Factors Influencing Reversion to Normal Cognition and Progression to Dementia in Elderly with Mild Cognitive Impairment: Analysis of the Korean Longitudinal Study of Ageing

Abstract

Purpose: The purpose of this study was to identify factors affecting reversion to normal cognition and progression to dementia from mild cognitive impairment (MCI) after 2 years.Methods: We analyzed data from the 6th and 7th “Korean Longitudinal Study of Ageing (KLoSA)”. A total of 773 participants aged 65 years and above classified as having MCI according to the Korean Mini-Mental State Examination in the 6th survey were included in the study. Data were analyzed by SPSS 26.0 software using x2 test, t-test, Mann-Whitney test and logistic regression analysis.Results: Of all the participants, 30.5% reverted to normal cognition, 48.5% remained with MCI, and 21.0% progressed to dementia. Factors such as young age (odds ratio [OR]=0.96, 95% confidence interval [CI]: 0.94~0.99), the absence of diabetes (OR=1.49, 95% CI: 1.01~2.19), and frequent neighbor networks “at least once or twice a month” (OR=2.35, 95% CI: 1.26~4.37), and “at least once a week” (OR=1.63, 95% CI: 1.03~2.56) compared to “never or less than 6 times a year” significantly associated with reversion to normal cognition. Meanwhile, factors such as old age (OR=1.09, 95% CI: 1.05~1.12), low level of perceived socioeconomic status (reference. above middle) (OR=1.59, 95% CI: 1.05~2.41), low levels of instrumental activities of daily living (OR=1.17, 95% CI: 1.05~1.32), and a small number of social activities (OR=0.70, 95% CI: 0.51~0.96) significantly associated with dementia progression.Conclusion: The study indicates the necessity of follow-up research for developing interventions that could aid individuals in reverting to normal cognitive function by managing diabetes or encouraging interaction with neighbors and preventing the progression to dementia by improving Instrumental Activities of Daily Living levels or encouraging participation in social activities.

Dementia onset among community-dwelling older adults with mild cognitive impairment: A longitudinal study

“…A longitudinal study of cognitive changes over 8 years in older adults with MCI aged 55 years or older enrolled in a dementia clinic in Switzerland [15] reported that 22.2% (n = 21) of 95 individuals transitioned to dementia, which is approximately 5.0% higher than this current study. In South Korea, a study analyzing cognitive changes and influencing factors over a 2-year period in older adults with MCI aged 65 years and older using data from the 6th and 7th KLoSA [8] reported that 21.0% (n = 162) of the 773 subjects transitioned to dementia, which was 4.0% higher than this current study. In another Korean study, the transition rate to dementia was 17.0% (n = 52) after 1 year among 306 community-dwelling older adults with MCI aged 60 years or older [16], which is consistent with our results.…”

“…Second, the diagnostic process of MCI in this study was based on the MMSE-DS; if the sex-, age-, and education-adjusted z-score was less than -1.5 standard deviations from the mean score, the patient was classified as cognitively impaired and was referred to the detailed examination. Therefore, due to the ceiling effect of screening, many older adults with early MCI who did not show obvious cognitive decline were classified as normal, which may explain the difference in dementia transition rates compared to the studies [8] using the MMSE. Third, the mean number of having neuropsychological tests to complete the detailed examination in the 3 years after diagnosis of MCI in this study was 1.20 ± 0.43, which was lower than the mean of 1.32 in a previous study [17] on transition to dementia in older adults with MCI.…”

“…Previous international studies have shown that the factors associated with MCI and dementia are similar, including sex, age, education, marital status, and smoking [6], and that managing risk factors such as alcohol consumption, obesity, and physical inactivity can prevent or delay the progression to dementia by up to 40% [7]. A study analyzing data from the Korean Longitudinal Study of Aging (KLo-SA) found that demographic characteristics, such as age and subjective socioeconomic status, as well as the number of social activities, such as participation in volunteer activities and activities of daily living (ADLs), were the main predictors of dementia among older adults with MCI [8].…”

Effect of Educational Training on Nurses’ Ability to Care for Patients with Pressure Injuries: A Meta-analysis

“…Although many studies have investigated the impact of PI educational training programs on patients, 11,12 limited evidence is available as to the impact of educational intervention for nurses who care for patients with PIs 13–15 . In addition, most studies on this topic were conducted as single-group pretest-posttest studies and a previous meta-analysis was limited to only these studies (with only three randomized controlled trials [RCTs]) 15 .…”