Article

Mild cognitive impairment.

McGill Center for Studies in Aging, Douglas Hospital, Montréal, Quebec, Canada.
The Lancet (Impact Factor: 39.21). 05/2006; 367(9518):1262-70. DOI: 10.1016/S0140-6736(06)68542-5
Source: PubMed

ABSTRACT Mild cognitive impairment is a syndrome defined as cognitive decline greater than expected for an individual's age and education level but that does not interfere notably with activities of daily life. Prevalence in population-based epidemiological studies ranges from 3% to 19% in adults older than 65 years. Some people with mild cognitive impairment seem to remain stable or return to normal over time, but more than half progress to dementia within 5 years. Mild cognitive impairment can thus be regarded as a risk state for dementia, and its identification could lead to secondary prevention by controlling risk factors such as systolic hypertension. The amnestic subtype of mild cognitive impairment has a high risk of progression to Alzheimer's disease, and it could constitute a prodromal stage of this disorder. Other definitions and subtypes of mild cognitive impairment need to be studied as potential prodromes of Alzheimer's disease and other types of dementia.

2 Followers
 · 
158 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: Atherosclerotic cardiovascular disease (ASCVD) remains the leading cause of death, especially in older adults. Managing modifiable risk factors (e.g., hyperlipidemia, hypertension) remains the primary approach to prevent ASCVD events and ASCVD-related mortality. Statins are generally considered one of the most effective approaches to reduce ASCVD risk, especially for secondary prevention, yet remain underutilized in older adults. The evidence to support statin therapy in older adults is less robust than in their younger counterparts, especially in individuals aged 75 years and older. Recent lipid guidelines have raised this concern, yet statin therapy is recommended in 'at risk' older adults. Determining which older adults should receive statin therapy for primary prevention of ASCVD is challenging, as the currently available risk estimation tools are of limited use in those aged over 75 years. Furthermore, non-statin therapies have been de-emphasized in recent clinical practice guidelines and remain understudied in the older adult population. This is unfortunate given that older adults are less likely to tolerate moderate- to high-intensity statins. Non-statin therapies could be viable options in this population if more was understood about their ability to lower ASCVD risk and safety profiles. Nevertheless, lipid-lowering agents remain an integral component of the overall strategy to reduce atherogenic burden in older adults. Future research in this area should aim to enroll more older adults in clinical trials, determine the utility of ASCVD risk estimation for primary prevention, and investigate the role of non-statin therapies in this population.
    Drugs & Aging 01/2015; DOI:10.1007/s40266-015-0240-6 · 2.50 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: We compared the sleep quality indices between patients with mild cognitive impairment (MCI) and normal elderly subjects and analyzed the effects of sleep characteristics on cognitive functions. Cases of MCI patients (320 persons, MCI group) and 630 normal elderly with matched age, gender, and level of education (control group) were enrolled in this study. The Pittsburgh Sleep Quality Index (PSQI) was used to assess the sleep characteristics. The Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) were used to assess cognitive function. There were 110 (34.3 %) and 170 (27 %) cases with sleep disorders in the MCI and control groups, respectively (P < 0.01). There was a significant difference of total PQSI scores between the two groups, and the scores of sleep duration (factor III) and habitual sleep efficiency (factor IV) in the MCI group were significantly lower than those in the control group. Total PQSI scores negatively correlated with MoCA scores and MMSE scores. MoCA scores negatively correlated with scores of the sleep latency (factor II), sleep duration (factor III), and habitual sleep efficiency (factor IV), while MMSE scores negatively correlated with scores of factor III and factor IV. The scores of attention and calculation, reading and language understanding, and visuospatial function (MMSE), and also of visuospatial/executive function, attention, and clockdrawing test (MoCA) in MCI patients without sleep disorders were significantly higher than those in MCI patients with such disorders. The incidence of sleep disorders is higher in patients with MCI, compared with normal elderly. Effects of sleep disorders on cognitive functions are mainly reflected in the state of attention and visuospatial/executive function.
    Neurophysiology 02/2014; 46(1):88-94. DOI:10.1007/s11062-014-9410-0 · 0.17 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background: A moderate elevation of plasma total homocysteine (tHcy) is considered a potential risk factor for Alzheimer's disease (AD). Methods: We have investigated the main determinants (age, renal impairment, cobalamin/folate status and the presence of vascular disease) of plasma tHcy in 326 patients with AD, and also in 281 patients with mild cognitive impairment (MCI), since about half of these patients develop AD during the first 5 years. Results: Elevated plasma tHcy in patients with AD could mainly be attributed to cobalamin/folate deficiency or renal impairment. Younger patients (below 75 years) with AD and patients with MCI without cobalamin/folate deficiency or renal impairment showed normal levels of plasma tHcy. Conclusion: Our findings suggest that plasma tHcy is not primarily involved in the pathogenesis of AD but rather a reflection of changes of the main determinants of plasma tHcy in AD patients. Copyright (C) 2012 S. Karger AG, Basel
    Dementia and Geriatric Cognitive Disorders 01/2012; 34(2):121-127. DOI:10.1159/000342612 · 2.81 Impact Factor

Full-text (2 Sources)

Download
146 Downloads
Available from
Jul 25, 2014

Serge Gauthier