Mild Cognitive Impairment Subtypes and Vascular Dementia in Community‐Dwelling Elderly People: A 3‐Year Follow‐Up Study

Zanetti, M.; Ballabio, Claudia; Abbate, Carlo; Cutaia, Chiara; Vergani, Carlo; Bergamaschini, Luigi

doi:10.1111/j.1532-5415.2006.00658.x

Cited by 123 publications

(122 citation statements)

References 41 publications

(57 reference statements)

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“…As amnestic MCI eventually progress into AD with a smaller percentage progression to other forms of dementia, abnormal nocturnal BP profile may therefore predict future development of AD type dementia, but not vascular type dementia. 33 In this study, incidence of MCI was highest among risers. As a group, risers were slightly older and had higher baPWV.…”

Section: Discussionmentioning

confidence: 87%

Abnormal nocturnal blood pressure profile is associated with mild cognitive impairment in the elderly: the J-SHIPP study

et al. 2009

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Mild cognitive impairment (MCI), a syndrome characteristic of the transition phase between normal cognitive function and dementia, has been shown to carry the risk of progression to dementia. Dysregulation of blood pressure (BP) is thought to be an indicator of cerebrovascular damage, including cognitive impairment. Here, we investigated the possible association of circadian BP variation with MCI in community-dwelling persons exhibiting no definitive dementia. Our study enrolled 144 persons (68 ± 7 years). Nocturnal BP profile was defined as dipper, with a 10-19% drop in nocturnal systolic BP; extreme dipper, X20% drop; non-dipper, 0-10% drop; and riser, any increase in nocturnal BP. MCI was assessed using the MCI screen, a cross-validated, staff-administered battery of tests. Subjects with MCI (n¼38) were significantly older (74±6, 67±6 years, Po0.001) and had higher frequency of apolipoprotein E e4 allele (36.8, 18.9%, P¼0.018). Although the ambulatory measured BP and the percent changes in nocturnal systolic BP (À10 ± 12% and À12 ± 8%, respectively; P¼0.291) did not differ between MCI subjects and normal controls, frequency of MCI was significantly higher in the extreme dippers (32.0%), non-dippers (30.0%) and risers (50.0%) than in dippers (13.2%, P¼0.018). Multiple logistic regression analysis identified a blunted nocturnal BP decline, non-dipping or increase in nocturnal BP and extreme drop in BP as potent determinants of MCI (odds ratio 3.062, P¼0.039), after adjustment for possible confounding factors, including apolipoprotein E e4 genotype. Abnormal nocturnal BP profile was found to be a strong indicator of MCI in otherwise apparently healthy community-dwelling elderly persons. Keywords: ambulatory blood pressure monitoring; mild cognitive impairment; nocturnal blood pressure INTRODUCTION Mild cognitive impairment (MCI) is a syndrome defined as cognitive decline greater than expected for an individual's age and education level that does not notably interfere with activities of daily life. 1 MCI is classified into four subtypes: amnestic MCI involving only memory impairment (single domain) or memory impairment along with deficits in another cognitive domain such as language function, visuospatial skills, or executive function (multiple domain) and non-amnestic MCI involving discrete cognitive impairments in single or multiple domains other than memory function. 2 MCI prevalence has been estimated to be between 6 and 10% based on community assessments, 3 a frequency about four times that of dementia. MCI also exhibits Alzheimer-type dementia-like neuropathology on autopsy, and at least half of those diagnosed with MCI, in particular amnestic MCI subtype, eventually progress into Alzheimer-type dementia (AD) with a smaller percentage progression to other forms of dementia,

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Section: Discussionmentioning

confidence: 87%

Abnormal nocturnal blood pressure profile is associated with mild cognitive impairment in the elderly: the J-SHIPP study

et al. 2009

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“…clinics (39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52) and eight were population studies conducted in the community (53)(54)(55)(56)(57)(58)(59)(60). Sixteen were conducted using modified (non-Mayo) criteria.…”

Section: Search Resultsmentioning

confidence: 99%

“…Nine studies examined the trajectories of subtypes of MCI, specifically aMCI and ⁄ or mMCI and ⁄ or nmMCI (42,44,48,50,55,62,64,76,77). The corrected ACR for aMCI was 11.7% (nine studies sample size = 646), mMCI 12.2% (eight studies, sample size = 446) and nmMCI 4.1% (five studies, sample size = 354).…”

