TY - JOUR
T1 - Staging cognitive impairment and incidence of dementia
AU - Santabárbara, J.
AU - Lopez-Anton, R.
AU - Gracia-García, P.
AU - De-La-Cámara, C.
AU - Vaquero-Puyuelo, D.
AU - Lobo, E.
AU - Marcos, G.
AU - Salvador-Carulla, L.
AU - Palomo, T.
AU - Sartorius, N.
AU - Lobo, A.
N1 - Funding Information:
Supported by Grants from the Fondo de Investigación Sanitaria, Instituto de Salud Carlos III, Spanish Ministry of Economy and Competitiveness, Madrid, Spain (grants 94/1562, 97/1321E, 98/0103, 01/0255, 03/0815, 06/0617, G03/128) and Gobierno de Aragón/ Programa Operativo Fondo Social Europeo 2007-2013.
Publisher Copyright:
© Cambridge University Press 2015.
PY - 2016/12/1
Y1 - 2016/12/1
N2 - Aims. In a background of interest in staging models in psychiatry, we tested the validity of a simple staging model of cognitive impairment to predict incident dementia. Method. A large community sample of adults aged ≥55 years (N = 4803) was assessed in the baseline of a longitudinal, four-wave epidemiological enquiry. A two-phase assessment was implemented in each wave, and the instruments used included the Mini-Mental Status Examination (MMSE); the History and Aetiology Schedule and the Geriatric Mental State-AGECAT. For the standardised degree of cognitive impairment Perneczky et al's MMSE criteria were applied. A panel of psychiatrists diagnosed cases of dementia according to DSM-IV criteria, and cases and sub-cases of dementia were excluded for the follow-up waves. Competing risk regression models, adjusted by potential confounders, were used to test the hypothesised association between MMSE levels and dementia risk. Results. Out of the 4057 participants followed up, 607 (14.9%) were classified as 'normal' (no cognitive impairment), 2672 (65.8%) as 'questionable' cognitive impairment, 732 (18.0%) had 'mild' cognitive impairment, 38 (0.9%) had 'moderate' cognitive impairment and eight (0.2%) had 'severe' impairment. Cognitive impairment was associated with risk of dementia, the risk increasing in parallel with the level of impairment (hazard ratio: 2.72, 4.78 and 8.38 in the 'questionable', 'mild' and 'moderate' level of cognitive impairment, respectively). Conclusions. The documented gradient of increased risk of dementia associated with the severity level of cognitive impairment supports the validity of the simple staging model based on the MMSE assessment.
AB - Aims. In a background of interest in staging models in psychiatry, we tested the validity of a simple staging model of cognitive impairment to predict incident dementia. Method. A large community sample of adults aged ≥55 years (N = 4803) was assessed in the baseline of a longitudinal, four-wave epidemiological enquiry. A two-phase assessment was implemented in each wave, and the instruments used included the Mini-Mental Status Examination (MMSE); the History and Aetiology Schedule and the Geriatric Mental State-AGECAT. For the standardised degree of cognitive impairment Perneczky et al's MMSE criteria were applied. A panel of psychiatrists diagnosed cases of dementia according to DSM-IV criteria, and cases and sub-cases of dementia were excluded for the follow-up waves. Competing risk regression models, adjusted by potential confounders, were used to test the hypothesised association between MMSE levels and dementia risk. Results. Out of the 4057 participants followed up, 607 (14.9%) were classified as 'normal' (no cognitive impairment), 2672 (65.8%) as 'questionable' cognitive impairment, 732 (18.0%) had 'mild' cognitive impairment, 38 (0.9%) had 'moderate' cognitive impairment and eight (0.2%) had 'severe' impairment. Cognitive impairment was associated with risk of dementia, the risk increasing in parallel with the level of impairment (hazard ratio: 2.72, 4.78 and 8.38 in the 'questionable', 'mild' and 'moderate' level of cognitive impairment, respectively). Conclusions. The documented gradient of increased risk of dementia associated with the severity level of cognitive impairment supports the validity of the simple staging model based on the MMSE assessment.
KW - Cognitive impairment
KW - dementia
KW - Mini-Mental Status Examination
KW - staging
UR - http://www.scopus.com/inward/record.url?scp=84944096904&partnerID=8YFLogxK
U2 - 10.1017/S2045796015000918
DO - 10.1017/S2045796015000918
M3 - Article
C2 - 26467185
AN - SCOPUS:84944096904
SN - 2045-7960
VL - 25
SP - 562
EP - 572
JO - Epidemiology and Psychiatric Sciences
JF - Epidemiology and Psychiatric Sciences
IS - 6
ER -