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Dementia and Geriatric Cognitive Disorders
Poulose P.a· Varma R.P.b· Surendran M.a· Ramachandran S.S.a· Rajesh P.G.a· Thomas B.c· Kesavadas C.c· Menon R.N.aaDepartment of Neurology, Sree Chitra Tirunal Institute for Medical Sciences & Technology (SCTIMST), Thiruvananthapuram, India
bAchutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences & Technology (SCTIMST), Thiruvananthapuram, India
cDepartment of Imaging Sciences & Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences & Technology (SCTIMST), Thiruvananthapuram, India
Dement Geriatr Cogn Disord
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Article / Publication Details
Received: October 31, 2022
Accepted: January 13, 2023
Published online: April 04, 2023
Number of Print Pages: 17
Number of Figures: 4
Number of Tables: 10
ISSN: 1420-8008 (Print)
eISSN: 1421-9824 (Online)
For additional information: https://www.karger.com/DEM
AbstractIntroduction: The study aimed to explore longitudinal cognitive outcomes and to ascertain predictors of conversion to dementia in a hospital-based mild cognitive impairment (MCI) cohort classified according to the neuropsychological phenotype at baseline. Materials and Methods: Subjects aged >55 years who had a clinical diagnosis of MCI at initial visit between 2010 and 2018, with at least one formal neuropsychological assessment at baseline and follow-up of a minimum of 2 years were included. The prospective study was completed based on evaluation at last follow-up to gauge conversion to dementia, quantification of performance on activities of daily living and when available, longitudinal neuropsychological test scores. Results: Ninety-five patients with MCI met the inclusion criteria with a mean age of 68.4 ± 6.4 years at baseline and a mean duration of follow-up for 6.4 ± 3.2 years. The cumulative conversion rate to dementia was 22.2% (21/95) and the annualized conversion rate was 3.3% per year of follow-up. The majority of subjects who had converted had multidomain MCI (66%). Only white matter changes on MRI brain revealed correlation with baseline neuropsychology tests. The multivariate logistic regression analysis revealed the utility of lower baseline list recognition (adjusted odds ratio: 0.735 [95% confidence interval: 0.589–0.916]; p 0.006), lower immediate logical memory (0.885 [0.790–0.990]; p 0.03), and high perseverative error scores on set shifting (3.116 [1.425–6.817]; p 0.004) as predictors of conversion. A model score of +2.615 could predict conversion with sensitivity of 72% and specificity of 98% over 6.4 years follow-up. Conclusion: There was a higher risk of conversion associated with multidomain MCI. Logistic regression-based estimations of dementia risk utilizing domain-based neuropsychology test scores in MCI have high specificity for diagnosis at baseline.
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Received: October 31, 2022
Accepted: January 13, 2023
Published online: April 04, 2023
Number of Print Pages: 17
Number of Figures: 4
Number of Tables: 10
ISSN: 1420-8008 (Print)
eISSN: 1421-9824 (Online)
For additional information: https://www.karger.com/DEM
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