Reversible Mild Cognitive Impairment: The Role of Comorbidities at Baseline Evaluation

Giulia Grande, Valentina Cucumo, Ilaria Cova, Roberta Ghiretti, Laura Maggiore, Eleonora Lacorte, Daniela Galimberti, Elio Scarpini, Francesca Clerici, Simone Pomati, Nicola Vanacore, Claudio Mariani

Research output: Contribution to journalArticlepeer-review

Abstract

The prognostic value of mild cognitive impairment (MCI) is being questioned, with some MCI subjects reverting to normal cognition (NC). The reversion rate varies mostly depending on the study design, the setting, and both MCI and NC definitions. Previous studies have focused on the profile of subjects who revert to NC, but the role of comorbidities has not been entirely investigated. We aimed to evaluate the proportion of MCI subjects who revert to NC in a memory clinic context, focusing on the role of comorbidities. Between 2004 and 2013, 374 MCI subjects were recruited. During a mean time of 32 ± 25.5 months, 21 subjects (5.6) reverted to NC. Subjects who reverted to NC were younger (p = 0.0001), more educated (p = 0.0001), had a better global cognition (p = 0.0001), as assessed by the Mini-Mental State Examination (MMSE) and suffered from more comorbidities (p = 0.002), as assessed by Cumulative Illness Rating Scale (CIRS) than those who developed dementia. The Cox Regression Model, constructed to adjust for the confounders, showed that the higher were the MMSE (HR = 1.83, CI 95: 1.07-3.11) and the CIRS score (HR = 1.3, CI 95 0.88-1.92) at baseline, the higher was the probability of returning to NC than developing dementia, though the last association was not significant. Subjects who reverted to NC were more frequently affected by respiratory (p = 0.002), urologic (p = 0.012), and psychiatric (p = 0.012) diseases. The cognitive performance of subjects with medical comorbidities could benefit from preventive strategies aimed at treating the underlying diseases.

Original languageEnglish
Pages (from-to)57-67
Number of pages11
JournalJournal of Alzheimer's Disease
Volume51
Issue number1
DOIs
Publication statusPublished - Feb 27 2016

Keywords

  • Comorbidity
  • dementia
  • mild cognitive impairment
  • prevention

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Geriatrics and Gerontology
  • Clinical Psychology

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