Abstract
Objective Mild cognitive impairment (MCI) is a transitional state between normal aging and early dementia. It has a heterogeneous etiology and clinical course. This study aimed to examine the factors associated with the progression of MCI in different types of dementia disorders. Method A retrospective, longitudinal, observational study of outpatients with MCI was conducted at a medical center in northern Taiwan. Patient medical records were reviewed, and risk factors were analyzed by multivariate analysis. Results Among 279 patients with MCI, 163 (58.4%), 68 (24.4%), and 48 (17.2%) were diagnosed with Alzheimer's disease, vascular cognitive impairment, and Lewy body diseases, respectively. During the observation period, 37.2% of patients progressed to dementia. Older age and a higher Clinical Dementia Rating Scale-Sum of Boxes were associated with the risk of progression. Hyperlipidemia was associated with a decreased risk. Converters were more likely to receive an antidementia prescription. Conclusion Our study suggests the importance of comprehensive clinical profiling, risk factor assessment, and detailed drug history evaluations in improving our understanding and management of dementia subtypes.
Highlights
Dementia can result from several underlying diseases, including Alzheimer’s disease (AD), cerebrovascular disease, Lewy body diseases (LBD), frontotemporal dementia, and other less common disorders such as Huntington’s disease, supranuclear palsy, and others
Many epidemiological studies have reported that the presence of vascular risk factors in midlife is associated with an increased risk of cognitive impairment and dementia, AD and vascular dementia (VaD) [2, 3]
37.4% of our Mild cognitive impairment (MCI) patients progressed to dementia with a mean follow-up period of 27.09 ± 15.09 months
Summary
Dementia can result from several underlying diseases, including Alzheimer’s disease (AD), cerebrovascular disease, Lewy body diseases (LBD), frontotemporal dementia, and other less common disorders such as Huntington’s disease, supranuclear palsy, and others. Mild cognitive impairment (MCI) is considered an intermediate state between normal cognitive aging and very early dementia. Many epidemiological studies have reported that the presence of vascular risk factors (i.e., hypertension, diabetes, cerebrovascular disease, and hyperlipidemia) in midlife is associated with an increased risk of cognitive impairment and dementia, AD and vascular dementia (VaD) [2, 3]. Previous studies have reported older age, lower education status, prestroke cognitive and functional status, and history of diseases as risk factors for poststroke dementia [4]. Apart from vascular risk factors, other clinical conditions have been reported to show associations with MCI and dementia, including chronic obstructive pulmonary disease [6], chronic heart disease [7], cirrhosis [8], and chronic kidney disease [9]. There has been a limited focus on whether chronic
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