Clinical predictors of cognitive decline in patients with mild cognitive impairment: The Chongqing aging study

Department of Neurology, Third Military Medical University, Daping, Chongqing, China.
Journal of Neurology (Impact Factor: 3.38). 12/2011; 259(7):1303-11. DOI: 10.1007/s00415-011-6342-0
Source: PubMed


Mild cognitive impairment (MCI) is considered as the early stage of dementia which currently has no effective treatments. Reducing progression of cognitive decline at the MCI stage could be an important strategy for preventing conversion to dementia. The goal of this work was to screen for clinical predictors indicating the prognosis of MCI comprehensively; therefore, we assumed vascular risk factors (VRFs), carotid stenosis, and white matter changes (WMC) to be independent predictors. A total of 257 patients with MCI underwent collection of VRF information, neuropsychological evaluation, computed tomography angiography (CTA) to investigate carotid stenosis, and magnetic resonance imaging (MRI) to identify severity of WMC. After a 3-year follow-up period, the neuropsychological evaluation, CTA, and MRI were repeated to assess the progression of cognitive decline, carotid stenosis, and WMC. The conversion rate from MCI to dementia was 11.65% per year, and the conversion rate from MCI to Alzheimer's disease was 7.05% per year in our cohort. Cognitive decline (in terms of changes in Mini Mental State Examination scores) was associated with diabetes mellitus (p = 0.004), baseline WMC severity (p < 0.001), baseline carotid stenosis (p < 0.001), and WMC severity change (p < 0.001). Besides, diabetes, baseline WMC severity, baseline moderate-to-severe carotid stenosis, and carotid stenosis change during follow-up were predictors of conversion from MCI to dementia. Given the potential clinical predictors, our findings could imply that controlling blood glucose, removing carotid stenosis, and improving cerebral perfusion could be effective measures to delay cognitive decline in patients with MCI and prevent conversion from MCI to dementia.

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Available from: Xu Yi, Nov 07, 2015
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    • "Mild cognitive impairment (MCI) is characterized as an early but measurable stage of cognitive impairment [8] [9]. MCI is predictive of progression to dementia and the conversion rate from MCI to dementia was 11.65% per year [10]. One study suggests that individuals with diabetes are 1.5 times more likely to experience cognitive decline and have 1.6 times greater risk of future dementia than individuals without diabetes [11]. "
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