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Cognitive impairment without dementia in older people: prevalence, vascular risk factors, impact on disability. The Italian Longitudinal Study on Aging.

Abstract

OBJECTIVES

To investigate prevalence of "cognitive impairment, no dementia" (CIND) in the Italian older population, evaluating the association with cardiovascular disease and the impact on activities of daily living (ADL). CIND may provide pathogenic clues to dementia and independently affect ADL.

DESIGN

Cross-sectional examination in the context of the Italian Longitudinal Study on Aging.

SETTING

Random population sample from eight Italian municipalities.

PARTICIPANTS

A total of 3,425 individuals aged 65-84 years, residing in the community or institutionalized.

MEASUREMENTS

Study participants were screened for cognitive impairment by using the Mini-Mental State Examination. Trained neurologists examined those scoring <24. CIND diagnosis relied on clinical and neuropsychological examination, informant interview, and assessment of functional activities. Age-related cognitive decline (ARCD) was diagnosed in CIND cases without neuropsychiatric disorders responsible for the cognitive impairment.

RESULTS

Prevalence was 10.7% for CIND and 7.5% for ARCD, increased with age, and was higher in women. Age (odds ratio [OR], 1.09; 95% confidence interval [CI], 1.06-1.12), stroke (OR, 2.05; 95% CI, 1.26-3.35) and heart failure (OR, 1.73; 95% CI, 1.11-2.68) were significantly and positively associated with CIND at multivariate analysis. Education (OR, 0.61; 95% CI, 0.56-0.65) and smoking (OR, 0.72; 95% CI, 0.54-0.98) showed a negative correlation. Age and myocardial infarction were positively associated with ARCD, whereas a negative correlation was found for education and smoking. The effect of smoking was no more significant either on CIND or ARCD considering current habits or "pack year" exposure. CIND showed an independent impact on ADL (OR, 1.88; 95% CI, 1.41-2.49).

CONCLUSIONS

CIND is very frequent in older people. The effect of demographic variables and vascular conditions offers opportunities for prevention. The association with functional impairment is useful to evaluate the burden of disability and healthcare demands.

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  • Authors+Show Affiliations

    ,

    National Research Council of Italy, Italian Longitudinal Study on Aging, Florence.

    , , , , ,

    Source

    MeSH

    Activities of Daily Living
    Aged
    Aged, 80 and over
    Cognition Disorders
    Cross-Sectional Studies
    Dementia
    Dementia, Vascular
    Disability Evaluation
    Female
    Geriatric Assessment
    Humans
    Italy
    Longitudinal Studies
    Male
    Mental Status Schedule
    Risk Factors

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    10894316

    Citation

    Di Carlo, A, et al. "Cognitive Impairment Without Dementia in Older People: Prevalence, Vascular Risk Factors, Impact On Disability. the Italian Longitudinal Study On Aging." Journal of the American Geriatrics Society, vol. 48, no. 7, 2000, pp. 775-82.
    Di Carlo A, Baldereschi M, Amaducci L, et al. Cognitive impairment without dementia in older people: prevalence, vascular risk factors, impact on disability. The Italian Longitudinal Study on Aging. J Am Geriatr Soc. 2000;48(7):775-82.
    Di Carlo, A., Baldereschi, M., Amaducci, L., Maggi, S., Grigoletto, F., Scarlato, G., & Inzitari, D. (2000). Cognitive impairment without dementia in older people: prevalence, vascular risk factors, impact on disability. The Italian Longitudinal Study on Aging. Journal of the American Geriatrics Society, 48(7), pp. 775-82.
    Di Carlo A, et al. Cognitive Impairment Without Dementia in Older People: Prevalence, Vascular Risk Factors, Impact On Disability. the Italian Longitudinal Study On Aging. J Am Geriatr Soc. 2000;48(7):775-82. PubMed PMID: 10894316.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Cognitive impairment without dementia in older people: prevalence, vascular risk factors, impact on disability. The Italian Longitudinal Study on Aging. AU - Di Carlo,A, AU - Baldereschi,M, AU - Amaducci,L, AU - Maggi,S, AU - Grigoletto,F, AU - Scarlato,G, AU - Inzitari,D, PY - 2000/7/14/pubmed PY - 2000/8/1/medline PY - 2000/7/14/entrez SP - 775 EP - 82 JF - Journal of the American Geriatrics Society JO - J Am Geriatr Soc VL - 48 IS - 7 N2 - OBJECTIVES: To investigate prevalence of "cognitive impairment, no dementia" (CIND) in the Italian older population, evaluating the association with cardiovascular disease and the impact on activities of daily living (ADL). CIND may provide pathogenic clues to dementia and independently affect ADL. DESIGN: Cross-sectional examination in the context of the Italian Longitudinal Study on Aging. SETTING: Random population sample from eight Italian municipalities. PARTICIPANTS: A total of 3,425 individuals aged 65-84 years, residing in the community or institutionalized. MEASUREMENTS: Study participants were screened for cognitive impairment by using the Mini-Mental State Examination. Trained neurologists examined those scoring <24. CIND diagnosis relied on clinical and neuropsychological examination, informant interview, and assessment of functional activities. Age-related cognitive decline (ARCD) was diagnosed in CIND cases without neuropsychiatric disorders responsible for the cognitive impairment. RESULTS: Prevalence was 10.7% for CIND and 7.5% for ARCD, increased with age, and was higher in women. Age (odds ratio [OR], 1.09; 95% confidence interval [CI], 1.06-1.12), stroke (OR, 2.05; 95% CI, 1.26-3.35) and heart failure (OR, 1.73; 95% CI, 1.11-2.68) were significantly and positively associated with CIND at multivariate analysis. Education (OR, 0.61; 95% CI, 0.56-0.65) and smoking (OR, 0.72; 95% CI, 0.54-0.98) showed a negative correlation. Age and myocardial infarction were positively associated with ARCD, whereas a negative correlation was found for education and smoking. The effect of smoking was no more significant either on CIND or ARCD considering current habits or "pack year" exposure. CIND showed an independent impact on ADL (OR, 1.88; 95% CI, 1.41-2.49). CONCLUSIONS: CIND is very frequent in older people. The effect of demographic variables and vascular conditions offers opportunities for prevention. The association with functional impairment is useful to evaluate the burden of disability and healthcare demands. SN - 0002-8614 UR - https://www.unboundmedicine.com/medline/citation/10894316/Cognitive_impairment_without_dementia_in_older_people:_prevalence_vascular_risk_factors_impact_on_disability__The_Italian_Longitudinal_Study_on_Aging_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&amp;sid=nlm:pubmed&amp;issn=0002-8614&amp;date=2000&amp;volume=48&amp;issue=7&amp;spage=775 DB - PRIME DP - Unbound Medicine ER -