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Vol. 21, No. 1, 2006
Issue release date: December 2005
Dement Geriatr Cogn Disord 2006;21:51–58

Conversion of Mild Cognitive Impairment to Dementia: Predictive Role of Mild Cognitive Impairment Subtypes and Vascular Risk Factors

Ravaglia G. · Forti P. · Maioli F. · Martelli M. · Servadei L. · Brunetti N. · Pantieri G. · Mariani E.
aDepartment of Internal Medicine, Cardioangiology and Hepatology, University Hospital S. Orsola-Malpighi, bLaboratory of Immunology and Genetics, Codivilla Putti Research Institute, Rizzoli Orthopedic Institute, Bologna, Italy

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Mild cognitive impairment (MCI) is regarded as a precursor to dementia, but not all patients with MCI develop dementia. We followed up 165 elderly outpatients with MCI for a mean of 3 years. The aims were (1) to investigate the risk of conversion to dementia for different MCI subtypes diagnosed according to standardized criteria (amnestic; impairment of memory plus other cognitive domains; nonamnestic); (2) to assess whether the risk of conversion was affected by several established and emerging vascular risk factors. Forty-eight subjects (29%) converted to dementia, and the risk of conversion was doubled for amnestic MCI with respect to the other subtypes. Independently of MCI subtype, risk of conversion was associated with atrial fibrillation and low serum folate levels. Our results show that current diagnostic criteria for MCI define heterogeneous populations, but some potentially treatable vascular risk factors may be of help in predicting conversion to dementia.

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  1. Petersen RC, Smith GE, Waring SC, Ivnik RJ, Tangalos EG, Kokmen E: Mild cognitive impairment: clinical characterization and outcome. Arch Neurol 1999;56:303–308.
  2. Petersen RC, Doody R, Kurz A, Mohs RC, Morris JC, Rabins PV, Ritchie K, Rossor M, Thal L, Winblad B: Current concepts in mild cognitive impairment. Arch Neurol 2001;58:1985–1992.
  3. Knopman DS, DeKosky ST, Cummings JL, Chui H, Corey-Bloom J, Relkin N, Small GW, Miller B, Stevens JC: Practice parameter: diagnosis of dementia (an evidence-based review). Report of the Quality Standards Subcomittee of the American Academy of Neurology. Neurology 2001;56:1143–1153.
  4. Petersen RC, Stevens JC, Ganguli M, Tangalos EG, Cummings JL, DeKosky ST: Practice parameter: early detection of dementia: mild cognitive impairment (an evidence-based review). Report of the Quality Standards Subcomittee of the American Academy of Neurology. Neurology 2001;56:1133–1142.
  5. Palmer K, Fratiglioni L, Winblad B: What is mild cognitive impairment ? Variations in definitions and evolution of nondemented persons with cognitive impairment. Acta Neurol Scand 2003;179(suppl):14–20.

