Outcomes of mild cognitive impairment by definition: A population study

Mary Ganguli, Beth E. Snitz, Judith A. Saxton, Chung Chou H Chang, Ching Wen Lee, Joni Vander Bilt, Tiffany F. Hughes, David A. Loewenstein, Frederick W. Unverzagt, Ronald Carl Petersen

Research output: Contribution to journalArticle

148 Citations (Scopus)

Abstract

Background: Mild cognitive impairment (MCI) has been defined in several ways. Objective: To determine the 1-year outcomes of MCI by different definitions at the population level. Design: Inception cohort with 1-year follow-up. Participants were classified as having MCI using the following definitions operationalized for this study: amnestic MCI by Mayo criteria, expanded MCI by International Working Group criteria, Clinical Dementia Rating (CDR) =0.5, and a purely cognitive classification into amnestic and nonamnestic MCI. Setting: General community. Participants: Stratified random population-based sample of 1982 individuals 65 years and older. Main Outcome Measures: For each MCI definition, there were 3 possible outcomes: worsening (progression to dementia [CDR≥1] or severe cognitive impairment), improvement (reversion toCDR=0 or normal cognition), and stability (unchangedCDRor cognitive status). Results: Regardless of MCI definition, over 1 year, a small proportion of participants progressed to CDR>1 (range, 0%-3%) or severe cognitive impairment (0%-20%) at rates higher than their cognitively normal peers. Somewhat larger proportions of participants improved or reverted to normal (6%-53%). Most participants remained stable (29%-92%). Where definitions focused on memory impairment and on multiple cognitive domains, higher proportions progressed and lower proportions reverted on the CDR. Conclusions: As ascertained by several operational definitions, MCI is a heterogeneous entity at the population level but progresses to dementia at rates higher than in normal elderly individuals. Proportions of participants progressing to dementia are lower and proportions reverting to normal are higher than in clinical populations. Memory impairments and impairments in multiple domains lead to greater progression and lesser improvement. Research criteria may benefit from validation at the community level before incorporation into clinical practice.

Original languageEnglish (US)
Pages (from-to)761-767
Number of pages7
JournalArchives of Neurology
Volume68
Issue number6
DOIs
StatePublished - Jun 2011

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Dementia
Population
Cognitive Dysfunction
Mild Cognitive Impairment
Proportion
Cognition
Outcome Assessment (Health Care)
Rating
Impairment
Research
Cognitive Impairment
Progression

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Ganguli, M., Snitz, B. E., Saxton, J. A., Chang, C. C. H., Lee, C. W., Vander Bilt, J., ... Petersen, R. C. (2011). Outcomes of mild cognitive impairment by definition: A population study. Archives of Neurology, 68(6), 761-767. https://doi.org/10.1001/archneurol.2011.101

Outcomes of mild cognitive impairment by definition : A population study. / Ganguli, Mary; Snitz, Beth E.; Saxton, Judith A.; Chang, Chung Chou H; Lee, Ching Wen; Vander Bilt, Joni; Hughes, Tiffany F.; Loewenstein, David A.; Unverzagt, Frederick W.; Petersen, Ronald Carl.

In: Archives of Neurology, Vol. 68, No. 6, 06.2011, p. 761-767.

Research output: Contribution to journalArticle

Ganguli, M, Snitz, BE, Saxton, JA, Chang, CCH, Lee, CW, Vander Bilt, J, Hughes, TF, Loewenstein, DA, Unverzagt, FW & Petersen, RC 2011, 'Outcomes of mild cognitive impairment by definition: A population study', Archives of Neurology, vol. 68, no. 6, pp. 761-767. https://doi.org/10.1001/archneurol.2011.101
Ganguli M, Snitz BE, Saxton JA, Chang CCH, Lee CW, Vander Bilt J et al. Outcomes of mild cognitive impairment by definition: A population study. Archives of Neurology. 2011 Jun;68(6):761-767. https://doi.org/10.1001/archneurol.2011.101
Ganguli, Mary ; Snitz, Beth E. ; Saxton, Judith A. ; Chang, Chung Chou H ; Lee, Ching Wen ; Vander Bilt, Joni ; Hughes, Tiffany F. ; Loewenstein, David A. ; Unverzagt, Frederick W. ; Petersen, Ronald Carl. / Outcomes of mild cognitive impairment by definition : A population study. In: Archives of Neurology. 2011 ; Vol. 68, No. 6. pp. 761-767.
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