Risk Of Incident Mild Cognitive Impairment Research Articles

Benzodiazepine use and risk of incident MCI and dementia in a community sample.

Older adults commonly take benzodiazepines (BZDs) that may have long-term adverse cognitive effects. We investigated whether BZD use was related to developing mild cognitive impairment (MCI) or dementia in cognitively normal older adults in the community. A population-based cohort (n = 1959) of adults aged 65 and over, recruited from communities of low socioeconomic status. BZD use, Clinical Dementia Rating (CDR), anxiety symptoms, depression symptoms, sleep difficulties, and APOE genotype. We examined time from study entry to MCI (CDR = 0.5) and time from study entry to dementia (CDR ≥ 1) in participants who were cognitively normal at baseline (CDR = 0). We used survival analysis (Cox model), adjusted for age, sex, education, sleep, anxiety, and depression. For all the models, we included an interaction term between BZD use and APOE*4. Taking BZDs was significantly associated with higher risk of developing MCI, but not of developing dementia. The effect was not affected by APOE genotype. In a population-based sample of cognitively normal older adults, BZD use is associated with developing MCI, but not dementia. BZD use may be a potentially modifiable risk factor for MCI.

Association of Circulating Caprylic Acid with Risk of Mild Cognitive Impairment and Alzheimer's Disease in the Alzheimer's Disease Neuroimaging Initiative (ADNI) Cohort.

Medium-chain fatty acids (MCFAs) can rapidly cross the blood-brain barrier and provide an alternative energy source for the brain. This study aims to determine 1) whether plasma caprylic acid (C8:0) is associated with risk of incident mild cognitive impairment (MCI) among baseline cognitively normal (CN) participants, and incident Alzheimer's Disease (AD) among baseline MCI participants; and 2) whether these associations differ by sex, comorbidity of cardiometabolic diseases, apolipoprotein E (APOE) ε4 alleles, and ADAS-Cog 13. Within the Alzheimer's Disease Neuroimaging Initiative (ADNI) cohort, plasma C8:0 was measured at baseline in 618 AD-free participants aged 55 to 91. Logistic regression models were used to estimate odds ratios (ORs) and 95% CIs with incident MCI and AD as dependent variables, separately. The inverse association between circulating C8:0 and risk of incident MCI was of borderline significance. The inverse association between circulating levels of C8:0 and risk of incident MCI was significant among CN participants with ≥1 cardiometabolic diseases [OR (95% CI): 0.75 (0.58-0.98) (P=0.03)], those with one copy of APOE ε4 alleles [OR (95% CI): 0.43 (0.21-0.89) (P=0.02)], female [OR (95% CI): 0.60 (0.38-0.94) (P=0.02)], and ADAS-Cog 13 above the median [OR (95%CI): 0.69 (0.50-0.97)(P=0.03)] after adjusting for all covariates. The inverse associations were present only among subgroups of CN participants, including female individuals, those with one or more cardiometabolic diseases, or one APOE ε4 allele, or higher ADAS-Cog 13 scores. If confirmed, this finding will facilitate precision prevention of MCI, in turn, AD among CN older adults.

Anticholinergic Drug Burden and Risk of Incident MCI and Dementia: A Population-based Study.

We investigated whether anticholinergic drug use was related to developing mild cognitive impairment (MCI) or dementia in older adults at the population level. We used an Anticholinergic Rating (ACR) scale, Clinical Dementia Rating, APOE genotype, and number of prescription medications. We examined time to incident MCI and incident dementia in a population-based cohort (n=1959). We assessed whether developing MCI or dementia was associated with (1) any anticholinergic drug use, (2) total ACR score, or (3) number of anticholinergic drugs taken. Taking any anticholinergic drug was significantly associated with higher risk of developing MCI; however, higher ACR score or higher number of anticholinergic drugs, compared with lower, were not associated with greater risk of developing MCI. We found no significant relationship between anticholinergic use and developing dementia. The relationship between anticholinergic use and cognitive outcome was not affected by APOE genotype. Among cognitively normal older adults in a population-based sample, anticholinergic drug use is independently associated with subsequently developing MCI, but not dementia. Thus, anticholinergic drug use may influence risk of MCI that is nonprogressive to dementia and potentially be a modifiable risk factor for MCI.

