Cognitive impairment in the nondemented elderly. Results from the Canadian Study of Health and Aging. Arch Neurol 52: 612-619

Department of Pathology, University of Calgary, Alberta.
JAMA Neurology (Impact Factor: 7.01). 07/1995; 52(6):612-9.
Source: PubMed

ABSTRACT To describe a population that was categorized as "cognitively impaired not demented" (CIND) and to examine the utility of some of the proposed criteria for describing this degree of cognitive impairment.
Population-based prevalence study of dementia in those subjects who were 65 years and older.
Community and institutional settings in Canada.
Individuals who underwent a clinical evaluation (N = 2914).
Initial screening with the Modified Mini-Mental State Examination (3MS) to identify potential cognitive impairment; the 3MS was followed by a detailed clinical examination to confirm the presence of dementia and to determine the probable cause. Clinical examinations were performed on all those subjects who were residing in institutions, those in the community with a 3MS score less than 78, and a sample of those in the community with a 3MS score of 78 or more. Neuropsychological testing was performed as part of the clinical examination when the 3MS score was 50 or more. At the conclusion of the assessment, subjects were categorized as being cognitively normal, CIND, and demented.
Frequency of a diagnosis of CIND; demographical, cognitive, and functional characteristics of cognitively normal and CIND subjects and those with early and late dementia; and proportion of subjects who were CIND and met the proposed criteria.
Subjects who were categorized as CIND were common and fell between cognitively normal subjects and those with dementia in terms of age, 3MS score, general intellectual function, and performance of daily activities. Because of the restrictive inclusion and exclusion criteria, the proposed criteria for cognitive impairment described only 30% of our subjects who were CIND.
Subjects who were categorized as CIND appeared to be distinct from and intermediate between subjects with dementia and cognitively normal subjects. Most individuals did not meet the criteria that were evaluated for describing this group. While the various criteria that were evaluated may accurately define a select subset of cognitively impaired individuals, the natural history and prognosis of such groups, currently unknown, may not be generalizable to the larger population of subjects who are CIND. Further work is needed to clearly define this group, and longitudinal studies are required to determine an outcome.

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    • "RESEARCH ARTICLE number of patients diagnosed as having MCI will become demented, some will remain at the MCI stage for years, and others will return to normal (Ebly et al., 1995; Wolf et al., 1998; Morris et al., 2001; Larrieu et al., 2002). Hence, MCI does not necessarily represent a transitional stage between normal aging and dementia, but a condition associated with an elevated risk of developing dementia (Smith, 2002). "
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    ABSTRACT: Objective The study was conducted to explore the effects of EGb 761® (Dr. Willmar Schwabe GmbH & Co. KG, Karlsruhe, Germany) on neuropsychiatric symptoms (NPS) and cognition in patients with mild cognitive impairment (MCI).Methods One hundred and sixty patients with MCI who scored at least 6 on the 12-item Neuropsychiatric Inventory (NPI) were enrolled in this double-blind, multi-center trial and randomized to receive 240 mg EGb 761 daily or placebo for a period of 24 weeks. Effects on NPS were assessed using the NPI, the state sub-score of the State-Trait Anxiety Inventory and the Geriatric Depression Scale. Further outcome measures were the Trail-Making Test (A/B) for cognition and global ratings of change. Statistical analyses followed the intention-to-treat principle.ResultsThe NPI composite score decreased by 7.0 ± 4.5 (mean, standard deviation) points in the EGb 761-treated group and by 5.5 ± 5.2 in the placebo group (p = 0.001). Improvement by at least 4 points was found in 78.8% of patients treated with EGb 761 and in 55.7% of those receiving placebo (p = 0.002). Superiority of EGb 761 over placebo (p < 0.05) was also found for the State-Trait Anxiety Inventory score, the informants' global impression of change, and both Trail-Making Test scores. There were statistical trends favoring EGb 761 in the Geriatric Depression Scale and the patients' global impression of change. Adverse events (all non-serious) were reported by 37 patients taking EGb 761 and 36 patients receiving placebo.ConclusionsEGb 761 improved NPS and cognitive performance in patients with MCI. The drug was safe and well tolerated. Copyright © 2014 John Wiley & Sons, Ltd.
    International Journal of Geriatric Psychiatry 10/2014; 29(10). DOI:10.1002/gps.4103 · 3.09 Impact Factor
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    • "The reported prevalence of MCI in Europe and North America varies from 2.8 to 17.5%.[5]-[7] The prevalence of MCI in different regions in China varied between 5.4 and 25.0% (11.6% in Beijing in 2004[8]; 15.4% in Guizhou Province in 2005[9]; 5.4% in Taiyuan City in 2006[10]; 9.89% in Xinjiang Province in 2007[11]; 6.3% in Guangzhou City in 2010[12]; and 25.0% in Shaanxi Province in 2011[13]). "
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    ABSTRACT: The rapid aging of the Chinese population has spurred interest in research about the cause and prevention of dementia and its precursor, mild cognitive impairment (MCI). This review summarizes the last decade of research in China about MCI. Extensive research about the epidemiology, neuropsychological characteristics, diagnosis, genetic etiology, neuroimaging and electrophysiological changes, and treatment of MCI has provided some new insights but few breakthroughs. Further advances in the prevention and treatment of MCI will require a greater emphasis on multi-disciplinary prospective studies with large, representative samples that use standardized methods to assess and monitor changes in cognitive functioning over time.
    02/2014; 26(1):4-14. DOI:10.3969/j.issn.1002-0829.2014.01.002
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    • "There have been a number of attempts to define an intermediate or transitional stage between successful aging and dementia, such as Age-Associated Memory Impairment (AAMI) [4], Late-Life Forgetfulness (LLF) [5], Aging-Associated Cognitive Decline (AACD) [6], Cognitive Impairment No Dementia (CIND) [7], and various concepts of Mild Cognitive Impairment [8] [9] [10] [11]. Longitudinal studies have shown that part of the patients diagnosed as having any of these conditions will become demented, another part will remain in the stage of mild impairment for years and a third part will return to normal [7] [12] [13] [14]. The likelihood for each of these possible courses seems to depend on the diagnostic criteria and the patients' age. "
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    ABSTRACT: Objective: To assess effects of EGb 761 ® on cognition and quality of life in subjects with very mild cognitive impairment. Methods: We randomized 300 subjects aged 45 to 65 with cognitive complaints and low functioning (more than one standard deviation below appropriate norm) in at least one cognitive test to double-blind treatment with once daily 240 mg EGb 761 ® or placebo for 12 weeks. Results: The exploratory intention-to-treat analysis showed significant im-provement (p < 0.025, one-sided) beyond practice effects for EGb 761 ® in a measure of attention (Vienna Test System-Work Performance Series) and trends in favour of EGb 761 ® in measures of memory (Wechsler Memory Scale III-Faces I, Appointments Test—delayed recall), and perceived physical health (SF36-factor score Physical Health). Cog-nitive effects were more pronounced and more consistent (p < 0.025 in 4 of 5 tests) in subjects with lower memory func-tion at baseline. Specifically, practice effects in the more demanding tests were attenuated or absent in these subjects. Conclusion: Ginkgo biloba extract EGb 761 ® improved cognitive functioning and aspects of quality of life in subjects with very mild cognitive impairment.
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