In a recent study, researchers attempted to explore sociodemographic and medical predictors of incident MCI and subsequent course of MCI at follow-up, including sustained MCI diagnosis, classification as cognitively normal, and progression to dementia.

Findings from a recent community–based cohort study published in Neurology indicated that approximately 50% of individuals with incident MCI diagnoses were considered cognitively normal at follow-up. In the study, researchers selected participants from a longitudinal study of aging and dementia among a community that included non-Hispanic White, non-Hispanic Black and Hispanic individuals. They recruited via random sampling 2,903 cognitively normal participants at baseline who were aged 65 years or older and who were eligible for Medicare from three census tracts in New York across three waves in 1992, 1999, and 2009.

The results revealed that among 2,903 cognitively normal participants at baseline, 752 developed MCI over an average of 6.3 (SD = 4.5) years (incidence rate: 56/1,000 person-years). The presence of apolipoprotein E ε4 (APOE) and higher medical burden heightened risk of incident MCI, while more years of education, more leisure activities, and higher income diminished this risk. They also noted that of the incident MCI cases, after an average of 2.4 years follow-up, 12.9% progressed to dementia, 9.6% declined in functioning and did not meet the algorithmic criteria for MCI but did not meet the clinical criteria for dementia either, 29.6% continued to meet MCI criteria, and 47.9% no longer met MCI criteria. Factors correlated to an augmented risk for progression to dementia included multidomain MCI, presence of APOE e4, depressive symptoms, and antidepressant use.

The authors, Milou J Angevaare, MD, of the Department of Neurology and Taub Institute for Research on Alzheimer's Disease and the Aging Brain at Columbia University, and colleagues wrote, "Identifying risk factors of mild cognitive impairment (MCI)—a prodromal phase of dementia—in cognitively normal older adults can aid characterization of a target group for prevention or intervention strategies of dementia."

The authors concluded that the findings of this community-based study revealed that nearly half of the individuals with incident MCI diagnoses were classified as cognitively normal at follow-up. They also noted that predictors of incident MCI demonstrably differed from those of subsequent MCI courses; these findings can refine expectations for cognitive and functional course of those presenting with MCI.

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