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Estimation of the risk of conversion of mild cognitive impairment of Alzheimer type to Alzheimer's disease in a south Brazilian population-based elderly cohort: the PALA study

Published online by Cambridge University Press:  17 November 2011

Cláudia Godinho ,
Ana Luiza Camozzato ,
Diego Onyszko  and
Márcia Lorena Chaves
Cláudia Godinho
Affiliation:
Dementia Clinic, Neurology Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil UFRGS School of Medicine, Porto Alegre, Brazil
Ana Luiza Camozzato
Affiliation:
Dementia Clinic, Neurology Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
Diego Onyszko
Affiliation:
Dementia Clinic, Neurology Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
Márcia Lorena Chaves*
Affiliation:
Dementia Clinic, Neurology Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil UFRGS School of Medicine, Porto Alegre, Brazil Internal Medicine Department, UFRGS School of Medicine, Porto Alegre, Brazil
*
Correspondence should be addressed to: Márcia L. F. Chaves, Rua Ramiro Barcelos, 2350/ sala 2040, 90035-091, Porto Alegre, RS, Brasil. Phone: +55 51 2101.8520; Fax: +55 51 2101.8001. Email: [email protected].
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Abstract

Background: Higher mild cognitive impairment (MCI) prognostic variability has been related to sample characteristics (community-based or specialized clinic) and to diverse operationalization criteria. The aim of the study was to evaluate the trajectory of MCI of Alzheimer type in a population-based elderly cohort in Southern Brazil. We also estimated the risk for the development of probable Alzheimer's disease (AD) in comparison with healthy subjects.

Methods: Data were derived from a population-based cohort (the PALA study). MCI outcomes were sub-classified into three categories: conversion, stabilization, and reconversion. The risk of progression to dementia was compared between MCI and normal participants. The analysis was based on 21 MCI subjects and 220 cognitively intact participants (N = 241).

Results: Of the 21 MCI subjects, 38% developed dementia, 24% remained stable and 38% improved. The MCI annual conversion rate to AD was 8.5%. MCI was associated with significantly higher risk of conversion to AD (HR = 49.83, p = 0.004), after adjustment for age, education, sex and Mini-Mental State Examination score.

Conclusions: Independent of the heterogeneity of the outcomes, MCI of the Alzheimer type participants showed significantly higher risk of developing probable AD, demonstrating the impact of the use of these MCI criteria that emphasize long-term episodic memory impairment.

Keywords

mild cognitive impairmentmild cognitive impairment of Alzheimer typeconversion rateprodromal ADAlzheimer's disease
Type
Research Article
Information
International Psychogeriatrics , Volume 24 , Issue 4 , April 2012 , pp. 674 - 681
Copyright
Copyright © International Psychogeriatric Association 2011

