The Prevalence of Mild Cognitive Impairment in Diverse Geographical and Ethnocultural Regions: The COSMIC Collaboration

Background Changes in criteria and differences in populations studied and methodology have produced a wide range of prevalence estimates for mild cognitive impairment (MCI). Methods Uniform criteria were applied to harmonized data from 11 studies from USA, Europe, Asia and Australia, and MCI prevalence estimates determined using three separate definitions of cognitive impairment. Results The published range of MCI prevalence estimates was 5.0%–36.7%. This was reduced with all cognitive impairment definitions: performance in the bottom 6.681% (3.2%–10.8%); Clinical Dementia Rating of 0.5 (1.8%–14.9%); Mini-Mental State Examination score of 24–27 (2.1%–20.7%). Prevalences using the first definition were 5.9% overall, and increased with age (P < .001) but were unaffected by sex or the main races/ethnicities investigated (Whites and Chinese). Not completing high school increased the likelihood of MCI (P ≤ .01). Conclusion Applying uniform criteria to harmonized data greatly reduced the variation in MCI prevalence internationally.

[1]  S. DeKosky,et al.  Mild cognitive impairment, amnestic type , 2004, Neurology.

[2]  R. Howard,et al.  Dementia and Ethnicity , 1998, International Psychogeriatrics.

[3]  R. Mayeux,et al.  Implementing diagnostic criteria and estimating frequency of mild cognitive impairment in an urban community. , 2005, Archives of neurology.

[4]  Kaarin J Anstey,et al.  Cohort profile: the PATH through life project. , 2012, International journal of epidemiology.

[5]  V. Pankratz,et al.  Higher risk of progression to dementia in mild cognitive impairment cases who revert to normal , 2014, Neurology.

[6]  E. Kua,et al.  Cognitive function and tea consumption in community dwelling older Chinese in Singapore , 2010, The journal of nutrition, health & aging.

[7]  R. Sperling,et al.  Hippocampal activation in adults with mild cognitive impairment predicts subsequent cognitive decline , 2007, Journal of Neurology, Neurosurgery, and Psychiatry.

[8]  R. Stewart,et al.  Prevalence, Distribution, and Impact of Mild Cognitive Impairment in Latin America, China, and India: A 10/66 Population-Based Study , 2012, PLoS medicine.

[9]  Antonio Lobo,et al.  The ZARADEMP Project on the incidence, prevalence and risk factors of dementia (and depression) in the elderly community: II. Methods and first results , 2005 .

[10]  P. Sachdev,et al.  Mild cognitive impairment in a community sample: The Sydney Memory and Ageing Study , 2013, Alzheimer's & Dementia.

[11]  A. Villringer,et al.  Mild Cognitive Impairment: Incidence and Risk Factors: Results of the Leipzig Longitudinal Study of the Aged , 2010, Journal of the American Geriatrics Society.

[12]  Ronald C Petersen,et al.  Outcomes of mild cognitive impairment by definition: a population study. , 2011, Archives of neurology.

[13]  C. Myers,et al.  The Relationship between Associative Learning, Transfer Generalization, and Homocysteine Levels in Mild Cognitive Impairment , 2012, European Psychiatry.

[14]  Tih-Shih Lee,et al.  Metabolic syndrome and amnestic mild cognitive impairment: Singapore Longitudinal Ageing Study-2 findings. , 2013, Journal of Alzheimer's disease : JAD.

[15]  J. Brandt,et al.  The Fate of the 0.5s: Predictors of 2-Year Outcome in Mild Cognitive Impairment , 2010, Journal of the International Neuropsychological Society.

[16]  P. Sachdev,et al.  Characterizing mild cognitive disorders in the young-old over 8 years: Prevalence, estimated incidence, stability of diagnosis, and impact on IADLs , 2013, Alzheimer's & Dementia.

[17]  P. Sachdev,et al.  The Sydney Memory and Ageing Study (MAS): methodology and baseline medical and neuropsychiatric characteristics of an elderly epidemiological non-demented cohort of Australians aged 70–90 years , 2010, International Psychogeriatrics.