Assessing within-task verbal fluency performance: the utility of individual time intervals in predicting incident mild cognitive impairment

ABSTRACT The current study aimed to determine whether word generation performance on individual within-task 20-second time intervals predicted conversion to Mild Cognitive Impairment (MCI) status. Longitudinal data (Mean follow-up=2.95±1.64 years) was collected from cognitively-healthy community-dwelling older adults (N=344; %female=56.1). Performance on letter and semantic fluency tasks was divided into three consecutive within-task 20-second intervals. Incident MCI status (n=50) was determined via established diagnostic case conference. Fully adjusted Cox proportional-hazards regression models revealed that greater word production on semantic fluency across all time intervals significantly predicted a reduced risk of incident MCI [0-20 seconds (HR=0.906, p=0.002), 21-40 seconds (HR=0.904, p=0.02), and 41-60 seconds (HR=0.892, p=0.017)]. Conversely, on letter fluency, greater word production within the 41-60 second time interval only was significantly associated with reduced risk of incident MCI (HR=0.886, p=0.002). Overall, the clinical use of within-interval performance is supported given evidence of predictive sensitivity and ease of administration.

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.

Serum Thyroid-Stimulating Hormone as a Predictor of Cognitive Impairment in an Elderly Cohort

Background: It is unclear whether in late life serum thyroid-stimulating hormone (TSH) predicts risk of developing cognitive impairment. Objective: This study investigated the prospective relationship of serum TSH with the risk of developing mild cognitive impairment (MCI), Alzheimer’s disease (AD) and vascular dementia (VaD) in an elderly cohort with a 4-year follow-up. Methods: Data are for 660 subjects aged 65 years and older from an Italian population-based cohort who were cognitively normal at an extensive assessment in 1999/2000 and underwent follow-up assessment in 2003/2004. Serum TSH was measured at baseline. Multinomial logistic models adjusted for sociodemographic and cardiovascular risk factors were used to investigate the association of serum TSH (both as a tertile and continuous log-transformed variable) with risk of incident MCI, AD and VaD diagnosed according to international criteria. Results: Over 3.8 ± 0.7 years of follow-up, there were 149 incident MCI cases (77 with impairment of memory and 72 with impairment of nonmemory domains) and 86 incident dementia cases (53 with AD, 28 with VaD). No association between baseline TSH and risk of developing any MCI subtype or AD was found. The highest TSH tertile had a threefold higher increased risk of VaD (OR: 3.25, 95% CI: 1.01–10.77, p = 0.048) compared to the lowest tertile. Risk of VaD increased about 60% for each 1 SD increase in log-transformed TSH (OR: 1.61, 95% CI: 1.06–2.44, p = 0.025). Conclusions: In this elderly cohort, baseline TSH was not related to the risk of developing MCI or AD, but high TSH was associated with an increased risk of VaD. These results suggest further need for research using larger samples to examine the role of TSH as a predictor of VaD and the role of thyroid autoimmunity in vascular cognitive impairment.

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.

Vegetables, Unsaturated Fats, Moderate Alcohol Intake, and Mild Cognitive Impairment

Background/Aims: To investigate associations of the Mediterranean diet (MeDi) components and the MeDi score with mild cognitive impairment (MCI). Methods: Participants (aged 70–89 years) were clinically evaluated to assess MCI and dementia, and completed a 128-item food frequency questionnaire. Results: 163 of 1,233 nondemented persons had MCI. The odds ratio of MCI was reduced for high vegetable intake [0.66 (95% CI = 0.44–0.99), p = 0.05] and for high mono- plus polyunsaturated fatty acid to saturated fatty acid ratio [0.52 (95% CI = 0.33–0.81), p = 0.007], adjusted for confounders. The risk of incident MCI or dementia was reduced in subjects with a high MeDi score [hazard ratio = 0.75 (95% CI = 0.46–1.21), p = 0.24]. Conclusion: Vegetables, unsaturated fats, and a high MeDi score may be beneficial to cognitive function.