Incidence of dementia in oldest-old with amnestic MCI and other cognitive impairments

Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, USA.
Neurology (Impact Factor: 8.29). 11/2011; 77(21):1906-12. DOI: 10.1212/WNL.0b013e318238ee89
Source: PubMed


To examine the incidence of dementia among the oldest-old people with normal cognition and different types of cognitive impairment.
This study included 395 participants without dementia (mean age 93.3 years) from The 90+ Study, a prospective, population-based study of aging and dementia in people aged 90 years and older. The participants had evaluations for dementia every 6 months, and their average follow-up was 2.5 years. We examined the incidence of all-cause dementia in participants stratified into 4 cognitive groups: normal, amnestic mild cognitive impairment (aMCI), nonamnestic mild cognitive impairment (naMCI), and other cognitive impairment (OCI).
Dementia incidence was highest for participants with aMCI (31.4% per year) and OCI (39.9% per year). Participants with naMCI had an incidence of 14.1% per year, and participants with normal cognition had an incidence of 8.4% per year. Dementia incidence was associated with increasing age in both normal and cognitively impaired participants; however, an APOE4 allele was associated with a higher dementia incidence only in participants with baseline cognitive impairment.
The risk of developing dementia in the oldest-old is high and increases to higher rates when cognitive impairment is present. Similar to results of studies in younger elderly individuals, cognitive impairment and increasing age were related to increased dementia incidence. High dementia incidence rates in the oldest-old individuals, particularly when cognitively impaired, emphasize the need to further study cognitive impairment and dementia in this rapidly expanding age group.

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Available from: María M Corrada, Jun 20, 2014
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    • "La prévalence de la démence en général après 65 ans est estimée aux alentours de 6 à 8 %, et de 4,4 % pour la MA [3] [4]. L'incidence annuelle reste inférieure à 1 % entre 65 et 79 ans, mais double tous les cinq ans pour atteindre 13 % entre 90 et 94 ans et 21 % entre 95 et 99 ans [5]. Sur le plan mondial, 34 millions de personnes sont atteints actuellement d'une pathologie démentielle, chiffre qui pourrait s'élever jusqu'à 106,8 millions en 2050 selon les projections les plus récentes [6] [7]. "
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    ABSTRACT: Le fardeau personnel mais également social et économique lié aux démences est extrêmement important. C’est pourquoi l’élaboration de stratégies de prévention et de traitement est primordiale. Plusieurs recherches sont en cours, mais les traitements pharmacologiques actuellement disponibles ont une efficacité modeste, voire nulle en ce qui concerne la prévention de la démence. En revanche, de nombreuses études récentes indiquent que l’exercice physique représente probablement un point clé dans la prévention des troubles cognitifs au grand âge. Cet article est une revue de la littérature sur les effets de l’exercice physique sur le vieillissement cérébral pathologique, ainsi que sur son rôle dans la prévention de la démence au grand âge.
    NPG Neurologie - Psychiatrie - Gériatrie 06/2013; 13(75):172-178. DOI:10.1016/j.npg.2012.11.005
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    • "By the end of the observation period, dementia had developed in 199 of the participants; for the other 1099 participants, death, drop-out, or completion of the study was the end-point for observation and they were classified as non-demented (Ganguli et al., 2000). Given annual dementia incidence rates of 8–40% among the non-demented oldest old (Peltz et al., 2011), and a consensus that Alzheimer's disease pathology may be present for many years before the first symptoms emerge (Albert et al., 2011), the assumption that the 1099 " survivors " in the MoVIES cohort were truly disease-free may be inaccurate. Although not practical for most researchers, future analyses conducted on large longitudinal data sets (like MoVIES or the Framingham cohort) should include analytic methods account for expected incident dementia rates. "
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    ABSTRACT: Characterizing the cognitive declines associated with aging, and differentiating them from the effects of disease in older adults, are important goals for human neuroscience researchers. This is also an issue of public health urgency in countries with rapidly aging populations. Progress toward understanding cognitive aging is complicated by numerous factors. Researchers interested in cognitive changes in healthy older adults need to consider these complexities when they design and interpret studies. This paper addresses important factors in study design, patient demographics, co-morbid and incipient medical conditions, and assessment instruments that will allow researchers to optimize the characterization of healthy participants and produce meaningful and generalizable research outcomes from studies of cognitive aging. Application of knowledge from well-designed studies should be useful in clinical settings to facilitate the earliest possible recognition of disease and guide appropriate interventions to best meet the needs of the affected individual and public health priorities.
    Frontiers in Aging Neuroscience 09/2012; 4:23. DOI:10.3389/fnagi.2012.00023 · 4.00 Impact Factor
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