Predictors of Mild Cognitive Impairment Stability, Progression, or Reversion in the Lothian Birth Cohort 1936.

Miles Welstead,Michelle Luciano,Stina Saunders,Donncha S Mullin,Tom C Russ,Graciela Muniz-Terrera

doi:10.3233/jad-201282

Miles Welstead, Michelle Luciano + Show 4 more

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https://doi.org/10.3233/jad-201282

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Abstract

Background:Mild cognitive impairment (MCI) describes a borderland between healthy cognition and dementia. Progression to and reversion from MCI is relatively common but more research is required to understand the factors affecting this fluidity and improve clinical care interventions.Objective:We explore these transitions in MCI status and their predictive factors over a six-year period in a highly-phenotyped longitudinal study, the Lothian Birth Cohort 1936.Methods:MCI status was derived in the LBC1936 at ages 76 (n = 567) and 82 years (n = 341) using NIA-AA diagnostic guidelines. Progressions and reversions between healthy cognition and MCI over the follow-up period were assessed. Multinomial logistic regression assessed the effect of various predictors on the likelihood of progressing, reverting, or maintaining cognitive status.Results:Of the 292 participants who completed both time points, 41 (14%) participants had MCI at T1 and 56 (19%) at T2. Over the follow-up period, 74%remained cognitively healthy, 12%transitioned to MCI, 7%reverted to healthy cognition, and 7%maintained their baseline MCI status. Findings indicated that membership of these transition groups was affected by age, cardiovascular disease, and number of depressive symptoms.Conclusion:Findings that higher baseline depressive symptoms increase the likelihood of reverting from MCI to healthy cognition indicate that there may be an important role for the treatment of depression for those with MCI. However, further research is required to identify prevention strategies for those at high risk of MCI and inform effective interventions that increase the likelihood of reversion to, and maintenance of healthy cognition.

Highlights

Mild cognitive impairment (MCI) is used to describe individuals presenting with cognitive decline above what would be expected of normal ageing but not severe enough to warrant a diagnosis of dementia [1, 2]
MCI was coded for 567 participants at T1 and 341 at T2, but 49 of those individuals did not have MCI status at T1 so the final number of participants with MCI status ascertained at both time points was 292
While a considerable amount of longitudinal research has investigated the factors associated with dementia risk, fewer studies have focused on the progression and reversion transitions between a healthy cognition and MCI

Summary

Introduction

Mild cognitive impairment (MCI) is used to describe individuals presenting with cognitive decline above what would be expected of normal ageing but not severe enough to warrant a diagnosis of dementia [1, 2]. Progressions and reversions between healthy cognition and MCI over the follow-up period were assessed. Multinomial logistic regression assessed the effect of various predictors on the likelihood of progressing, reverting, or maintaining cognitive status. Over the follow-up period, 74% remained cognitively healthy, 12% transitioned to MCI, 7% reverted to healthy cognition, and 7% maintained their baseline MCI status. Conclusion: Findings that higher baseline depressive symptoms increase the likelihood of reverting from MCI to healthy cognition indicate that there may be an important role for the treatment of depression for those with MCI. Further research is required to identify prevention strategies for those at high risk of MCI and inform effective interventions that increase the likelihood of reversion to, and maintenance of healthy cognition

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