Predicting the Course of Mild Cognitive Impairment in a Memory Disorder Clinic Sample
Abstract
Objective: The present study examines a number of psychosocial and medical
risk factors for dementia and their association with the outcome of mild cognitive
impairment (MCI) in a memory disorder clinic sample.
Method: Twelve years of archival cognitive testing data from 125 East Central
Florida Memory Disorder Clinic patients was utilized. Participants were included
in this study if they were diagnosed with MCI following initial cognitive testing
and then re-evaluated and diagnosed with either stable MCI, dementia of the
Alzheimer’s type (AD) or mixed dementia (dementia of the Alzheimer’s type and
vascular dementia), or cognition within normal limits. Patients’ medical and
psychosocial information was obtained from their electronic medical records
(EMR) and included as predictors in this present study.
Results: Age of patients (M = 77.2, SD = 6.2) at initial visit was associated with
an increase in the odds of receiving a final diagnosis of dementia, with an odds
ratio of 1.074 (95% CI, 1.014 to 1.137), Wald, χ2
(1) = 5.893, p = .015. Individuals
who were diagnosed with amnestic MCI at their initial evaluation were more
likely to convert to dementia (χ
2
(18) = 45.65, p < .001). A history of depression
was also associated with an increase in the odds of receiving a final diagnosis of
dementia, with an odds ratio of 3.213 (95% CI, 1.200 to 8.605), Wald, χ2
(1) = 5.396, p = .020. The odds of receiving a final diagnosis of dementia were also
significantly higher for patients who had a diagnosis of hypertension, with an
odds ratio of 2.771 (95% CI, 1.240 to 6.197), Wald , χ2
(1) = 6.166, p = .013.
Additionally, patients with a history of comorbid depression and hypertension had
increased odds of converting to dementia, with an odds ratio of 8.894 (95% CI,
3.564 to 22.192), Wald, χ2
(1) = 21.942, p = < .001. In contrast, patients with a
history of age-related macular degeneration had increased odds of remaining
stable MCI, with an odds ratio of 4.762 (95% CI, 1.115 to 20.333), Wald, χ2
(1) =
4.440, p = .035. Conclusion: The results of the present study support previous
literature that suggests advancing age is the largest non-modifiable risk factor for
dementia. Prior research suggesting amnestic MCI patients are more likely to
convert to dementia was also supported. The present study’s findings also suggest
that patients with MCI may be more likely to progress to AD if they have
histories of depression and/or hypertension. This supports previous research that
suggests a relationship between cardiovascular risk factors and mental health
conditions such as depression, with future cognitive impairment. This highlights
the importance of treating modifiable risk factors for dementia, particularly
depression and hypertension, in order to delay the onset of AD in patients who
have MCI. Lastly, the results of this study may assist clinicians in determining
which patients with MCI may be most likely to convert to dementia, with older
patients who have amnestic MCI, depression, and hypertension, being the most
likely to convert.