What is mild cognitive impairment? Variations in definitions and evolution of nondemented persons with cognitive impairment
Katie Palmer
Aging Research Center, Division of Geriatric Epidemiology, Neurotec, Karolinska Institutet and Stockholm Gerontology Research Center, Stockholm, Sweden
Search for more papers by this authorLaura Fratiglioni
Aging Research Center, Division of Geriatric Epidemiology, Neurotec, Karolinska Institutet and Stockholm Gerontology Research Center, Stockholm, Sweden
Search for more papers by this authorBengt Winblad
Aging Research Center, Division of Geriatric Epidemiology, Neurotec, Karolinska Institutet and Stockholm Gerontology Research Center, Stockholm, Sweden
Search for more papers by this authorKatie Palmer
Aging Research Center, Division of Geriatric Epidemiology, Neurotec, Karolinska Institutet and Stockholm Gerontology Research Center, Stockholm, Sweden
Search for more papers by this authorLaura Fratiglioni
Aging Research Center, Division of Geriatric Epidemiology, Neurotec, Karolinska Institutet and Stockholm Gerontology Research Center, Stockholm, Sweden
Search for more papers by this authorBengt Winblad
Aging Research Center, Division of Geriatric Epidemiology, Neurotec, Karolinska Institutet and Stockholm Gerontology Research Center, Stockholm, Sweden
Search for more papers by this authorAbstract
Numerous studies have endeavoured to explore the nature of cognitive impairment in nondemented elderly persons. Comparison of this literature is hampered by huge variations in criteria and methodology. Despite these limitations, there are repeated reports that nondemented persons with cognitive impairment have a higher chance of progressing to dementia. Evidence also indicates higher mortality in cognitively impaired persons but there is also a chance of improvement in cognition over time. The current paper provides an overview of the various concepts and criteria proposed for cognitive impairment in nondemented persons, discusses some of the problems with current research in this field, and presents some of the findings concerning the evolution of cognitive impairment in relation to dementia, mortality and cognitive improvement.
References
- 1 Shah Y, Tangalos EG, Petersen RC. Mild cognitive impairment: when is it a precursor to Alzheimer's Disease? Geriatrics 2000; 55: 62–8.
- 2 Petersen RC, Smith GE, Waring SC, Ivnik RJ, Tangalos EG, Kokmen E. Mild cognitive impairment: clinical characterization and outcome. Arch Neurol 1999; 56: 303–8.
- 3 Crook T, Bartus RT, Ferris SH, Whitehouse P, Cohen GD, Gershon S. Age aAssociated memory impairment: proposed diagnostic criteria and measures of clinical change: report of a National Institute of Mental Health Work Group. Dev Neuropsychol 1986; 2: 261–76.
- 4 Levy R, on behalf of the Ageing-Associated Cognitive Decline Working Party. Ageing-associated cognitive decline. Int Psychogeriatric 1994; 6: 63–8.
- 5 Ritchie K, Ledesert B, Touchon J. Subclinical cognitive impairment: epidemiology and clinical characteristics. Compr Psychiatr 2000; 41: 61–5.
- 6 Ebly EM, Hogan DB, Parhad IM. Cognitive impairment in the non-demented elderly: results from the Canadian study on health and aging. Arch Neurol 1995; 52: 612–9.
- 7 Graham JE, Rockwood K, Beattie BL et al. Prevalence and severity of cognitive impairment with and without dementia in an elderly population. Lancet 1997; 349: 1793– 6.
- 8 Johansson B, Zarit SH. Early cognitive markers of the incidence of dementia and mortality: a longitudinal study of the oldest old. Int J Geriatr Psychiatry 1997; 12: 53–9.
- 9 Devanand DP, Folz M, Gorlyn M, Moeller JR, Stern Y. Questionable dementia: clinical course and predictors of outcome. JAGS 1997; 45: 321–8.
- 10 Daly E, Zaitchik D, Copeland M, Schmahmann J, Gunther J, Albert M. Predicting conversion to Alzheimer disease using standardized clinical information. Arch Neurol 2000; 57: 675–80.
- 11 Petersen RC, Doody R, Kurz A et al. Current concepts in mild cognitive impairment. Arch Neurol 2001; 58: 1985–92.
