Article

Prevalence of mild cognitive impairment is higher in men: The Mayo Clinic Study of Aging

Department of Neurology, College of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Neurology (Impact Factor: 8.29). 09/2010; 75(10):889-97. DOI: 10.1212/WNL.0b013e3181f11d85
Source: PubMed

ABSTRACT

We investigated the prevalence of mild cognitive impairment (MCI) in Olmsted County, MN, using in-person evaluations and published criteria.
We evaluated an age- and sex-stratified random sample of Olmsted County residents who were 70-89 years old on October 1, 2004, using the Clinical Dementia Rating Scale, a neurologic evaluation, and neuropsychological testing to assess 4 cognitive domains: memory, executive function, language, and visuospatial skills. Information for each participant was reviewed by an adjudication panel and a diagnosis of normal cognition, MCI, or dementia was made using published criteria.
Among 1,969 subjects without dementia, 329 subjects had MCI, with a prevalence of 16.0% (95% confidence interval [CI] 14.4-17.5) for any MCI, 11.1% (95% CI 9.8-12.3) for amnestic MCI, and 4.9% (95% CI 4.0-5.8) for nonamnestic MCI. The prevalence of MCI increased with age and was higher in men. The prevalence odds ratio (OR) in men was 1.54 (95% CI 1.21-1.96; adjusted for age, education, and nonparticipation). The prevalence was also higher in subjects who never married and in subjects with an APOE epsilon3epsilon4 or epsilon4epsilon4 genotype. MCI prevalence decreased with increasing number of years of education (p for linear trend <0.0001).
Our study suggests that approximately 16% of elderly subjects free of dementia are affected by MCI, and amnestic MCI is the most common type. The higher prevalence of MCI in men may suggest that women transition from normal cognition directly to dementia at a later age but more abruptly.

Download full-text

Full-text

Available from: Stephen S Cha, Oct 14, 2014
    • "The concept of MCI has evolved over the past decade. The prevalence of MCI differs depending on clinical setting and inclusion criteria, but generally ranges between 11% and 20% (Petersen et al., 2010). MCI has been proposed as a transitional state between normal aging and dementia with considerable heterogeneity in etiology, clinical presentation, and prognosis and outcome. "
    [Show abstract] [Hide abstract]
    ABSTRACT: The objective of this meta-analysis was to improve understanding of the heterogeneity in the relationship between cognition and functional status in individuals with mild cognitive impairment (MCI). Demographic, clinical, and methodological moderators were examined. Cognition explained an average of 23% of the variance in functional outcomes. Executive function measures explained the largest amount of variance (37%), whereas global cognitive status and processing speed measures explained the least (20%). Short- and long-delayed memory measures accounted for more variance (35% and 31%) than immediate memory measures (18%), and the relationship between cognition and functional outcomes was stronger when assessed with informant-report (28%) compared with self-report (21%). Demographics, sample characteristics, and type of everyday functioning measures (i.e., questionnaire, performance-based) explained relatively little variance compared with cognition. Executive functioning, particularly measured by Trails B, was a strong predictor of everyday functioning in individuals with MCI. A large proportion of variance remained unexplained by cognition.
    No preview · Article · Jan 2016 · Archives of Clinical Neuropsychology
  • Source
    • "Data from the evaluation were reviewed for a diagnosis of MCI defined as: (i) cognitive concern; (ii) impairment in one or more cognitive domains; (iii) essentially normal functional activities; and (iv) absence of dementia (Petersen, 2004; Roberts et al., 2008; Petersen et al., 2009, 2010), taking into account level of education and longest held occupation. A diagnosis of dementia was based on DSM IV criteria (American Psychiatric Association, 2000; Petersen, 2004; Roberts et al., 2008; Petersen et al., 2009, 2010); diagnosis of normal cognition was made in persons who performed in the normal cognitive range and did not meet criteria for MCI or dementia (Roberts et al., 2008; Petersen et al., 2010). "
    [Show abstract] [Hide abstract]
    ABSTRACT: We conducted a preliminary case-control investigation of the association of pancreatic polypeptide (PP) with mild cognitive impairment (MCI) in 202 MCI cases (mean age, 81.6 years) and 202 age- and sex-matched cognitively normal controls in the Mayo Clinic Study of Aging. Plasma PP was measured and examined as the natural logarithm (continuous) and dichotomized at the median. The OR (95% CI) of MCI increased with increasing PP [1.46 (1.04-2.05)]. There was a negative interaction of PP with apolipoprotein E (APOE) ε4 allele; compared to the reference group (no APOE ε4 allele and low PP), the OR (95% CI) for combinations of ε4 and PP were: 2.64 (1.39-5.04) for APOE ε4 plus low PP; 2.09 (1.27-3.45) for no APOE ε4 plus high PP; and 1.91 (1.04-3.53) for no APOE ε4 plus high PP (P for interaction = 0.017). There was also a trend toward a negative interaction with type 2 diabetes (P for interaction = 0.058). Compared to no diabetes and low PP, the OR (95% CI) was 3.02 (1.22-7.46) for low PP plus diabetes but 1.80 (1.01-3.22) for high PP plus diabetes. Participants with high PP had a greater mean (SD) weight loss (kilograms per decade) than persons with low PP [-2.27 (4.07) vs. -1.61 (5.24); P = 0.016]. MCI cases had a non-significantly greater weight loss per decade compared to controls. These findings suggest that high PP alone or jointly with APOE ε4 allele or type 2 diabetes is associated with MCI, and that high PP may mitigate some effects of APOE ε4 allele and type 2 diabetes on cognition. Potential mechanisms may involve PP-related weight loss and centrally mediated effects of PP on cognition. These findings remain to be validated in other studies.
    Full-text · Article · Oct 2015 · Frontiers in Aging Neuroscience
  • Source
    • "Therefore mild cognitive decline in the elderly has come into focus of research because there is increased evidence that clinical symptoms of SCD may be first symptomatic manifestations of Alzheimer's disease (AD). Prevalence rates of 15.4% for amnestic mild cognitive impairment (aMCI) and 25.2% for nonamnestic MCI (naMCI) were found among patients aged 75 years and older [10] [11]. However, MCI diagnosis frequencies are substantially affected by the criteria used for estimation of MCI [12]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: Health related quality of life (HRQOL) is an important issue in the context of dementia care. Objectives: The purpose of this study was to investigate HRQOL in patients with subjective cognitive decline (SCD) and mild cognitive impairment (MCI) and its relation to Activity of Daily Living (ADL). Methods: In this cross sectional study, four experimental groups (each n = 98), controls, SCD, naMCI and aMCI, were compared. For data collection, neuropsychological methods (NTBV) and psychological questionnaires (SF-36 and B-ADL) were used. Multivariate analysis of variance was calculated to detect differences in HRQOL between groups. Correlations between HRQOL and ADL were explored. Results: The dimensions of HRQOL showed mainly consistent differences between the control and the SCD group and MCI subgroups. In almost every dimension of HRQOL, the control group scored higher than subjects with SCD, naMCI, or aMCI. The controls showed low to moderate negative correlations between HQROL and B-ADL in some dimensions of the HRQOL. In the SCD group, low negative correlations with ADL were observed in some HRQOL scales. Low to moderate correlations were found between each scale of the SF-36 and the B-ADL in both MCI subtypes. We found gender differences in HRQOL. Conclusion: In conclusion, we could demonstrate that patients with SCD report reduced quality of life. This knowledge is important to get a better understanding of the individuals with SCD and may pave the way for the development of early intervention.
    Full-text · Article · Sep 2015 · Journal of Alzheimer's disease: JAD
Show more