Regular Research ArticlesRetrospective Identification and Characterization of Mild Cognitive Impairment From a Prospective Population Cohort
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PARTICIPANTS
Subjects for this study were recruited randomly from the electoral roles of three French cities (Bordeaux, Dijon, and Montpellier) between 1999 and 2001 as part of a multisite cohort study of community-dwelling persons aged 65 years and older (the Three-City Study). Subjects were interviewed initially either at a study center or in their own homes if disabled. The cohort was followed up twice at 2-year intervals. Given that cognitive impairment may commence up to 20 years before the diagnosis
Sociodemographic and Clinical Variables
A standardized interview included questions relating to sociodemographic characteristics, physical activities, weight, and height. Information was also obtained on exposure to anesthesia in the preceding year, subjectively evaluated health (six items relating to inhabitual difficulties in everyday activities, related to learning, calculating, language, and orientation), sleep quality, herpes infections, subjective report of appetite loss, self-reported social isolation, current alcohol
RESULTS
Within this sample, 320 persons (192 women) without dementia at baseline were diagnosed with dementia at one of the two follow-up examinations. The subjects in the Dem-MCI group are older than the comparison group (78 versus 74 years). Table 1 compares the clinical characteristics of the Dem-MCI group at baseline with those who did not develop dementia. Dem-MCI subjects were found to differ on a number of clinical and sociodemographic characteristics, notably, higher age, lower education, ApoE
DISCUSSION
In this study, we have chosen to substitute the usual definition of MCI based on cross-sectional statistical criteria for cognitive dysfunction by a pragmatic definition that comes closer to the clinical meaning of this concept, i.e., nondemented elderly persons in a predementia phase (Dem-MCI). Comparing our Dem-MCI cases at baseline with the remainder of the nondemented population, we found, not surprisingly, significant differences on all the cognitive domains tested. Our principal interest
CONCLUSION
Prospective studies may provide a more clinically relevant method of identifying persons with MCI by redefining it as persons without dementia who will develop the disorder within a short time period. From this alternative MCI cohort, we have been able to identify a number of gender-specific noncognitive clinical variables, which may increase the specificity of current case-finding procedures. Although the limitations of our study and the need for validation in other cohorts would prevent us
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2017, The LancetCitation Excerpt :A Mediterranean diet decreases the risk of conversion from amnestic mild cognitive impairment to Alzheimer's disease compared with other diets.206 A slightly different view emerged from a large, but unreplicated, community cohort study in which people were retrospectively classified as having mild cognitive impairment.207 It suggested that risk factors for progression to dementia differed between men and women; interventions should focus principally on risk of stroke in men, and depressive symptomatology and reducing anticholinergic medication in women.208
The authors thank the Génopôle of Lille, the Laboratories of Biochemistry of the University Hospitals of Dijon (Pr. Gambert) and Montpellier (Dr. Dupuy), the Town Council of Dijon, the Conseil Général of Côte d'Or, and the clinical case validation committee of the 3C study.
The 3C Study was conducted under a partnership agreement between Inserm, the Victor Segalen–Bordeaux II University, and Sanofi-Synthélabo. The Fondation pour la Recherche Médicale funded the preparation and first phase of the study. The 3C-Study is also supported by the Caisse Nationale Maladie des Travailleurs Salariés, Direction Générale de la Santé, MGEN, the Institut de la Longévité, Agence Française de Sécurité Sanitaire des Produits de Santé, the Regional Governments of Aquitaine, Bourgogne and Languedoc-Roussillon, and the Fondation de France, France Alzheimer, the Ministry of Research-Inserm Programme “Cohorts and collection of biological material.” The Lille Génopôle received an unconditional grant from Eisai.