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References

Artero, S. et al. (2008). Risk profiles for mild cognitive impairment and progression to dementia are gender specific. Journal of Neurology, Neurosurgery and Psychiatry, 79, 979–984.CrossRefGoogle ScholarPubMed
Bozoki, A., Giordani, B., Heidebrink, J. L., Berent, S. and Foster, N. L. (2001). Mild cognitive impairments predict dementia in non demented elderly patients with memory loss. Archives of Neurology, 58, 411–416.CrossRefGoogle Scholar
Bruscoli, M. and Lovestone, S. (2004). Is MCI really just early dementia? A systematic review of conversion studies. International Psychogeriatrics, 16, 129–140.CrossRefGoogle ScholarPubMed
Chaves, M. L., Camozzato, A. L., Godinho, C., Piazenski, I. and Kaye, J. (2009a). Incidence of mild cognitive impairment and Alzheimer disease in southern Brazil. Journal of Geriatric Psychiatry and Neurology, 22, 181–187.CrossRefGoogle ScholarPubMed
Chaves, M. L., Camozzato, A. L., Eizirik, C. L and Kaye, J. (2009b). Predictors of normal and successful aging among urban-dwelling elderly Brazilians. Journal of Gerontology: Psychological Sciences, 64B, 597–602.CrossRefGoogle Scholar
Das, S. K. et al. (2007). An epidemiologic study of mild cognitive impairment in Kolkata, Índia. Neurology, 68, 2019–2026.CrossRefGoogle ScholarPubMed
Devanand, D. P. et al. (2007). Hippocampal and entorhinal atrophy in mild cognitive impairment prediction of Alzheimer disease. Neurology, 68, 828–836.CrossRefGoogle ScholarPubMed
Dickerson, B. C. et al. (2007). Clinical prediction of Alzheimer disease dementia across the spectrum of mild cognitive impairment. Archives of General Psychiatry, 64, 1443–1450.CrossRefGoogle ScholarPubMed
Dubois, B. and Albert, M. L. (2004). Amnestic MCI or prodromal Alzheimer's disease? Lancet Neurology, 3, 246–248.CrossRefGoogle ScholarPubMed
Dubois, B. et al. (2007). Research criteria for the diagnosis of Alzheimer's disease: revising the NINCDS–ADRDA criteria. Lancet Neurology, 6, 734–746.CrossRefGoogle ScholarPubMed
Ferri, C. P. et al. (2005). Alzheimer's Disease International global prevalence of dementia: a Delphi consensus study. Lancet, 366, 2112–2117.CrossRefGoogle ScholarPubMed
Galvin, J., Roe, C., Xiong, C. and Morris, J. C. (2006). Validity and reliability of the AD8 informant interview in dementia. Neurology, 67, 1942–1948.CrossRefGoogle ScholarPubMed
Ganguli, M. et al. (2011). Outcomes of mild cognitive impairment by definition. a population study. Archives of Neurology, 68, 761–767.CrossRefGoogle ScholarPubMed
Hansson, O., Zetterberg, H., Buchhave, P., Londos, E., Blennow, K. and Minthon, L. (2006). Association between CSF biomarkers and incipient Alzheimer's disease in patients with mild cognitive impairment: a follow-up study. Lancet Neurology, 5, 228–234.CrossRefGoogle ScholarPubMed
Huang, J. et al. (2005). Progression of Mild Cognitive Impairment to Alzheimer's or vascular dementia versus normative aging among elderly Chinese. Current Alzheimer Research, 2, 571–578.CrossRefGoogle ScholarPubMed
Ishikawa, T., Ikeda, M., Matsumoto, N., Shigenobu, K., Brayne, C. and Hirotaka, T. H. (2006). A longitudinal study regarding conversion from mild memory impairment to dementia in a Japanese community. International Journal of Geriatric Psychiatry, 21, 134–139.CrossRefGoogle Scholar
Jack, C. R. et al. (2004). Comparison of different MRI brain atrophy rate measures with clinical disease progression in AD. Neurology, 62, 591–600.CrossRefGoogle ScholarPubMed
Kukull, W. A. et al. (2002). Dementia and Alzheimer disease incidence. Archives of Neurology, 59, 1737–1746.CrossRefGoogle ScholarPubMed
Larrieu, S. et al. (2002). Incidence and outcome of mild cognitive impairment in a population-based prospective cohort. Neurology, 59, 1594–1595.CrossRefGoogle Scholar
Manly, J. J., Tang, M. X., Schupf, N., Stern, Y., Vonsattel, J. P. and Mayeux, R. (2008). Frequency and course of mild cognitive impairment in a multi-ethnic community. Annals of Neurology, 63, 494–506.CrossRefGoogle Scholar
Matthews, F. E. et al. (2008). Medical Research Council Cognitive Function and Ageing Study. Two-year progression from mild cognitive impairment to dementia: to what extent do different definitions agree? Journal of the American Geriatrics Society, 56, 1424–1433.CrossRefGoogle ScholarPubMed
Mitchell, A. J. and Shiri-Feshki, M. (2009). Rate of progression of mild cognitive impairment to dementia: meta-analysis of 41 robust inception cohort studies. Acta Psychiatrica Scandinavica, 119, 256–265.CrossRefGoogle ScholarPubMed
Palmer, K., Wang, H-X., Backman, L., Winblad, B. and Fratiglioni, L. (2002). Differential evolution in non demented older persons: results from the Kungsholmen Project. American Journal of Psychiatry, 159, 436–442.CrossRefGoogle Scholar
Palmer, K., Backman, L., Winblad, B. and Fratiglioni, L. (2008). Mild cognitive impairment in the general population: occurrence and progression to Alzheimer disease. American Journal of Geriatric Psychiatry, 16, 603–611.CrossRefGoogle ScholarPubMed
Petersen, R., Smith, G., Waring, S., Ivnik, R., Kokmen, E. and Tangelos, E. (1997). Aging, memory, and mild cognitive impairment. International Psychogeriatrics, 9, 65–69.CrossRefGoogle ScholarPubMed
Petersen, R. C. et al. (2001). Current concepts in mild cognitive impairment. Archives of Neurology, 58, 1985–1992.CrossRefGoogle ScholarPubMed
Sarazin, M. et al. (2007). Amnestic syndrome of the medial temporal type identifies prodromal AD: a longitudinal study. Neurology, 69, 1859–1867.CrossRefGoogle ScholarPubMed
Schmidtke, K. and Hermeneit, S. (2008). High rate of conversion to Alzheimer's disease in a cohort of amnestic MCI patients. International Psychogeriatrics, 20, 96–108.CrossRefGoogle Scholar
Solfrizzi, V., Panza, F. and Colacicco, A. M. (2004). Vascular risk factors, incidence of MCI, and rates of progression to dementia. Neurology, 63, 1882–1891.CrossRefGoogle ScholarPubMed
Winblad, B. et al. (2004). Mild cognitive impairment beyond controversies, towards a consensus: report of the International Working Group on Mild Cognitive Impairment. Journal of Internal Medicine, 256, 240–246.CrossRefGoogle Scholar
Wolf, H. et al. (1998). The prognosis of mild cognitive impairment in the elderly. Journal of Neural Transmission Supplement, 54, 31–50.CrossRefGoogle ScholarPubMed