Predicting the risk of mild cognitive impairment in the Mayo Clinic Study of Aging

Abstract

Objective: We sought to develop risk scores for the progression from cognitively normal (CN) to mild cognitive impairment (MCI). Methods:We recruited into a longitudinal cohort study a randomly selected, population-based sample of Olmsted County, MN, residents, aged 70 to 89 years on October 1, 2004. At baseline and subsequent visits, participants were evaluated for demographic, clinical, and neuropsychological measures, and were classified as CN, MCI, or dementia. Using baseline demographic and clinical variables in proportional hazards models, we derived scores that predicted the risk of progressing from CN to MCI. We evaluated the ability of these risk scores to classify participants for MCI risk. Conclusions:We have developed MCI risk scores using variables easily assessable in the clinical setting and that may be useful in routine patient care. Because of variability among populations, validation in independent samples is required. These models may be useful in identifying patients who might benefit from more expensive or invasive diagnostic testing, and can inform clinical trial design. Inclusion of biomarkers or other risk factors may further enhance the models. As clinicians and researchers strive to identify individuals at the highest risk of dementia in the earliest possible stages, understanding the predictors of mild cognitive impairment (MCI) is crucial because individuals with MCI have an increased risk of developing dementia. A method that predicts an individual's risk of developing MCI, particularly one that is brief, inexpensive, and noninvasive, is essential for risk stratification at the population level and would enhance the design and conduct of interventional trials.Estimates of the prevalence and incidence of MCI have been published from the prospective population-based Mayo Clinic Study of Aging (MCSA), designed to examine cognitive changes among individuals initially without dementia.

Effect of a long-term intensive lifestyle intervention on prevalence of cognitive impairment

“…In general populations, the incidence of cognitive impairment is greater among men than women at younger ages, but the rates appear to cross around the age of 80 years. 37 Thus, it is possible that the sex-related differences we see in Look AHEAD reflect the relatively younger age distribution of the cohort.…”

The frequency and influence of dementia risk factors in prodromal Alzheimer's disease

“…Diabetes mellitus, depression, hypertension, stroke and cardiovascular diseases have also been associated with an increased risk of progressing from cognitively normal to MCI (Pankratz, et al, 2015;Roberts, et al, 2015). Moreover, an association with cognitive decline has been found in both cognitively normal and MCI subjects (Jefferson, et al, 2015;Kaffashian, et al, 2013).…”

Association of Mild Cognitive Impairment With Exposure to General Anesthesia for Surgical and Nonsurgical Procedures

“…15-17 It has identified several factors, including age, education, sex, ApoE genotype, diabetes, depression, cardiovascular disease, and stroke as risk factors for incident MCI. 18 In the present study we combined the resources of Rochester Epidemiology Project (REP), 19 which provides access to all medical records of residents of Olmsted County, MN, and the MCSA study data to test the hypothesis that exposure to general anesthesia after the age of 40 is associated with the incidence of MCI in the elderly. The study cohort included patients who were cognitively normal at the time of their enrollment in the MCSA so that the primary outcome of incident MCI could be assessed.…”