Dementia and mild cognitive impairment: prevalence, conversion rates, and longevity between ages 70 and 95
Innovation in Aging(2023)
摘要
Abstract This study describes the prevalence and conversion rates of Mild Cognitive Impairment (MCI) and dementia between age 70-95, and the association between cognitive status and mortality. The Jerusalem Longitudinal Study (1990-2023) prospectively follows a representative community-dwelling cohort born 1920-21, assessed at home visit during 1990,1998, 2005, 2010, 2015 at ages 70, 78, 85, 90, and 95 (n=437, 806, 1170, 584, 468) respectively. Comprehensive assessment included Mini Mental State Examination (MMSE), defining normal cognition (29-30/30), MCI (24-28/30) and dementia (≤23/30). Mortality data were collected from the Ministry of Interior. Cox proportional hazards ratios (HR) were determined, adjusting for gender, education, self-rated health, physical activity, BADL status, diabetes, hypertension, ischemic heart disease. At ages 70, 78, 85, 85, 90, and 95 the prevalence of MCI was 13.5%, 21.5%, 38.7%, 37.0%, and 50%; prevalence of dementia was 3.2%, 4.2%, 24.3%, 31.3%, 35.7%. Between age 70-78, 78-85, 85-90, 90-95, conversion rates from MCI back to normal were 74.2%, 27.4%, 18.2%, 7.3%; MCI declining to dementia were 6.5%, 29.2%, 37.0%, 50.9%; MCI remaining MCI were 19.4%, 43.4%, 44.8%, 41.8%. Dementia was significantly associated with increased mortality throughout the entire study period: at age 70-78 Hazards Ratio=4.36 (CI 95%: 2.09-9.10), age 90-95 HR=1.5 (CI 95%: 1.01-2.21). In contrast, MCI was not associated with increased mortality, apart from at age 85: HR=1.38 (CI 95%: 1.04-1.82). Our findings show that conversion rates from MCI to dementia are age-dependent, with less than half of MCI subjects progressing to dementia. Unlike dementia, MCI was largely unassociated with mortality.
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