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The Changing Face of Mild Cognitive Impairment (MCI) and Mild Dementia

Lookup NU author(s): Dr Connor Richardson, Dr Blossom Stephan, Louise Robinson, Professor Carol Brayne, Professor Fiona Matthews

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Abstract

Background:Much work on identifying individuals at high risk of dementia has focused on the clinical concept of MCI, which attempts to capture an intermediate state between normal cognitive ageing and dementia from which progression can be predicted. However this emerging concept, regardless of specific name and definition, remains controversial. Multiple definitions for this state have been developed and tested. Two key ones, commonly used internationally, are amnestic-MCI and Cognitive Impairment no Dementia (CIND). The analysis presented here aims to provide contemporary MCI prevalence for the UK, and also test for changes in MCI and mild dementia prevalence over two decades using identical approaches to diagnosis in the Cognitive Function and Ageing Studies (CFAS I & II). Methods: MRC CFAS undertook baseline interviews in populations aged 65+ years from five identical centres in England andWales (1989–1994). Two decades later three of the original centres (CFAS I) were selected for new sampling (2008–2011) with the same geographical boundaries and approach methods (CFAS II). A comprehehensive cognitive spectrum was mapped in both cohorts, including those most popular within clinical communities. These included amnestic MCI (a-MCI), non-amnestic MCI (na-MCI), multi-domain MCI (m-MCI), CIND and mild dementia, amongst others. In cross sectional analysis, logistic regression models were used to obtain predicted probabilities of MCI which were then standardised to the UK population in the corresponding cohort year. Results: In cross sectional analysis, logistic regression models were used to obtain predicted probabilities of MCI. This study found a decline in prevalence of MCI for most definitions between 1991 and 2011 (mild dementia (1.9%) Severe Cognitive Impairment (SCI) (2.9%)), although a small proportion remained stable (MCI with impairment in activities of daily living) or increased (CIND (1%) & amnestic-MCI (2.2%)). Conclusions: Although previous studies have shown a decrease in dementia prevalence, this study provides evidence of a shift in the cognitive burden on the population, increasing prevalence of MCI outlines the growing burden of cognitive decline on an ageing population.


Publication metadata

Author(s): Richardson C, Stephan B, Robinson L, Brayne C, Matthews F

Publication type: Conference Proceedings (inc. Abstract)

Publication status: Published

Conference Name: Alzheimer's Association International Conference 2017

Year of Conference: 2017

Pages: P544-P545

Print publication date: 01/07/2017

Acceptance date: 01/07/2017

Publisher: Alzheimer's & Dementia: The Journal of the Alzheimer's Association

URL: http://www.alzheimersanddementia.com/article/S1552-5260(17)33050-9/pdf


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