Risk of conversion from mild cognitive impairment to dementia in low‐ and middle‐income countries: A systematic review and meta‐analysis

McGrattan, Andrea; Pakpahan, Eduwin; Siervo, Mario; Mohan, Devi; Reidpath, Daniel D.; Prina, Matthew; Allotey, Pascale; Zhu, Yueping; Chen, Shulin; Yates, Jen; Paddick, Stella‐Maria; Robinson, Louise; Stephan, Blossom C. M.

doi:10.1002/trc2.12267

Cited by 40 publications

(25 citation statements)

References 88 publications

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“…2 Same pathological processes underlie milder forms of cognitive deterioration (e.g., MCI) and dementia, partly explaining high conversion rate of MCI into dementia. 3 Moreover, both dementia and MCI are classified within the same cluster of neurocognitive disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5); MCI or other milder forms of pathological cognitive decline as mild neurocognitive disorders, and dementias represent major neurocognitive disorder. 4 Dementias and even milder forms of pathological cognitive decline are debilitating conditions that significantly compromise the quality of life and impose an enormous socioeconomic burden on caregivers and healthcare systems.…”

Section: Introductionmentioning

confidence: 99%

Periodontal health, cognitive decline, and dementia: A systematic review and meta‐analysis of longitudinal studies

Asher

Stephen

Mäntylä

et al. 2022

J American Geriatrics Society

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Background Emerging evidence indicates that poor periodontal health adversely impacts cognition. This review examined the available longitudinal evidence concerning the effect of poor periodontal health on cognitive decline and dementia. Methods Comprehensive literature search was conducted on five electronic databases for relevant studies published until April 2022. Longitudinal studies having periodontal health as exposure and cognitive decline and/or dementia as outcomes were considered. Random effects pooled estimates and 95% confidence intervals were generated (pooled odds ratio for cognitive decline and hazards ratio for dementia) to assess whether poor periodontal health increases the risk of cognitive decline and dementia. Heterogeneity between studies was estimated by I2 and the quality of available evidence was assessed through quality assessment criteria. Results Adopted search strategy produced 2132 studies for cognitive decline and 2023 for dementia, from which 47 studies (24 for cognitive decline and 23 for dementia) were included in this review. Poor periodontal health (reflected by having periodontitis, tooth loss, deep periodontal pockets, or alveolar bone loss) was associated with both cognitive decline (OR = 1.23; 1.05–1.44) and dementia (HR = 1.21; 1.07–1.38). Further analysis, based on measures of periodontal assessment, found tooth loss to independently increase the risk of both cognitive decline (OR = 1.23; 1.09–1.39) and dementia (HR = 1.13; 1.04–1.23). Stratified analysis based on the extent of tooth loss indicated partial tooth loss to be important for cognitive decline (OR = 1.50; 1.02–2.23) and complete tooth loss for dementia (HR = 1.23; 1.05–1.45). However, the overall quality of evidence was low, and associations were at least partly due to reverse causality. Conclusions Poor periodontal health and tooth loss appear to increase the risk of both cognitive decline and dementia. However, the available evidence is limited (e.g., highly heterogenous, lacking robust methodology) to draw firm conclusions. Further well‐designed studies involving standardized periodontal and cognitive health assessment and addressing reverse causality are highly warranted.

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Section: Introductionmentioning

confidence: 99%

Periodontal health, cognitive decline, and dementia: A systematic review and meta‐analysis of longitudinal studies

Asher

Stephen

Mäntylä

et al. 2022

J American Geriatrics Society

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“…Each year, some people with SCD will convert to MCI (about 5% per year; Parfenov et al, 2020) and some people with MCI will convert to dementia (about 6% per year; McGrattan et al, 2022). To assess whether the ND test score and linguistic features could predict future decline, we examined longitudinal CDR-SB data using a linear mixed model with age fully crossed with baseline cognitive-status group, and random effects of participant and age within participant to allow each participant a different trajectory of CDR-SB (decline within the fitted model).…”

Section: Statistical Analysesmentioning

confidence: 99%

Further evaluation of narrative description as a measure of cognitive function in Alzheimer’s disease.

