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: 3.84). 12/2011; 259(7):1303-11. DOI: 10.1007/s00415-011-6342-0
Source: PubMed

ABSTRACT 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.

1 Follower
  • [Show abstract] [Hide abstract]
    ABSTRACT: To identify some risk factors of MCI among patients with type 2 diabetes(T2DM) and to find if there is any correlation between these factors and the degree of cognitive decline. A total of 155 patients with T2DM referred to the Department of Endocrinology at First Hospital of Qinhuangdao were enrolled. To assess MCI the Montreal Cognitive Assessment (MoCA) scoring system was used. There were 66 patients with MCI and 89 patients without MCI (control). HbAlc, blood lipid, liver and renal functions were measured in all subjects. Compared with the control group, type 2 diabetic patients with MCI had a longer duration of diabetes; higher non-high-density lipoprotein cholesterol (non-HDL-C), triglycerides, total cholesterol, HbA1c, and BMI; and lower high-density lipoprotein cholesterol (HDL-C) (P<0.05). The rates of patients with a history of habitual light-to-moderate alcohol consumption, a high proportion of Mediterranean-type diet, and regular physical activity were lower; and the rate of current smoking was higher in type 2 diabetic patients with MCI than the control group (P<0.05). Among patients with MCI, the results indicated that MoCA score was negatively correlated with non-HDL-C (r=-0.761 P<0.001). Our results suggest that non-HDL-C can act as a readily available method for estimating risk of MCI in Chinese type 2 diabetic patient in routine clinical practice. Good lifestyle likely reduces MCI risk in diabetic patients.
    Journal of diabetes and its complications 07/2013; 27(5). DOI:10.1016/j.jdiacomp.2013.06.001 · 1.93 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To assess the impact of intracranial arterial stenosis on the progression from mild cognitive impairment (MCI) to Alzheimer disease (AD). A total of 423 participants with MCI were included and evaluated with clinical and neuropsychological examinations annually for 4 years. The incidence of dementia due to AD was investigated. CT angiography was used to measure the stenosis of major intracranial arteries in the studied population. A mixed-effects regression model was used to analyze the association between intracranial arterial stenosis and the progression of MCI, which was assessed with the Mini-Mental State Examination and the Activities of Daily Living scale. Cox proportional hazards models were used to identify the association between intracranial arterial stenosis and dementia progression. At the end of the follow-up, 116 participants had progressed to dementia due to AD, while 223 remained in the MCI stage. Participants with moderate or severe intracranial arterial stenosis had a faster decline in cognition and function relative to participants without such stenosis. The presence of moderate or severe intracranial arterial stenosis significantly increased the risk of dementia progression, even after controlling for age, sex, education, vascular risk factors, and silent MRI lesions. Intracranial arterial stenosis increased the risk of developing AD dementia after MCI.
    Neurology 01/2014; 82(10). DOI:10.1212/WNL.0000000000000185 · 8.30 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Is synchronization altered in amnestic mild cognitive impairment (aMCI) and normal cognitive functions subjects in type 2 diabetes mellitus (T2DM)? Resting eye-closed EEG data were recorded in 8 aMCI subjects and 11 age-matched controls in T2DM. Three multivariate synchronization algorithms (S-estimator (S), synchronization index (SI), and global synchronization index (GSI)) were used to measure the synchronization in five ROIs of sLORETA sources for seven bands. Results showed that aMCI group had lower synchronization values than control groups in parietal delta and beta2 bands, temporal delta and beta2 bands, and occipital theta and beta2 bands significantly. Temporal (r = 0.629; P = 0.004) and occipital (r = 0.648; P = 0.003) theta S values were significantly positive correlated with Boston Name Testing. In sum, each of methods reflected that the cortical source synchronization was significantly different between aMCI and control group, and these difference correlated with cognitive functions.
    08/2014; 2014:523216. DOI:10.1155/2014/523216


Available from