[18]  E. Tangalos,et al.  Mild Cognitive Impairment Clinical Characterization and Outcome , 1999 .

[19]  O. Selnes A Compendium of Neuropsychological Tests , 1991, Neurology.

[20]  P. Sachdev,et al.  Factors Predicting Reversion from Mild Cognitive Impairment to Normal Cognitive Functioning: A Population-Based Study , 2013, PloS one.

[21]  S. Pluijm,et al.  Are IADLs comparable across countries? Sociodemographic associates of harmonized IADL measures , 2003, Aging clinical and experimental research.

[22]  C. Brayne,et al.  Cognition and survival: an exploration in a large multicentre study of the population aged 65 years and over. , 2001, International journal of epidemiology.

[23]  Kaarin J Anstey,et al.  COSMIC (Cohort Studies of Memory in an International Consortium): An international consortium to identify risk and protective factors and biomarkers of cognitive ageing and dementia in diverse ethnic and sociocultural groups , 2013, Alzheimer's & Dementia.

[24]  W. Sturm,et al.  Neuropsychological assessment , 2007, Journal of Neurology.

[25]  Carol Brayne,et al.  Cohort profile: the Medical Research Council Cognitive Function and Ageing Study (CFAS). , 2006, International journal of epidemiology.

[26]  L. Rodríguez-Mañas,et al.  Mild cognitive impairment diagnosed with the new DSM‐5 criteria: prevalence and associations with non‐cognitive psychopathology , 2015, Acta psychiatrica Scandinavica.

[27]  E G Tangalos,et al.  Prevalence of mild cognitive impairment is higher in men , 2010, Neurology.

[28]  A. Wimo,et al.  The global prevalence of dementia: A systematic review and metaanalysis , 2013, Alzheimer's & Dementia.

[29]  S. DeKosky,et al.  Ten-year incidence of dementia in a rural elderly US community population , 2000, Neurology.

[30]  R. Newcombe Two-sided confidence intervals for the single proportion: comparison of seven methods. , 1998, Statistics in medicine.

[31]  D. Royall,et al.  Risk factors for mild cognitive impairment among Mexican Americans , 2013, Alzheimer's & Dementia.

[32]  Dan Mungas,et al.  Progression of mild cognitive impairment to dementia in clinic- vs community-based cohorts. , 2009, Archives of neurology.

[33]  R. Costa,et al.  Incidence of AD in African-Americans, Caribbean Hispanics, and Caucasians in northern Manhattan , 2001, Neurology.

[34]  J. Morris,et al.  Clinical Dementia Rating: A Reliable and Valid Diagnostic and Staging Measure for Dementia of the Alzheimer Type , 1997, International Psychogeriatrics.

[35]  M. Lawton,et al.  Assessment of older people: self-maintaining and instrumental activities of daily living. , 1969, The Gerontologist.

[36]  Gianluigi Forloni,et al.  Brain aging and dementia during the transition from late adulthood to old age: design and methodology of the “Invece.Ab” population-based study , 2013, BMC Geriatrics.

[37]  K. Yaffe,et al.  The projected effect of risk factor reduction on Alzheimer's disease prevalence , 2011, The Lancet Neurology.

[38]  J. D. Crawford,et al.  Impairment in instrumental activities of daily living with high cognitive demand is an early marker of mild cognitive impairment: the Sydney Memory and Ageing Study , 2013, Psychological Medicine.

[39]  Nick C Fox,et al.  The Diagnosis of Mild Cognitive Impairment due to Alzheimer’s Disease: Recommendations from the National Institute on Aging-Alzheimer’s Association Workgroups on Diagnostic Guidelines for Alzheimer’s Disease , 2011 .

[40]  E. Teng,et al.  Persistence of Neuropsychological Testing Deficits in Mild Cognitive Impairment , 2009, Dementia and Geriatric Cognitive Disorders.

[41]  W. Krampla,et al.  Conversion from subtypes of mild cognitive impairment to Alzheimer dementia , 2007, Neurology.

