic factors that are potentially manageable are pre-diabetes and the metabolic syndrome, neuropsychiatric symptoms and low dietary folate. Dietary interventions and interventions to reduce neuropsychiatric symptoms including depression, which increase conversion risk to dementia, may decrease incident dementia.

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Conversion of mild cognitive impairment to dementia in elderly subjects: A preliminary study in a memory and cognitive disorder unit

Cited by 112 publications

References 26 publications

Progression of Mild Cognitive Impairment to Dementia

Progression of Mild Cognitive Impairment to Dementia

CAIDE Dementia Risk Score and biomarkers of neurodegeneration in memory clinic patients without dementia

Modifiable Predictors of Dementia in Mild Cognitive Impairment: A Systematic Review and Meta-Analysis

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