Incidence Rates Of Mild Cognitive Impairment Research Articles

Impact of Multivitamin‐Mineral and Cocoa Extract on Incidence of Mild Cognitive Impairment and Dementia: Results from the Cocoa Supplement and Multivitamin Outcomes Study for the Mind COSMOS‐Mind

AbstractBackgroundCOSMOS‐Mind, a large, randomized placebo‐controlled pragmatic trial in older adults, recently reported that daily supplementation with multivitamin‐mineral, but not cocoa extract, benefited global cognition. We assessed effects of these supplements on prespecified secondary outcomes of mild cognitive impairment (MCI) and all‐cause dementia (DM). We also assessed treatment‐related cognitive trajectories leading to conversion to MCI or dementia.MethodCOSMOS‐Mind (N = 2262) administered a telephone‐based cognitive battery at baseline and annually for 3 years. Proxies of participants meeting criteria for suspected cognitive impairment based on a cognitive screener (TICSm) were interviewed. An expert panel adjudicated cognitive status. Incidence rates of MCI, and separately DM, were compared among arms with proportional hazards regression. Changes in cognitive trajectories leading to MCI and DM were assessed with linear models.ResultAt baseline, adjudication for suspected cognitive impairment was triggered for 419 (20%) participants, yielding adjudications of 217 (10%) MCI and 4 (0.2%) DM cases. During follow‐up, triggers were less frequent in the MVM than placebo arms: hazard ratio = 0.73 (p = 0.04). Across 3 years, 110 incident MCI and 14 incident DM cases were adjudicated. Incidence rates of these outcomes did not vary by assignment to multivitamin‐mineral or cocoa extract (all p≥0.05), however statistical power was low. Incident MCI was associated with a marked decline in cognitive function from the previous year (p<0.001). When participants assigned to multivitamin‐mineral versus placebo converted to MCI, their scores for global cognition (p = 0.03) and executive function (p<0.001) were higher and had declined less relative to the previous year (p = 0.03 for global cognition; p = 0.004 for executive function). Daily cocoa extract use did not attenuate cognitive decline leading up to MCI.ConclusionCOSMOS‐Mind does not provide evidence that cocoa extract or multivitamin‐mineral therapy lowers risk of incident MCI or DM. Multivitamin‐mineral therapy, but not cocoa extract, may provide cognitive resilience countering conversion to MCI.

Association of body mass index and dietary intake with mild cognitive impairment and dementia: a retrospective cohort study

BackgroundThe prevalence of cognitive impairment in older adults is gradually increasing, and this is leading to many adverse outcomes. Common causes of cognitive impairment in advancing age are mild cognitive impairment (MCI) and dementia. However, how the nutritional status and nutrient intake are related to MCI and dementia is controversial. Therefore, we aimed to evaluate the association of body mass index (BMI) and dietary intake with the risk of MCI and dementia.MethodsThis retrospective cohort study involved 821 participants aged ≥ 50 years from a previous population-based cohort study: the Electricity Generating Authority of Thailand (EGAT) study in 2013–2014 (baseline) and 2018–2019 (follow-up). Dietary intake was recorded using a 12-month self-reported food frequency questionnaire. MCI and dementia were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria using the Montreal Cognitive Assessment with ADL and the Kessler Psychological Distress Scale (K10) at study entry and at the 5-year follow-up.ResultsAmong the 821 participants, the mean age was 60.0 ± 4.3 years, and the incidence rate of MCI and dementia was 42.5 and 11.2 per 1,000 person-years, respectively. The rate of MCI and dementia was higher in participants aged ≥ 60 years and with an education level of < 7 years. The rate of MCI was also higher in those with a BMI of ≥ 25 kg/m2 and type 2 diabetes. Compared to BMI 18.5–22.9 kg/m2, BMI of ≥ 25 kg/m2 (odds ratio 1.91 [95% confidence interval, 1.12–3.26], p < 0.001) was associated with an increased risk of MCI after adjusted for age, education level, and type 2 diabetes. Regarding dietary intake, fresh red meat consumption was inversely associated with the risk of MCI (p = 0.037) and dementia (p = 0.011) after adjusting for age, education level, type 2 diabetes, and BMI.ConclusionObesity was associated with a greater risk of MCI. Moreover, low consumption of fresh red meat could be a risk factor for MCI and dementia. Further studies are required to confirm and explain these findings.