    External Resources

  6. Winblad B, Palmer K, Kipivelto M, Fratiglioni L, Wahlund LO, Nordberg A, Backman L, Albert M, Almkvist O, Arai H, Basun H, Blennow K, de Leon M, DeCarli C, Erkinjuntti T, Giacobini E, Graff C, Hardy J, Jack C, Jorm A, Ritchie K, van Duijn C, Visser P, Petersen RC: Mild cognitive impairment – beyond controversies, towards a consensus: report of the International Working Group on Mild Cognitive Impairment. J Intern Med 2004;256:240–246.
  7. Petersen RC: Mild cognitive impairment as a diagnostic entity. J Intern Med 2004;256:183–194.
  8. Ganguli M, Dodge HH, Changyu S, DeKosky ST: Mild Cognitive impairment, amnestic type. An epidemiologic study. Neurology 2004;63:115–121.
  9. Gorelick PB: Risk factors for vascular dementia and Alzheimer Disease. Stroke 2004;35:2620–2622.
  10. DeCarli C, Miller BL, Swan GE, Reed T, Wolf PA, Carmelli D: Cerebrovascular and brain morphologic correlates of mild cognitive impairment in the National Heart, Lung, and Blood Institute Twin Study. Arch Neurol 2001;58:643–647.
  11. Lopez OL, Jagust WJ, Dulberg C, Becker JT, DeKosky ST, Fitzpatrick A, Breitner J, Lyketsos C, Jones B, Kawas C, Carlson M, Kuller LH: Risk factors for mild cognitive impairment in the Cardiovascular Health Study Cognition Study Part 2. Arch Neurol 2003;60:1394–1399.
  12. De Carli C, Mungas D, Harvey D, Reed B, Weiner M, Chui H, Jagust W: Memory impairment, but not cerebrovascular disease, predicts progression of MCI to dementia. Neurology 2004;63:220–227.
  13. Solfrizzi V, Panza F, Colacicco AM, D’Introno A, Capurso C, Torres F, Grigoletto F, Maggi S, Del Parigi A, Reiman EM, Caselli RJ, Scafato E, Farchi G, Capurso A: Vascular risk factors, incidence of MCI, and rates of progression to dementia. Neurology 2004;63:1882–1891.
  14. Valente C, Maione P, Lippi A, Taiti P, Cavarzeran F, Rocca WA, Amaducci L, Bevazzano A: Validation of the Mini Mental State Examination (MMSE) as a screening instrument for dementia in an Italian Population. G Gerontol 1992;40:161–165.
  15. Magni E, Binetti G, Bianchetti A, Rozzini R, Trabucchi M: Mini-Mental State Examination: a normative study in an Italian elderly population. Eur J Neurol 1996;3:1–5.
  16. Katz S, Downs TD, Cash HR, Grotz RC: Progress in development of the index of ADL. Gerontologist 1970;10:20–30.
  17. Lawton MP, Brody EM: Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 1969;9:179–185.
  18. Yesavage JA, Brink TL, Rose TL, Lum O, Huang V, Adey M, Leirer VO: Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res 1982;17:37–49.
  19. Morris JC: The Clinical Dementia Rating (CDR): current version and scoring rules. Neurology 1993;43:2412–2414.
  20. Italian Group on the Neuropsychological Study of Ageing: Italian standardization and classification of neuropsychological tests. Ital J Neurol Sci 1987;suppl 8:1–120.
  21. Carlesimo GA, Caltagirone C, Gainotti G: The Mental Deterioration Battery: normative data, diagnostic reliability and qualitative analyses of cognitive impairment. Eur J Neurol 1996;36:378–384.
  22. McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM: Clinical diagnosis of Alzheimer’s disease: report of NINCDS-ADRDA Work group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s disease. Neurology 1984;34:939–944.
  23. Roman GC, Tatemichi TK, Erkinjuntti T, Cummings JL, Masdeu JC, Garcia JH, Amaducci L, Orgogozo JM, Brun A, Hofman A, et al: Vascular dementia: diagnostic criteria for research studies. Report of the NINDS-AIREN International Workshop. Neurology 1993;43:250–260.
  24. Ravaglia G, Forti P, Maioli F, Bianchi G, Sacchetti L, Talerico T, Nativio V, Mariani E, Macini P: Plasma amino acid concentrations in healthy and cognitively impaired oldest-old individuals: associations with anthropometric parameters of body composition and functional disability. Br J Nutr 2002;88:563–572.
  25. Licastro F, Pedrini S, Ferri C, Casadei V, Govoni M, Pession A, Sciacca FL, Veglia F, Annoni G, Bonafè M, Olivieri F, Franceschi C, Grimaldi LM: Gene polymorphism affecting alpha-1-antichymotrypsin and interleukin-1 plasma levels increases Alzheimer’s disease risk. Ann Neurol 2000;48:388–391.
  26. The Homocysteine Studies Collaboration: Homocysteine and risk of ischemic heart disease and stroke. A meta-analysis. JAMA 2002;288:2015–22.
  27. Morris MS: Homocysteine and Alzheimer’s disease. Lancet Neurol 2003;2:425–428.
  28. Hosmer DW, Lemeshow S: Interpretation of a fitted proportional hazards regression model. In: Hosmer DW, Lemeshow S (eds): Applied Survival Analysis. New York, Wiley, 1999, pp 113–157.
  29. Morris JC, Storandt M, Miller JP, McKeel DW, Price JL, Rubin EH, Berg L: Mild cognitive impairment represents early-stage Alzheimer disease. Arch Neurol 2001;58:397–405.
  30. Bozoki A, Giordani B, Heidebrink JL, Berent S, Foster NL: Mild cognitive impairments predict dementia in nondemented elderly patients with memory loss. Arch Neurol 2001;58:411–416.
  31. Rasquin SMC, Lodder J, Visser PJ, Lousberg R, Verhey FRJ: Predictive accuracy of MCI subtypes for Alzheimer’s Disease and Vascular dementia in subjects with mild cognitive impairment: a 2-year follow-up study. Dement Geriatr Cogn Disord 2005;19:113–119.
  32. Polidori MC, Marvardi M, Cherubini A, Senin U, Mecocci P: Heart disease and vascular risk factors in the cognitively impaired elderly: implications for Alzheimer’s dementia. Aging Clin Exp Res 2001;13:231–239.
  33. Sabatini T, Frisoni GB, Barbisoni P, Bellelli G, Rozzini R, Trabucchi M: Atrial fibrillation and cognitive disorders in older people. J Am Geriatr Soc 2000;48:387–390.
  34. Tilvis RS, Kahonen-Vare MH, Jolkkonen J, Valvanne J, Pitkala KH, Strandberg TE: Predictors of cognitive decline and mortality of aged people over a 10-year period. J Gerontol 2004;59:M268–M274.
  35. Verghese J, Lipton RB, Hall CB, Kuslansky G, Katz MJ: Low blood pressure and the risk of dementia in very old individuals. Neurology 2003;61:1667–1672.
  36. Nourhashémi F, Deschamps V, Larrieu S, Letenneur L, Dartigues JF, Barberger-Gateau P: Body mass index and incidence of dementia. The PAQUID study. Neurology 2003;60:117–119.
  37. Wang HX, Wahlin A, Basun H, Fastbom J, Winblad B, Fratiglioni L: Vitamin B12 and folate in relation to the development of Alzheimer’s disease. Neurology 2001;56:1188–1194.
  38. Maxwell CJ, Hogan DB, Ebly EM: Serum folate levels and subsequent adverse cerebrovascular outcomes in elderly persons. Dement Geriatr Cogn Disord 2002;13:225–234.
  39. Petersen RC, Smith GE, Ivnik RJ, Tangalos EG, Schaid DJ, Thibodeau SN, Kokmen E, Waring SC, Kurland LT: Apolipoprotein E status as a predictor of the development of Alzheimer’s disease in memory-impaired individuals. JAMA 1995;273:1274–1278.

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