Prevalence of mild cognitive impairment is higher in men: The Mayo Clinic Study of Aging

Department of Neurology, College of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Neurology (Impact Factor: 8.29). 09/2010; 75(10):889-97. DOI: 10.1212/WNL.0b013e3181f11d85
Source: PubMed


We investigated the prevalence of mild cognitive impairment (MCI) in Olmsted County, MN, using in-person evaluations and published criteria.
We evaluated an age- and sex-stratified random sample of Olmsted County residents who were 70-89 years old on October 1, 2004, using the Clinical Dementia Rating Scale, a neurologic evaluation, and neuropsychological testing to assess 4 cognitive domains: memory, executive function, language, and visuospatial skills. Information for each participant was reviewed by an adjudication panel and a diagnosis of normal cognition, MCI, or dementia was made using published criteria.
Among 1,969 subjects without dementia, 329 subjects had MCI, with a prevalence of 16.0% (95% confidence interval [CI] 14.4-17.5) for any MCI, 11.1% (95% CI 9.8-12.3) for amnestic MCI, and 4.9% (95% CI 4.0-5.8) for nonamnestic MCI. The prevalence of MCI increased with age and was higher in men. The prevalence odds ratio (OR) in men was 1.54 (95% CI 1.21-1.96; adjusted for age, education, and nonparticipation). The prevalence was also higher in subjects who never married and in subjects with an APOE epsilon3epsilon4 or epsilon4epsilon4 genotype. MCI prevalence decreased with increasing number of years of education (p for linear trend <0.0001).
Our study suggests that approximately 16% of elderly subjects free of dementia are affected by MCI, and amnestic MCI is the most common type. The higher prevalence of MCI in men may suggest that women transition from normal cognition directly to dementia at a later age but more abruptly.

