Prevalence of Mild Cognitive Impairment and Its Subtypes among Chinese Older Adults: Role of Vascular Risk Factors

Abstract

Background/Aims: The prevalence of mild cognitive impairment (MCI) and its subtypes among Chinese older adults, and the contribution of vascular risk factors (VRF) and vascular disorders to MCI remain unclear. This study aims to investigate the prevalence of MCI and its different subtypes, and clarify the role of VRF and vascular diseases in the occurrence of MCI. Methods: A random sample of 5,214 nondementia (DSM-IV) individuals aged ≥65 years underwent neuropsychological assessments and clinical examinations. MCI, including amnestic MCI-single domain (aMCI-SD), amnestic MCI-multiple domains (aMCI-MD), nonamnestic MCI-single domain (naMCI-SD), and nonamnestic MCI-multiple domains (naMCI-MD), was defined according to modifications of the Petersen criteria. VRF (smoking, obesity, and diabetes) and vascular disorders (myocardial infarction, atrial fibrillation, stroke, and hypertension) were assessed based on information through self-report and medical records. Data were analyzed using multivariate logistic regression. Results: The prevalence of MCI was 11.33% (95% CI: 8.21-14.43), and that of aMCI-SD, aMCI-MD, naMCI-SD, and naMCI-MD was 4.48% (95% CI: 2.24-6.74), 2.09% (95% CI: 0.80-3.38), 4.22% (95% CI: 1.38-7.08), and 0.53% (95% CI: 0.32-0.75), respectively. The prevalence of MCI is higher in women than in men. Multivariate logistic regression analysis shows that VRF and vascular diseases were significantly related to increase the odds of MCI and its specific subtype. Conclusions: The prevalence of MCI is almost 11% among Chinese older adults. VRF and vascular disorders are associated with MCI, especially naMCI.

Diabetes, but Not Hypertension and Obesity, Is Associated with Postoperative Cognitive Dysfunction

“…The null finding suggests that vascular damage as a consequence of hypertension may only play a minor role in POCD development and replicates results of our meta-analysis of hypertension as a candidate risk factor for POCD [10]. Though we did not assess severity of hypertension which may be important in cognitive risk prediction [48], our finding warrants further enquiry particularly in view of established associations of this risk factor with cognitive impairment per se [15, 49, 50]. A beneficial effect of anti-hypertensive treatment on cognitive risk as an explanation of the null finding appears unlikely as the balance of evidence from RCTs speaks against such effects [51, 52].…”

“…However, these theories cannot easily explain the higher POCD risk in patients with diabetes. Patients with diabetes generally show greater cerebral and hippocampal atrophy [32-34], cerebral microvascular [35, 36] and macrovascular damage [37], and are also at increased risk of cognitive impairment [15, 38, 39] compared with non-diabetics. Similar observations have been made for hyperglycaemia short of diabetes diagnosis [40, 41] and poorer glycaemic control in patients with diabetes [42], which indicates fundamental influences of impaired glucose metabolism on the brain.…”

Prediction Models of Cognitive Trajectories in Patients with Nonamnestic Mild Cognitive Impairment

“…First, as the number of patients in the fast-decliners group was relatively small, the analyses may have had low statistical power. However, considering the prevalence of naMCI in community-based studies (0.5–6%) 13 , 31 , 32 , the results of our study still have clinical significance. Further investigation with larger sample sizes and a longer follow-up period is needed to understand long-term trajectory of naMCI.…”

Metabolic Syndrome and Cognition: Follow-Up Study of Chinese Over-55-Year-Olds

“…The metabolic syndrome (MetS), defined as the cooccurrence of at least 3 out of 5 cardiometabolic risk factors (abdominal adiposity, hyperglycemia, hypertriglyceridemia, lowered high-density lipoprotein cholesterol [HDL-C] and hypertension) [1] is known to significantly increase the risk of cardiovascular disease, type 2 diabetes and stroke [2][3][4]. Many studies have investigated the roles of individual cardiometabolic risk factors in the development and progression of dementia, mild cognitive impairment (MCI) and cognitive decline [5][6][7][8]. Studies of the associations of the MetS and its components with cognitive function and decline among nondemented older individuals are inconclusive and based on inconsistent data [9].…”