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Mild cognitive impairment is widespread. (People Over Age 70).

STOCKHOLM -- Nearly one in five nondemented people over age 70 meets the criteria for mild cognitive impairment, Dr. Oscar L. Lopez reported at the Eighth International Conference on Alzheimer's Disease and Related Disorders.

Mild cognitive impairment (MCI), a relatively new diagnostic entity, designates a group of individuals thought to be at increased risk for progression to Alzheimer's disease but who do not yet have signs of dementia.

The amnestic type is associated only with memory deficits; the multiple cognitive domain type encompasses a broader range of cognitive impairments, including memory.

Previous studies have estimated the prevalence rates of MCI at anywhere from 3% to 76%, depending on the population studied and the definition of MCI used, noted Dr. Lopez of the Alzheimer's Disease Research Center at the University of Pittsburgh.

The Modified Mini-Mental State Examination and the Digit Symbol Substitution Test were administered annually from 1988 to 1999 to 5,888 subjects. Participants were aged 65 and older, and 687 of them were African American. All were part of the Cardiovascular Health Study, a large U.S. epidemiologic trial. Most of the subjects underwent magnetic resonance brain imaging in 1992-1994, and again in 1997-1998. All had detailed neurologic and neuropsychological examinations at the end of the study period.

Of 3,602 subjects who had an MRI in 1992-1994, dementia was found in 707 (20%); 577 (16%) had MCI, and 2,318 (64%) had no deficits. Among the 2,895 nondemented subjects, the prevalence of MCI was 19%, increasing with age from 15% at age 75 to 31% in those aged 90 and older, said Dr. Lopez, also of the departments of neurology and psychiatry at the university.

The proportion of women and men was similar in the three groups. Compared with whites, a higher percentage of African American participants had dementia and MCI. Most of the MCI subjects had comorbid conditions that may have affected their cognitive functions, according to Dr. Lopez.

In Pittsburgh, the only site to classify MCI by type, 5% of the 723 nondemented subjects had MCI--amnestic type, and 14% had MCI--multiple cognitive domain type, he said at the meeting.
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Author:Tucker, Miriam E.
Publication:Clinical Psychiatry News
Date:Nov 1, 2002
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