Mild Cognitive Impairment: Epidemiology and Dementia Risk in an Elderly Italian Population

Authors

  • Giovanni Ravaglia MD,

    1. From the *Department of Internal Medicine, Cardioangiology, and Hepatology; University Hospital S. Orsola-Malpighi, Bologna, ItalyHealth District of Lugo, Local Health Unit, Ravenna, ItalyInstitute of Gerontology and Geriatrics, Perugia University Hospital, Perugia, Italy.
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  • Paola Forti MD,

    1. From the *Department of Internal Medicine, Cardioangiology, and Hepatology; University Hospital S. Orsola-Malpighi, Bologna, ItalyHealth District of Lugo, Local Health Unit, Ravenna, ItalyInstitute of Gerontology and Geriatrics, Perugia University Hospital, Perugia, Italy.
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  • Fausta Montesi MD,

    1. From the *Department of Internal Medicine, Cardioangiology, and Hepatology; University Hospital S. Orsola-Malpighi, Bologna, ItalyHealth District of Lugo, Local Health Unit, Ravenna, ItalyInstitute of Gerontology and Geriatrics, Perugia University Hospital, Perugia, Italy.
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  • Anna Lucicesare MD,

    1. From the *Department of Internal Medicine, Cardioangiology, and Hepatology; University Hospital S. Orsola-Malpighi, Bologna, ItalyHealth District of Lugo, Local Health Unit, Ravenna, ItalyInstitute of Gerontology and Geriatrics, Perugia University Hospital, Perugia, Italy.
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  • Nicoletta Pisacane MD,

    1. From the *Department of Internal Medicine, Cardioangiology, and Hepatology; University Hospital S. Orsola-Malpighi, Bologna, ItalyHealth District of Lugo, Local Health Unit, Ravenna, ItalyInstitute of Gerontology and Geriatrics, Perugia University Hospital, Perugia, Italy.
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  • Elisa Rietti MD,

    1. From the *Department of Internal Medicine, Cardioangiology, and Hepatology; University Hospital S. Orsola-Malpighi, Bologna, ItalyHealth District of Lugo, Local Health Unit, Ravenna, ItalyInstitute of Gerontology and Geriatrics, Perugia University Hospital, Perugia, Italy.
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  • Edoardo Dalmonte MD,

    1. From the *Department of Internal Medicine, Cardioangiology, and Hepatology; University Hospital S. Orsola-Malpighi, Bologna, ItalyHealth District of Lugo, Local Health Unit, Ravenna, ItalyInstitute of Gerontology and Geriatrics, Perugia University Hospital, Perugia, Italy.
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  • Marisa Bianchin MD,

    1. From the *Department of Internal Medicine, Cardioangiology, and Hepatology; University Hospital S. Orsola-Malpighi, Bologna, ItalyHealth District of Lugo, Local Health Unit, Ravenna, ItalyInstitute of Gerontology and Geriatrics, Perugia University Hospital, Perugia, Italy.
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  • Patrizia Mecocci MD

    1. From the *Department of Internal Medicine, Cardioangiology, and Hepatology; University Hospital S. Orsola-Malpighi, Bologna, ItalyHealth District of Lugo, Local Health Unit, Ravenna, ItalyInstitute of Gerontology and Geriatrics, Perugia University Hospital, Perugia, Italy.
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Address correspondence to Giovanni Ravaglia, MD, Department of Internal Medicine, Cardioangiology, and Hepatology, University Hospital S. Orsola-Malpighi, Via Massarenti 9, 40138 Bologna, Italy. E-mail: ravaglia@med.unibo.it

Abstract

OBJECTIVES: To investigate prevalence and incidence of mild cognitive impairment (MCI) and its risk of progression to dementia in an elderly Italian population.

DESIGN: Longitudinal.

SETTING: Population-based cohort aged 65 and older resident in an Italian municipality.

PARTICIPANTS: A total of 1,016 subjects underwent baseline evaluation in 1999/2000. In 2003/04, information about cognitive outcome was collected for 745 participants who were free of dementia at baseline.

MEASUREMENTS: MCI (classified as with or without impairment of the memory domain), dementia, Alzheimer's dementia (AD), and vascular dementia (VaD) diagnosed according to current international criteria.

RESULTS: Overall prevalence of MCI was 7.7% (95% confidence interval (CI)=6.1–9.7 %) and was greater with older age and poor education. During 4 years of follow-up, 155 incident MCI cases were diagnosed, with an incidence rate of 76.8 (95% CI=66.8–88.4) per 1,000 person-years. Approximately half of prevalent and incident MCI cases had memory impairment. Compared with normal cognition, multivariable-adjusted risk for progression from MCI with memory impairment to dementia was 4.78 (95% CI=2.78–8.07) for any dementia, 5.92 (95% CI=3.20–10.91) for AD, and 1.61 (95% CI=0.37–7.00) for VaD. No association with dementia risk was found for MCI without memory impairment. Approximately one-third of MCI cases with memory impairment did not progress to dementia.

CONCLUSION: MCI occurs often in this elderly Italian cohort and is associated with greater risk of AD, but only when the impairment involves the memory domain. However, a substantial proportion of MCI cases with memory impairment do not progress to dementia.

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