[42]  W. Chan,et al.  Cognitive predictors for five-year conversion to dementia in community-dwelling Chinese older adults , 2013, International Psychogeriatrics.

[43]  J. Escobar,et al.  Use of the Mini-Mental State Examination (MMSE) in a Community Population of Mixed Ethnicity: Cultural and Linguistic Artifacts , 1986, The Journal of nervous and mental disease.

[44]  B. Reisberg,et al.  The Global Deterioration Scale for assessment of primary degenerative dementia. , 1982, The American journal of psychiatry.

[45]  R. Petersen Mild cognitive impairment as a diagnostic entity , 2004, Journal of internal medicine.

[46]  B. Reisberg,et al.  Mild cognitive impairment in the elderly , 1991, Neurology.

[47]  C. Jack,et al.  Mild cognitive impairment: ten years later. , 2009, Archives of neurology.

[48]  J. Bond,et al.  Early Cognitive Change in the General Population: How Do Different Definitions Work? , 2007, Journal of the American Geriatrics Society.

[49]  J. Quinn,et al.  Nutritional biomarkers in Alzheimer's disease: the association between carotenoids, n-3 fatty acids, and dementia severity. , 2008, Journal of Alzheimer's disease : JAD.

[50]  C. P. Hughes,et al.  A New Clinical Scale for the Staging of Dementia , 1982, British Journal of Psychiatry.

[51]  W. Maier,et al.  Risk factors for incident mild cognitive impairment – results from the German Study on Ageing, Cognition and Dementia in Primary Care Patients (AgeCoDe) , 2010, Acta psychiatrica Scandinavica.

[52]  A. Roses,et al.  A comparison of neuropsychological performance between US and Russia: Preparing for a global clinical trial , 2014, Alzheimer's & Dementia.

[53]  Bruno Vellas,et al.  Disease-modifying trials in Alzheimer's disease: a European task force consensus , 2007, The Lancet Neurology.

[54]  H. Arrighi,et al.  Mild cognitive impairment: Disparity of incidence and prevalence estimates , 2012, Alzheimer's & Dementia.

[55]  C. Jack,et al.  Mild cognitive impairment – beyond controversies, towards a consensus: report of the International Working Group on Mild Cognitive Impairment , 2004, Journal of internal medicine.

[56]  D. Knook,et al.  Impact of mild cognitive impairment on survival in very elderly people: cohort study , 1997, BMJ.

[57]  Nathaniel Mercaldo,et al.  The Alzheimer's Disease Centers' Uniform Data Set (UDS): The Neuropsychologic Test Battery , 2009, Alzheimer disease and associated disorders.

[58]  L. Fratiglioni,et al.  Mild cognitive impairment: a concept in evolution , 2014, Journal of internal medicine.

[59]  Mark W. Bondi,et al.  Mild Cognitive Impairment: A Concept and Diagnostic Entity in Need of Input from Neuropsychology , 2014, Journal of the International Neuropsychological Society.

[60]  Henry Brodaty,et al.  Effect of different impairment criteria on prevalence of “objective” mild cognitive impairment in a community sample. , 2010, The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry.

[61]  S. Riedel-Heller,et al.  Recruitment Procedures and Their Impact on the Prevalence of Dementia , 2000, Neuroepidemiology.

[62]  G. Andrews,et al.  Effects of sociodemographic and health variables on Mini-Mental State Exam scores in older Australians. , 2007, The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry.

[63]  Amy E. Sanders,et al.  Age-specific and Sex-specific Prevalence and Incidence of Mild Cognitive Impairment, Dementia, and Alzheimer Dementia in Blacks and Whites: A Report From the Einstein Aging Study , 2012, Alzheimer disease and associated disorders.

[64]  James R. Burke,et al.  Systematic Review: Factors Associated With Risk for and Possible Prevention of Cognitive Decline in Later Life , 2010, Annals of Internal Medicine.

[65]  C. Berr,et al.  Designing prevention programmes to reduce incidence of dementia: prospective cohort study of modifiable risk factors , 2010, BMJ : British Medical Journal.