Dement Neurocogn Disord.  2016 Sep;15(3):68-74. 10.12779/dnd.2016.15.3.68.

Clinical Predictors for Mild Cognitive Impairment Progression in a Korean Cohort

Affiliations
  • 1Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
  • 2Department of Neurology, Konyang University College of Medicine, Daejeon, Korea.
  • 3Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea.
  • 4Department of Psychiatry, Ajou University School of Medicine, Suwon, Korea.
  • 5Department of Neurology, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 6Department of Neurology, Eulji University College of Medicine, Daejeon, Korea.
  • 7Department of Neurology, Ewha Womans University School of Medicine, Seoul, Korea.
  • 8Department of Neurology, Korea University College of Medicine, Seoul, Korea.
  • 9Department of Neurology, Inha University School of Medicine, Incheon, Korea. seonghye@inha.ac.kr
  • 10Department of Psychiatry, University of Ulsan College of Medicine, Seoul, Korea. sykim@amc.seoul.kr

Abstract

BACKGROUND AND PURPOSE
Patients with mild cognitive impairment (MCI) and their caregivers are concerned with the likelihood and time course of progression to dementia. This study was performed to identify the clinical predictors of the MCI progression in a Korean registry, and investigated the effects of medications without evidence, frequently prescribed in clinical practice.
METHODS
Using a Korean cohort that included older adults with MCI who completed at least one follow-up visit, clinical characteristics and total medical expenses including prescribed medications were compared between two groups: progressed to dementia or not. Cox proportional hazards regression analysis was conducted.
RESULTS
During the mean 1.42±0.72 years, 215 (27.63%) of 778 participants progressed to dementia. The best predictors were age [hazard ratio (HR), 1.036; 95% confidence interval (CI), 1.006-1.067; p=0.018], apolipoprotein ε4 allele (HR, 2.247; 95% CI, 1.512-3.337; p<0.001), Clinical Dementia Rating scale-sum of boxes scores (HR, 1.367; 95% CI, 1.143-1.636; p=0.001), Instrumental Activities of Daily Living scores (HR, 1.035; 95% CI, 1.003-1.067; p=0.029), and lower Mini-Mental State Examination scores (HR, 0.892; 95% CI, 0.839-0.949; p<0.001). Total medical expenses were not different.
CONCLUSIONS
Our data are in accordance with previous reports about clinical predictors for the progression from MCI to dementia. Total medical expenses were not different between groups with and without progression.

Keyword

cholinesterase inhibitors; dementia; mild cognitive impairment; predictors

MeSH Terms

Activities of Daily Living
Adult
Alleles
Apolipoproteins
Caregivers
Cholinesterase Inhibitors
Cohort Studies*
Dementia
Follow-Up Studies
Humans
Mild Cognitive Impairment*
Apolipoproteins
Cholinesterase Inhibitors
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