Reeves¹,

Williams²,

Blacker³

et al. 2023

Neuropsychology

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Objective: The narrative description (ND) test objectively measures the ability to understand and describe visual scenes. As subtle differences in speech occur early in cognitive decline, we analyzed linguistic features for their utility in detecting cognitive impairment and predicting downstream decline. Method: Participants (n = 52) with normal cognition to mild dementia performed the ND test (watched twenty 30-s video clips and described the visual content). Cognitive function was followed for up to 5 years. We computed simple linguistic features such as content efficiency, speech rate, and part of speech and unique word counts. We examined (a) relationships between cognitive status and ND score and linguistic features; (b) ability to discriminate early cognitive impairment from normal cognition using ND score and linguistic features; and (c) whether ND score and linguistic features were associated with future cognitive functional decline. Results: Many of the linguistic-feature metrics were related to cognitive status. Many of the linguistic features could distinguish between the cognitively normal group and the mild cognitive impairment (MCI) and Dementia groups. The area under the curve (AUC) for ND score alone was 0.74, with a nonsignificant increase to 0.78 when adding mean word length. Among participants with subjective cognitive decline (SCD) at the first visit, a smaller number of words plus more interjections or a lower ND score at baseline were predictive of future cognitive decline. Conclusions: While many linguistic features were associated with cognitive status, and some were able to detect early cognitive impairment or predictive of future cognitive decline, all the features we tested seem to have been captured by the ND score. Thus, adding linguistic measures to the ND test score did not add to its value in assessing current or predicting future cognitive status. Key PointsQuestion: Can we improve the narrative description test by adding detailed linguistic information? Findings: Most linguistic features were related to cognitive status, but did not substantially improve the discriminability of the narrative description test in detecting early mild cognitive impairment. Importance: There was preliminary evidence that the narrative description test might be predictive of future decline in cognitive function in people with early cognitive impairment. Next Steps: Further studies are needed to further develop the narrative description test to determine whether it could be employed remotely for frequent in-home testing.

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“…MCI is defined as cognitive decline greater than expected for a given age but does not notably interfere with daily activities ( Salmon, 2011 ). Current clinical evidence demonstrates about a 20% annual conversion rate of MCI to AD and that more than half of the individuals with MCI progress to dementia within 5 years ( Gauthier et al, 2006 ; Davatzikos et al, 2011 ; López et al, 2020 ; McGrattan et al, 2022 ). In addition to prevalence differences, females experience greater cognitive deterioration than males in the same disease stage ( Alzheimer’s Association, 2016 ) that are also present in individuals with MCI ( Sohn et al, 2018 ).…”

Section: Introductionmentioning

confidence: 99%

Sex differences in brain functional connectivity of hippocampus in mild cognitive impairment

Williamson

Yabluchanskiy

Mukli

et al. 2022

Front. Aging Neurosci.

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Mild cognitive impairment (MCI) is the prodromal stage of Alzheimer’s Disease (AD). Prior research shows that females are more impacted by MCI than males. On average females have a greater incidence rate of any dementia and current evidence suggests that they suffer greater cognitive deterioration than males in the same disease stage. Recent research has linked these sex differences to neuroimaging markers of brain pathology, such as hippocampal volumes. Specifically, the rate of hippocampal atrophy affects the progression of AD in females more than males. This study was designed to extend our understanding of the sex-related differences in the brain of participants with MCI. Specifically, we investigated the difference in the hippocampal connectivity to different areas of the brain. The Resting State fMRI and T2 MRI of cognitively normal individuals (n = 40, female = 20) and individuals with MCI (n = 40, female = 20) from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) were analyzed using the Functional Connectivity Toolbox (CONN). Our results demonstrate that connectivity of hippocampus to the precuneus cortex and brain stem was significantly stronger in males than in females. These results improve our current understanding of the role of hippocampus-precuneus cortex and hippocampus-brainstem connectivity in sex differences in MCI. Understanding the contribution of impaired functional connectivity sex differences may aid in the development of sex specific precision medicine to manipulate hippocampal-precuneus cortex and hippocampal-brainstem connectivity to decrease the progression of MCI to AD.

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Risk of conversion from mild cognitive impairment to dementia in low‐ and middle‐income countries: A systematic review and meta‐analysis

Cited by 40 publications

References 88 publications

Periodontal health, cognitive decline, and dementia: A systematic review and meta‐analysis of longitudinal studies

Periodontal health, cognitive decline, and dementia: A systematic review and meta‐analysis of longitudinal studies

Further evaluation of narrative description as a measure of cognitive function in Alzheimer’s disease.

Sex differences in brain functional connectivity of hippocampus in mild cognitive impairment

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