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Mild cognitive impairment in the general population: occurrence and progression to Alzheimer disease.
Am J Geriatr Psychiatry. 2008 Jul; 16(7):603-11.AJ

Abstract

OBJECTIVES

Our aims were to 1) detect the occurrence of three mild cognitive impairment (MCI) subtypes in the general population; 2) identify cases of cognitive impairment which are not detected by current operational criteria for MCI and; 3) determine the predictive value of the subtypes for identifying future Alzheimer disease (AD).

DESIGN

Three-year prospective study.

SETTING

Population-based Swedish study, the Kungsholmen Project.

PARTICIPANTS

Three hundred seventy-nine nondemented older adults aged 75-95.

MEASUREMENTS

Standard plus modified MCI criteria were applied at baseline. In the modified definitions, the requirement for normal general cognition was removed. A category for persons without MCI who had only global cognitive deficits was added. Three-year progression to AD was assessed (DSM-III-R criteria).

RESULTS

Occurrence per 100 nondemented persons of MCI-amnestic, MCI-multidomains, and MCI-single-nonmemory was 2.1%, 1.8%, and 7.2%, respectively. When applying modified definitions for MCI-amnestic and MCI-multidomains, the occurrence almost doubled. Seven percent of the sample had impairment on a global cognitive task but performed at normal levels on all other domain-specific tasks. MCI-multidomains showed the highest progression to AD (hazard ratio [HR]: 23.6, 9.3-60.1). MCI-amnestic reached similar predictivity only when using the modified definition (HR: 17.9, 6.8-46.9). Even participants without MCI who had only global deficits had a ninefold risk of AD (HR: 9.1, 2.8-29.4).

CONCLUSIONS

Two-thirds of MCI-multidomains, but only half of MCI-amnestic progress to AD. The standard MCI criteria failed to identify those people with global cognitive deficits who have, however, a high risk of progressing to AD.

Authors+Show Affiliations

Aging Research Center, Karolinska Institutet, and Stockholm Gerontology Research Center, Stockholm, Sweden. katie.palmer@ki.seNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

18591580

Citation

Palmer, Katie, et al. "Mild Cognitive Impairment in the General Population: Occurrence and Progression to Alzheimer Disease." The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry, vol. 16, no. 7, 2008, pp. 603-11.
Palmer K, Bäckman L, Winblad B, et al. Mild cognitive impairment in the general population: occurrence and progression to Alzheimer disease. Am J Geriatr Psychiatry. 2008;16(7):603-11.
Palmer, K., Bäckman, L., Winblad, B., & Fratiglioni, L. (2008). Mild cognitive impairment in the general population: occurrence and progression to Alzheimer disease. The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry, 16(7), 603-11. https://doi.org/10.1097/JGP.0b013e3181753a64
Palmer K, et al. Mild Cognitive Impairment in the General Population: Occurrence and Progression to Alzheimer Disease. Am J Geriatr Psychiatry. 2008;16(7):603-11. PubMed PMID: 18591580.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Mild cognitive impairment in the general population: occurrence and progression to Alzheimer disease. AU - Palmer,Katie, AU - Bäckman,Lars, AU - Winblad,Bengt, AU - Fratiglioni,Laura, PY - 2008/7/2/pubmed PY - 2008/8/30/medline PY - 2008/7/2/entrez SP - 603 EP - 11 JF - The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry JO - Am J Geriatr Psychiatry VL - 16 IS - 7 N2 - OBJECTIVES: Our aims were to 1) detect the occurrence of three mild cognitive impairment (MCI) subtypes in the general population; 2) identify cases of cognitive impairment which are not detected by current operational criteria for MCI and; 3) determine the predictive value of the subtypes for identifying future Alzheimer disease (AD). DESIGN: Three-year prospective study. SETTING: Population-based Swedish study, the Kungsholmen Project. PARTICIPANTS: Three hundred seventy-nine nondemented older adults aged 75-95. MEASUREMENTS: Standard plus modified MCI criteria were applied at baseline. In the modified definitions, the requirement for normal general cognition was removed. A category for persons without MCI who had only global cognitive deficits was added. Three-year progression to AD was assessed (DSM-III-R criteria). RESULTS: Occurrence per 100 nondemented persons of MCI-amnestic, MCI-multidomains, and MCI-single-nonmemory was 2.1%, 1.8%, and 7.2%, respectively. When applying modified definitions for MCI-amnestic and MCI-multidomains, the occurrence almost doubled. Seven percent of the sample had impairment on a global cognitive task but performed at normal levels on all other domain-specific tasks. MCI-multidomains showed the highest progression to AD (hazard ratio [HR]: 23.6, 9.3-60.1). MCI-amnestic reached similar predictivity only when using the modified definition (HR: 17.9, 6.8-46.9). Even participants without MCI who had only global deficits had a ninefold risk of AD (HR: 9.1, 2.8-29.4). CONCLUSIONS: Two-thirds of MCI-multidomains, but only half of MCI-amnestic progress to AD. The standard MCI criteria failed to identify those people with global cognitive deficits who have, however, a high risk of progressing to AD. SN - 1545-7214 UR - https://www.unboundmedicine.com/medline/citation/18591580/Mild_cognitive_impairment_in_the_general_population:_occurrence_and_progression_to_Alzheimer_disease_ L2 - https://linkinghub.elsevier.com/retrieve/pii/16/7/603 DB - PRIME DP - Unbound Medicine ER -