- 12
Johanson B,
Zarit SH,
Berg S.
Changes in cognitive functioning of the oldest old.
J Gerontol Psychol Sci
1992; 42: 75–80.
10.1093/geronj/47.2.P75 Google Scholar
- 13 Palmer K. Wang H-X, Bäckman L, Winblad B, Fratiglioni L. Differential evolution in non demented older persons: Results from the Kungsholmen Project. Am J Psychiatry 2002; 159: 436–42.
- 14 Folstein M, Folstein S, McHugh P. ‘Mini-mental state.’ A practical method for grading the cognitive state of patients for the clinician. J Psychiat Res 1975; 12: 189–98.
- 15 Morris J. The Clinical Dementia Rating (CDR): current, version and scoring rules. Neurology 1993 43: 2412–4.
- 16 Ritchie K, Touchon J. Mild cognitive impairment: conceptual basis and current nosological status. Lancet 2000; 355: 225–8.
- 17 Ritchie K, Artero S, Touchon J. Classification criteria for mild cognitive impairment. A population-based validation study. Neurology 2001; 56: 37–42.
- 18 Cullum C, Huppert FA, McGee M et al. Decline across different domains of cognitive functioning in normal ageing: results of a longitudinal population-based study using CAMCOG. Int J Geriatr Psychiatry 2000; 15: 853–62.
- 19 Schofield P, Marder K, Dooneief G, Jacobs DM, Sano M, Stern Y. Association of subjective memory complaints with subsequent cognitive decline in community-dwelling elderly individuals with baseline cognitive impairment. Am J Psychiatr 1997; 154: 609–15.
- 20 Bowen J, Teri L, Kukull W, McCormick W, McCurry SM, Larson EB. Progression to dementia in patients with isolated memory loss. Lancet 1997; 349: 763–5.
- 21 Flicker C, Ferris SH, Reisberg B. Mild cognitive impairment in the elderly: predictors of dementia. Neurology 1991; 41: 1006–9.
- 22 Braekhus A, Laake K, Engedal K. A low ‘normal’ score on the Mini-Mental State Examination predicts development of dementia after three years. JAGS 1995; 43: 656–61.
- 23 Wolf H, Grunwald M, Ecke GM et al. The prognosis of mild cognitive impairment in the elderly. J Neural Transm 1998; 54: 31–50.
- 24 Hänninen T, Hallikainen M, Koivisto K et al. A follow-up study of age-associated memory impairment: neuropsychological predictors of dementia. J Am Geriatr Soc 1995; 43: 1007–15.
- 25 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: 411–6.
- 26 Tierney MC, Szalai JP, Snow WG et al. Prediction of probable Alzheimer's disease in memory-impaired patients: a prospective longitudinal study. Neurology 1996; 46: 661–5.
- 27 Hogan DB, Ebly EM. Predicting who will develop dementia in a cohort of Canadian seniors. Can J Neurol Sci 2000; 27: 18–24.
- 28 Palmer K, Bäckman L, Winblad B, Fratiglioni L. Detection of Alzheimer's disease and dementia in the preclinical phase: population-based cohort study. British Medical Journal 2003; 326(7383): 245.
- 29 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 Subcommittee of the American Academy of Neurology. Neurology 2001; 56: 1133–42.
- 30 Helkala EL, Koivisto K, Hänninen T et al. Stability of age-associated memory impairment during a longitudinal population-based study. J Am Geriatr Soc 1997; 45: 120–2.
- 31 Andersen K, Nybo H, Gaist D et al. Cognitive Impairment and Mortality among Nonagenarians: The Danish 1905 Cohort Survey. Dement Geriatr Cogn Disord 2002; 13: 156–63.
- 32 Frisoni GB, Fratiglioni L, Fastbom J, Viitanen M, Winblad B. Mortality in nondemented subjects with cognitive impairment: the influence of health-related factors. Am J Epidemiol 1999; 150: 1031–44.
- 33 Fratiglioni L, Small B, Winblad B et al. The transition from normal functioning to dementia in the aging population. In: K Iqbal, SS Sisodia, B Winblad, eds. Alzheimer's Disease: Advances in Etiology, Pathogenesis and Therapeutics. Wiley 2001.