Application and Revision of Montreal Cognitive Assessment in China's Military Retirees with Mild Cognitive Impairment.

ObjectiveIn an effort to accommodate MOCA to better fit for the Chinese context, this study was designed to employ the MOCA criteria to screen mild cognitive impairment (MCI) and analyze associated risk factors in military retirees.MethodsThree hundred and four retired military cadres were recruited using a random cluster sampling technique with information collected including personal, prevalence, MOCA scale, and related neuropsychiatry scale. Thirty retirees were randomly chosen to be further analyzed one month later using the revised MOCA scale.Results①Our data indicated an incidence rate of 64.8% for mild cognitive impairment in retired military cadres. The incidence rate for MCI was significantly higher in those aged 80 or above compared with those 80 years of age or younger (P<0.05). The incidence rate of MCI was significantly higher in those with fewer than 6 years of education compared with those with over 7 years of education (P<0.05). The MCI incidence was higher for those with little exercise than those taking regular exercise (P<0.01). Moreover, the MCI incidence was higher in stroke patients than those who never had a stroke episode (P<0.05). ②There was a significant correlation between MOCA and MMSE scale scores (r = 0.81). MOCA scale scores were negatively correlated with ADL and CES-D scores (although not PSQI scores). ③ MOCA recension Cronbach’s alpha value was 0.862. The related coefficient of MOCA and MOCA recension was 0.878(P<0.01). When the Score of cut-off -point of the MOCA recension was 28, the area in ROC curve analyses was 0.859, as well as the largest area.ConclusionRetired cadres exhibited a greater incidence of MCI (than general population), which was closely associated with age, level of education and physical exercise and cerebral apoplexy. Revised MOCA scale displays a better validity and reaction degree of reliability and is more suitable for screening and diagnosis of MCI in the elderly in China.

Possible role of nicotine for the treatment of mild cognitive impairment

Evaluation of: Newhouse P, Kellar K, Aisen P et al. Nicotine treatment of mild cognitive impairment: a 6-month double-blind pilot clinical trial. Neurology 78(2), 91–101 (2012).There have been several drug trials in recent years investigating the efficacy of commonly used Alzheimer’s disease therapies for symptoms of mild cognitive impairment (MCI). However, there are no US FDA-approved pharmacological treatments for MCI. As the incidence rates of MCI are considerable, it is clear that better treatments for MCI need to be developed. The reviewed paper presents new data on a pilot clinical trial which shows that transdermal nicotine treatment for 6 months improved cognitive performance in subjects with amnestic MCI. Further studies will possibly bring us wider usage of nicotine for individuals with cognitive dysfunction.

Incidence of mild cognitive impairment - a systematic review

Background/Objectives: Dementia is not only one of the most burdensome diseases for sufferers and their caregivers, but also one of the biggest challenges for developed countries and their health care systems. Subjects with Mild Cognitive Impairment (MCI) constitute a risk population for developing dementia and thus a population of clinical interest. This study reviews recent work on the incidence of MCI in the elderly. Methods: Incidence papers were identified by a systematic literature search. Studies on incidence of MCI were considered if they identified ‘cognitively mild impaired’ subjects by application of the MCI criteria (self-reported and/or informant-reported cognitive complaints, preserved basic activities of daily living, cognitive impairment or decline in cognition evidenced by performance on objective cognitive tasks, preserved general cognitive functioning, and absence of dementia), used the ‘person-years-at-risk’ method, and were based on population-based or community-based samples. Results: Nine studies were identified. Incidence of Amnestic MCI subtypes ranged between 9.9 and 40.6 per 1,000 person-years, and incidence of Non-amnestic MCI subtypes was found to be 28–36.3 per 1,000 person-years. Regarding any MCI, incidence rates of 51–76.8 per 1,000 person-years have been found. A higher risk of incident MCI associated with higher age, lower education, and hypertension. Discussion/Conclusions: Incidence rates of MCI varied widely, and possible risk factors for incident MCI were analysed only to a limited extent. Findings call for an agreement concerning the criteria used for MCI and the operationalisation of these criteria (e.g. the use of consistent cut-offs in cognitive tests for the definition of objective cognitive impairment). Funding: This review was published in affiliation with the Leipzig Research Centre for Civilization Diseases (LIFE, University of Leipzig). LIFE is financed by the European Union, by the European Regional Development Fund (ERDF) and by the Free State of Saxony within the framework of the Excellence Initiative. Keywords: Outcome assessment, mild cognitive impairment, incidence.