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Available from: Stephen S Cha, Oct 14, 2014
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    • "In the literature, there are few studies confirming the higher prevalence of MCI in men, although there are exceptions, such as the study of Ganguli, Dodge, Shen, and DeKosky (2004), Petersen et al. (2010) and Roberts et al. (2012). We considered that new studies are necessary in which not only the prevalence of MCI is analysed but also the risk of developing AD as a function of gender. "
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    ABSTRACT: In the field of neuropsychology, it is essential to determine which neuropsychological tests predict Alzheimer's disease (AD) in people with mild cognitive impairment (MCI) and which cut-off points should be used to identify people at greater risk for converting to dementia. The aim of the present study was to analyse the predictive value of the cognitive tests included in a neuropsychological battery for conversion to AD among MCI participants and to analyse the influence of some sociodemographic variables - sex, age, schooling - and others, such as follow-up time and emotional state. A total of 105 participants were assessed with a neuropsychological battery at baseline and during a 3-year follow-up period. For the present study, the data were analysed at baseline. During the follow-up period, 24 participants (22.85%) converted to dementia (2.79 ± 1.14 years) and 81 (77.14%) remained as MCI. The logistic regression analysis determined that the long delay cued recall and the performance time of the Rey figure test were the best predictive tests of conversion to dementia after an MCI diagnosis. Concerning the sociodemographic factors, sex had the highest predictive power. The results reveal the relevance of the neuropsychological data obtained in the first assessment. Specifically, the data obtained in the episodic verbal memory tests and tests that assess visuospatial and executive components may help to identify people with MCI who may develop AD in an interval not longer than 4 years, with the masculine gender being an added risk factor. © 2015 The British Psychological Society.
    Journal of Neuropsychology 03/2015; DOI:10.1111/jnp.12067 · 2.49 Impact Factor
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    • "The neuropsychological battery was constructed as previously described (Roberts et al., 2008, 2012; Petersen et al., 2010). Four cognitive domains were assessed by nine tests: executive function (Trail Making Test: Part B, Wechsler Adult Intelligence Scale-R Digit Symbol); language (Boston Naming Test, category fluency); memory [Wechsler Memory Scale (WMS)-R Logical Memory-II (delayed recall), WMS-R Visual Reproduction-II (delayed recall), Auditory Verbal Learning Test delayed recall]; and visuospatial performance (WAIS-R Picture Completion, WAIS-R Block Design). "
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    ABSTRACT: Our primary objective was to investigate a biomarker driven model for the interrelationships between vascular disease pathology, amyloid pathology, and longitudinal cognitive decline in cognitively normal elderly subjects between 70 and 90 years of age. Our secondary objective was to investigate the beneficial effect of cognitive reserve on these interrelationships. We used brain amyloid-β load measured using Pittsburgh compound B positron emission tomography as a marker for amyloid pathology. White matter hyperintensities and brain infarcts were measured using fluid-attenuated inversion recovery magnetic resonance imaging as a marker for vascular pathology. We studied 393 cognitively normal elderly participants in the population-based Mayo Clinic Study of Aging who had a baseline 3 T fluid-attenuated inversion recovery magnetic resonance imaging assessment, Pittsburgh compound B positron emission tomography scan, baseline cognitive assessment, lifestyle measures, and at least one additional clinical follow-up. We classified subjects as being on the amyloid pathway if they had a global cortical amyloid-β load of ≥1.5 standard uptake value ratio and those on the vascular pathway if they had a brain infarct and/or white matter hyperintensities load ≥1.11% of total intracranial volume (which corresponds to the top 25% of white matter hyperintensities in an independent non-demented sample). We used a global cognitive z-score as a measure of cognition. We found no evidence that the presence or absence of vascular pathology influenced the presence or absence of amyloid pathology and vice versa, suggesting that the two processes seem to be independent. Baseline cognitive performance was lower in older individuals, in males, those with lower education/occupation, and those on the amyloid pathway. The rate of cognitive decline was higher in older individuals (P < 0.001) and those with amyloid (P = 0.0003) or vascular (P = 0.0037) pathologies. In those subjects with both vascular and amyloid pathologies, the effect of both pathologies on cognition was additive and not synergistic. For a 79-year-old subject, the predicted annual rate of global z-score decline was -0.02 if on neither pathway, -0.07 if on the vascular pathway, -0.08 if on the amyloid pathway and -0.13 if on both pathways. The main conclusions of this study were: (i) amyloid and vascular pathologies seem to be at least partly independent processes that both affect longitudinal cognitive trajectories adversely and are major drivers of cognitive decline in the elderly; and (ii) cognitive reserve seems to offset the deleterious effect of both pathologies on the cognitive trajectories. © The Author (2015). Published by Oxford University Press on behalf of the Guarantors of Brain.
    Brain 01/2015; 138(3). DOI:10.1093/brain/awu393 · 9.20 Impact Factor
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    • "Interpreting these results can be difficult given that these factors may act differently at different ages (Schoenmaker & Van Gool, 2004). In previous studies, a gender difference in the prevalence both of dementia (Katz et al., 2012) and of cognitive impairment (Petersen et al., 2010; Ravaglia et al., 2002; Sharp & Gatz, 2011) was found only in the oldest subjects investigated. Due to the rapid technological advances of recent decades, it is possible that members of the youngest and oldest sections of the elderly population, despite having done the same job, had very different working experiences in terms of physical effort and mental engagement – two aspects that can influence the risk of developing dementia and cognitive impairment in old age (Andel et al., 2005, 2007; Bosma et al., 2003; Krö ger et al., 2008; Smyth et al., 2004). "
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    ABSTRACT: The age-specific prevalence rates of dementia vary widely. Studies focusing on specific age groups are needed to provide reliable estimates for healthcare providers and policy makers. We estimated the prevalence of dementia, dementia subtypes and cognitive impairment in "InveCe.Ab" (, NCT01345110), a single-step multidimensional population-based study of 70-74-year olds living in Abbiategrasso (Milan, Italy). We also looked for associations with socio-demographic factors and the presence of the apolipoprotein E-ɛ4 allele. The overall dementia prevalence was 3% (95%CI: 2.1-4.1%) [Alzheimer's disease (AD): 1.2% (95%CI 0.6-1.9%); vascular dementia (VD): 1.4% (95%CI: 0.8-2.2%)]. Being single was found to be a risk factor for vascular dementia; subjects born in southern Italy were shown to be at greater risk both of overall dementia and of vascular dementia. The prevalence of cognitive impairment, with or without subjective cognitive complaints (cognitive impairment, no dementia, CIND) was 7.8% (95%CI: 6.4-9.4%). As regards the CIND subgroups, the prevalence of subjects with subjective cognitive complaints (mild cognitive impairment, MCI) was 5.0% (95%CI 3.9-6.3%), while the prevalence of those without MCI (CIND-other) was 2.8% (95%CI: 1.9-3.8). The males had a higher risk of MCI and CIND-other; the older subjects were more likely to have MCI, and those born in north-eastern Italy to have CIND-other. The prevalence of AD was higher among the apolipoprotein E-ɛ4 carriers. Our data highlight the importance of dementia and cognitive impairment in the transitional period from adulthood to old age, and reveal the presence of different associations with socio-demographic and genetic factors. Copyright © 2014 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.
    Archives of Gerontology and Geriatrics 11/2014; 60(2). DOI:10.1016/j.archger.2014.11.006 · 1.85 Impact Factor
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