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Difficulties with daily activities
associated with progression to Dementia
Newswise — Among individuals with mild
cognitive impairment, often considered a
transitional state between normal cognitive
function and Alzheimer’s dementia, those who
have more difficulties performing routine
activities appear more likely to progress
quickly to dementia, according to a report
in the September issue of Archives of
Neurology, one of the JAMA/Archives
journals.
Mild cognitive impairment is recognized as a
risk factor for dementia and an important
public health issue, according to background
information in the article.
“Annual conversion rates [from mild
cognitive impairment to dementia] often
range from 10 percent to 15 percent in
clinic samples. Conversion rates in
community-based studies are often
substantially lower (i.e., 3.8 percent to
6.3 percent per year),” the authors write.
“Clearly patients with mild cognitive
impairment compose a heterogeneous group, of
whom not all rapidly convert to dementia.
"As
such, it is important to identify risk
factors for progressing rapidly among
individuals diagnosed with mild cognitive
impairment.”
Sarah Tomaszewski Farias, Ph.D., of the
University of California, Davis, and
colleagues studied 111 individuals with mild
cognitive impairment.
Of these, 46 percent (51) were recruited
from patients referred to a university-based
memory disorders clinic on suspicion of
cognitive decline, and 54 percent (60) were
recruited directly through community
outreach.
All
participants underwent annual clinical
evaluations, diagnostic imaging, routine
laboratory tests and neuropsychological
evaluations.
During an average of 2.4 years of follow-up,
28 individuals progressed from mild
cognitive impairment to dementia, including
23 from the clinic and five from the
community.
Annually, 13 percent of the clinic-based
group and 3 percent of the community group
converted into dementia.
Other than recruitment source, the only
factor associated with conversion from mild
cognitive impairment to dementia was the
degree of functional impairment at the
beginning of the study—no demographic,
cognitive or neuroimaging variables
predicted this progression.
“Thus, regardless of whether an individual
was a clinic patient or recruited directly
from the community, more functional
impairment at baseline was an important risk
for future conversion to dementia,” the
authors write.
“The greater functional impairment at
baseline within the clinically recruited
group appears to account for their increased
risk of conversion.”
The results suggest that “in an
educationally and ethnically diverse
population, those with more functional
impairment at their baseline
evaluation—regardless of whether they are
actively seeking an evaluation for a
neurodegenerative disease—are at increased
risk for conversion to dementia even within
a relatively short follow-up period,” they
conclude.
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