Mild Cognitive Impairment: Incidence and Risk Factors: Results of the Leipzig Longitudinal Study of the Aged

To provide information on age- and sex-specific incidence rates of mild cognitive impairment (MCI) and risk factors for incident MCI. Prospective longitudinal cohort. Leipzig Longitudinal Study of the Aged, a population-based German study of the epidemiology of dementia and mild cognitive impairment. At baseline, 1,692 subjects aged 75 and older were included in the sample. Trained psychologists and physicians conducted structured clinical interviews including neuropsychological assessment and questions about sociodemographics, familial history of dementia, activities of daily living, subjective memory impairment, and lifestyle (alcohol consumption, smoking) at participants' homes. Structured third-party interviews were conducted with proxies. Incidence was calculated according to the person-years-at-risk method. Cox proportional hazards models were used to examine the association between risk factors and incident MCI. During an 8-year follow-up period, 26.4% (n=137) of the 519 study participants (population at risk) were identified as incident MCI cases (person-years=1,791.1). The overall incidence rate of MCI was 76.5 (95% confidence interval=64.7-90.4) per 1,000 person-years. Older age, subjective memory impairment, impairment in instrumental activities of daily living, and antecedent lower cognitive performance were found to be significantly associated with the development of future MCI. MCI is highly incident in the elderly population. For the purpose of early detection of dementia, subjective memory impairment should be taken seriously as a possible prestage of MCI.

Incidence of Mild Cognitive Impairment – A systematic review

Background: Subjects with Mild Cognitive Impairment (MCI) constitute a risk population of developing dementia and thus a population of clinical interest. This study reviews recent work on the incidence of MCI in the elderly. Methods: Incidence papers were identified by a systematic literature search. Studies on incidence of MCI were considered if they identified 'cognitively mild impaired' subjects by application of the MCI criteria, used the 'person-years-at-risk' method, and were based on population-based or community-based samples. Results: Nine studies were identified. Incidence of Amnestic MCI subtypes ranged between 9.9 and 40.6 per 1,000 person-years, and incidence of Non-amnestic MCI subtypes was found to be 28 and 36.3 per 1,000 person-years. Regarding any MCI, incidence rates of 51 and 76.8 per 1,000 person-years have been found. A higher risk of incident MCI mainly was found for higher age, lower education and hypertension. Discussion: Incidence rates of MCI varied widely, and possible risk factors for incident MCI were analysed only to a limited extent. Findings call for an agreement concerning the criteria used for MCI and the operationalisation of these criteria.

Frequency and course of mild cognitive impairment in a multiethnic community

To examine incidence rates and antecedents of mild cognitive impairment (MCI) and Alzheimer's disease (AD) among diverse elders without dementia at the initial visit, and to examine the characteristics of elders with MCI who reverted to normal on follow-up examination. A total of 2,364 Caribbean Hispanic, black, or non-Hispanic white subjects, aged 65 or older, who were free of dementia at initial evaluation were followed up every 18 to 24 months. Incidence rate of MCI and AD was determined by examination of neurological, medical, psychiatric, and neuropsychological function. Over 10,517 person-years, 21% of normal elderly subjects progressed to MCI (annual incidence rate, 5.1%; 95% confidence interval, 4.6-5.6%). Of those with MCI initially, 21.8% were subsequently diagnosed with AD (annual incidence rate, 5.4%; 95% confidence interval, 4.7-6.3%), 47% remained unchanged, and 31% reverted to normal. Those with MCI were 2.8 times more likely to experience development of AD than normal elderly subjects. MCI with impairment in memory and at least one other cognitive domain was associated with greatest risk for progression to AD and was also least likely to revert to normal at follow-up. Consistent diagnosis of MCI or incident probable or possible AD was 60% sensitive and 94% specific for the pathological diagnosis of AD. Impaired memory and language were useful predictors of transition to AD. Reversion to normal from MCI was frequent, but those with impairment in more than one cognitive domain were more likely to progress or remain impaired than those with single-domain impairment. Clinical diagnosis of MCI does not always predict AD neuropathology.