Mild Cognitive Impairment: Epidemiology and Dementia Risk in an Elderly Italian Population

Department of Internal Medicine, Cardioangiology, and Hepatology, University Hospital S. Orsola-Malpighi, Bologna, Italy.
Journal of the American Geriatrics Society (Impact Factor: 4.57). 02/2008; 56(1):51-8. DOI: 10.1111/j.1532-5415.2007.01503.x
Source: PubMed


To investigate prevalence and incidence of mild cognitive impairment (MCI) and its risk of progression to dementia in an elderly Italian population.
Population-based cohort aged 65 and older resident in an Italian municipality.
A total of 1,016 subjects underwent baseline evaluation in 1999/2000. In 2003/04, information about cognitive outcome was collected for 745 participants who were free of dementia at baseline.
MCI (classified as with or without impairment of the memory domain), dementia, Alzheimer's dementia (AD), and vascular dementia (VaD) diagnosed according to current international criteria.
Overall prevalence of MCI was 7.7% (95% confidence interval (CI)=6.1-9.7 %) and was greater with older age and poor education. During 4 years of follow-up, 155 incident MCI cases were diagnosed, with an incidence rate of 76.8 (95% CI=66.8-88.4) per 1,000 person-years. Approximately half of prevalent and incident MCI cases had memory impairment. Compared with normal cognition, multivariable-adjusted risk for progression from MCI with memory impairment to dementia was 4.78 (95% CI=2.78-8.07) for any dementia, 5.92 (95% CI=3.20-10.91) for AD, and 1.61 (95% CI=0.37-7.00) for VaD. No association with dementia risk was found for MCI without memory impairment. Approximately one-third of MCI cases with memory impairment did not progress to dementia.
MCI occurs often in this elderly Italian cohort and is associated with greater risk of AD, but only when the impairment involves the memory domain. However, a substantial proportion of MCI cases with memory impairment do not progress to dementia.

Download full-text


Available from: Paola Forti, Oct 02, 2015
1 Follower
111 Reads
  • Source
    • "Age associations were uncertain in older age groups: while a majority of studies (7 out of 11) observed an increase in prevalence with estimates >20% at ages ≥85 years; two MCI studies observed flat or moderately decreasing relationship in old age ([8] ≥85 years & [12] ≥90 years), and two CIND studies observed a convex relationship with lowest prevalence levels in 75–80 years old and a rapid increase afterwards [10] [13]). Regarding aMCI, the three studies gave conflicting results: one flat, one positive and one negative relationship with age [10] [11] [14]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Abstract: The prevalence of mild cognitive impairment (MCI) and dementia according to age remain uncertain. We systematically extracted age-stratified estimates of MCI and dementia prevalence reported in European studies since 1995, and performed meta-analyses for dementia. We identified 10 relevant studies on MCI and 26 studies on dementia. Studies on MCI presented visually substantial heterogeneity preventing a meta-analysis, a majority reporting an increase in prevalence at ≥75 years old. Prevalence of dementia rose continuously from 55 years of age, reaching 44.7% (39.8; 49.6) in those ≥95 years of age. Homogenization of MCI criteria, and additional studies in Northern European population would be warranted.
    Journal of Alzheimer's disease: JAD 01/2015; 48(2). · 4.15 Impact Factor
  • Source
    • "The prevalence of cognitive impairment, either CIND or MCI, reported in epidemiological studies varies considerably: in one systematic review, the prevalence of MCI ranged between 3% and 42% while that of CIND ranged between 5.1% and 35.9% (Ward et al., 2012). In Italian studies the prevalence of MCI in the over sixties ranged between 3.2% and 7.7%, and in 70–74-year-olds between 0% and 5.6% (Ravaglia et al., 2008; Solfrizzi et al., 2004); CIND had a prevalence of between 5.1% and 9.5% (De Ronchi et al., 2005; Di Carlo et al., 2007), with a rate of 4.2% recorded in 70–74- year olds (Di Carlo et al., 2007). This heterogeneity in prevalence estimates is probably due to the use of different diagnostic tools and criteria, both for dementia and for cognitive impairment, different study designs and small sample sizes. "
    [Show abstract] [Hide abstract]
    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
  • Source
    • "Identifying measures that can be used to predict which aMCI patients are most similar to AD is crucial because between 4 and 15% of aMCI patients annually progress to AD (Solfrizzi et al., 2004; Tschanz et al., 2006; Ravaglia et al., 2008). We speculate that similar brain changes as those occurring in AD may be influencing saccade behavior in aMCI patients, providing the potential for simple and affordable objective measures to assess executive control deficits in aMCI patients, and concurrently with other diagnostic tests, predict a future AD diagnosis. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Alzheimer's disease (AD) is a disorder of progressive memory loss and executive dysfunction. Little is known about the progression from amnestic mild cognitive impairment (aMCI; isolated memory loss) to AD. Studies have found impairments in mild-stage AD and aMCI in specific tests of executive function. Here, we used objective saccade tasks to determine if they can effectively assess executive function deficits otherwise assessed by neuropsychological testing. To determine which executive function deficits the saccade tasks are most sensitive to, we also investigated the relationship between performance on saccade tasks and neuropsychological test scores. Twenty-two aMCI patients (63-90years), 24 mild AD patients (61-87years) and 76 healthy controls (60-85years) performed a battery of neuropsychological tests, and two saccade tasks designed to probe sensory, motor and cognitive function. The prosaccade task requires a fast, automatic saccade toward an eccentric visual stimulus. The antisaccade task requires additional executive processing to inhibit the automatic prosaccade toward the stimulus, so that a voluntary saccade can be initiated to a location opposite the stimulus. Antisaccade performance was impaired similarly in aMCI and AD patients relative to controls; both groups were slower to initiate correct antisaccades and they made more direction errors (erroneous prosaccades), suggesting similar brain deficits. Scores on the Stroop task were inversely correlated with the percentage of short-latency direction errors in the antisaccade task for controls and aMCI patients, whereas other more global measures of executive function were not related to saccade measures in any subject group. Our results show that the antisaccade task is useful for detecting executive dysfunction in aMCI and AD, especially dysfunction in selective attention. Saccade tasks may therefore have potential to assess executive dysfunction when use of neuropsychological tests is not possible.
    European Journal of Neuroscience 06/2014; 39(11). DOI:10.1111/ejn.12617 · 3.18 Impact Factor
Show more