Section: Progression Of Dementia and ⁄ Or Ad In MCI Subgroupsmentioning

confidence: 99%

Rate of progression of mild cognitive impairment to dementia – meta‐analysis of 41 robust inception cohort studies

Mitchell

Shiri-Feshki

2009

Acta Psychiatr Scand

1,350

932

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Objective: To quantify the risk of developing dementia in those with mild cognitive impairment (MCI).Method: Meta‐analysis of inception cohort studies.Results: Forty‐one robust cohort studies were identified. To avoid heterogeneity clinical studies, population studies and clinical trials were analysed separately. Using Mayo defined MCI at baseline and adjusting for sample size, the cumulative proportion who progressed to dementia, to Alzheimer’s disease (AD) and to vascular dementia (VaD) was 39.2%, 33.6% and 6.2%, respectively in specialist settings and 21.9%, 28.9% and 5.2%, respectively in population studies. The adjusted annual conversion rate (ACR) from Mayo defined MCI to dementia, AD and VaD was 9.6%, 8.1% and 1.9%, respectively in specialist clinical settings and 4.9%, 6.8% and 1.6% in community studies. Figures from non‐Mayo defined MCI and clinical trials are also reported.Conclusion: The ACR is approximately 5–10% and most people with MCI will not progress to dementia even after 10 years of follow‐up.

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“…Despite its lower prevalence rate, conversion studies suggest that individuals with aMCI are almost twice as likely to convert to dementia within 2.5 years compared with individuals diagnosed with other nonamnesic forms of MCI (Fischer et al, 2007 ). In another study of dementia conversion, most amnesic and dysexecutive MCI patients were ultimately diagnosed with either AD or subcortical vascular dementia (Zanetti, Ballabio, Abbate, Cutaia, Vergani, & Bergamaschini, 2006 ). Furthermore, before converting to dementia, the single-domain dysexecutive MCI group presented with more vascular co-morbidities and signs of vascular disease on T2-weighted MRI studies.…”

Section: Heterogeneity Of Mild Cognitive Impairmentmentioning

confidence: 99%

The heterogeneity of mild cognitive impairment: A neuropsychological analysis

Libon

Xie

Eppig

et al. 2009

J Int Neuropsychol Soc

113

122

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A group of 94 nondemented patients self-referred to an outpatient memory clinic for memory diffi culties were studied to determine the incidence of single versus multi-domain mild cognitive impairment (MCI) using Petersen criteria. Fifty-fi ve community dwelling normal controls (NC) participants without memory complaints also were recruited. Tests assessing executive control, naming/lexical retrieval, and declarative memory were administered. Thirty-four patients exhibited single-domain MCI, 43 patients presented with multi-domain MCI. When the entire MCI sample ( n = 77) was subjected to a cluster analysis, 14 patients were classifi ed with amnesic MCI, 21 patients with dysexecutive MCI, and 42 patients were classifi ed into a mixed/multi-domain MCI group involving low scores on tests of letter fl uency, "animal" fl uency, and delayed recognition discriminability. Analyses comparing the three cluster-derived MCI groups versus a NC group confi rmed the presence of memory and dysexecutive impairment for the amnesic and dysexecutive MCI groups. The mixed MCI group produced lower scores on tests of letter fl uency compared with the amnesic MCI and NC groups and lower scores on tests of naming and memory compared with the NC group. In summary, multi-domain MCI is quite common. These data suggest that MCI is a highly nuanced and complex clinical entity. ( JINS , 2010, 16, 84-93.)

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Mild Cognitive Impairment Subtypes and Vascular Dementia in Community‐Dwelling Elderly People: A 3‐Year Follow‐Up Study

Abstract: All subjects who converted to subcortical VaD had been classified with mcd-MCI, suggesting that mcd-MCI might be an early stage of subcortical VaD.

Cited by 123 publications

References 41 publications

Abnormal nocturnal blood pressure profile is associated with mild cognitive impairment in the elderly: the J-SHIPP study

Abnormal nocturnal blood pressure profile is associated with mild cognitive impairment in the elderly: the J-SHIPP study

Rate of progression of mild cognitive impairment to dementia – meta‐analysis of 41 robust inception cohort studies

The heterogeneity of mild cognitive impairment: A neuropsychological analysis

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