Factors for predicting reversion from mild cognitive impairment to normal cognition: A meta‐analysis

Abstract

Objective Subjects with mild cognitive impairment (MCI) may revert to normal cognition (NC), but predictive factors are under study. We therefore sought to identify factors which could help in predicting reversion from MCI to NC. Methods Relevant studies were retrieved from PubMed, EMBASE, Cochrane Library, MEDLINE, Web of Science, EBSCO, and OVID. According to the inclusion and exclusion criteria, high‐quality assessments of relevant literatures were conducted, followed by data extraction and meta‐analysis with Stata 12.0 software. Results A total of 17 studies with 6829 participants were included in the meta‐analysis. The overall reversion rate is 27.57%. Positive predictive factors were found in younger age (SMD = −0.345, 95% CI, −0.501 to −0.189), higher education level (SMD = 0.337, 95% CI, 0.117‐0.558), no APOE ε4 allele (OR = 0.728, 95% CI, 0.575‐0.922), no hypertension (OR = 0.826, 95% CI, 0.692‐0.987), no stroke (OR = 0.696, 95% CI, 0.507‐0.953), and higher Mini‐Mental State Examination (MMSE) score (SMD = 0.707, 95% CI, 0.461‐0.953). Conclusion Individuals who are at young age, have higher education level and MMSE score, and have no APOEe4 allele, no hypertension, and no stroke had a high probability to revert from MCI to NC.

Biomarker counseling, disclosure of diagnosis and follow‐up in patients with mild cognitive impairment: A European Alzheimer's disease consortium survey

“…Another issue is that biomarkers may be perceived as potentially more harmful in MCI due to the uncertainty related to individual patient prognosis. Although the probability of progression from MCI to dementia on a group level is highly increased depending on the biomarker status, 28 it is difficult to determine at the individual patient level, with some patients progressing after variable time periods, some remaining stable, and some reverting back to normal cognition 6,29‐31 . Modelling of the risk of progression at the individual patient level is underway 32 and likely to improve the ability of physicians to counsel patients about the individual risks of progression.…”

Predementia constructs: Mild cognitive impairment or mild neurocognitive disorder? A narrative review

“…Another minor proportion reverts to normality at follow-up (8% in clinical studies, until 25% in community surveys), which could be unstable in some cases (changing again to MCI or dementia). [59][60][61][62][63][64] Finally, another significant proportion deceases or is lost. 47,48,[55][56][57]63 The MCI evolution-to-dementia risk is greater in the first years of diagnosis and decreases afterward, with conversion to AD being the most common compared to vascular or other dementia subtypes.…”

“…21 The new concept of NCD has generated comments with pros and cons. [126][127][128][129][130][131][132][133] T A B L E 5 Main risk factors for MCI evolution to dementia a 11,30,[37][38][39][40][47][48][49][53][54][55][56][60][61][62][63][64][65]93,[89][90][91][94][95][96][97][98][99] and author' consensus.…”

“…and its expensive biomarkers are not accessible in the vast majority of clinical settings.Finally, the main characteristics of MCI reversers to normality are: younger and more educated people, those with higher general cognitive function, less IADL impairment, better health, and absence of ApoE ε4 genotype 42,[60][61][62][63][64]. …”

The Association Between Hypertension and Cognitive Impairment, and the Role of Antihypertensive Medications: A Literature Review

“…One way to ascertain a link between cognitive dysfunction and hypertension can be to study the risk factors of cognitive impairment (CI) (Table 3). Xue et al looked for factors that could predict the chance of reversion from MCI to normal cognition (NC) [20]. They looked at a total of 17 studies and performed a meta-analysis accordingly.…”