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From the Sanders-Brown Center on Aging (R.J.K., F.A.S., M.S.M., and W.R.M.), Department of Statistics (R.J.K.), Department of Biostatistics (R.J.K., W.R.M.), Department of Neurology (F.A.S., W.R.M.), Departments of Psychiatry, Psychology, and Behavioral Science (F.A.S.), and Department of Pathology and Laboratory Medicine (W.R.M.), University of Kentucky and Department of Statistics (J.C.S.), University of Columbia, Medellin.
Address correspondence and reprint requests to Dr. Richard Kryscio, University of Kentucky Medical Center, 311 Sanders-Brown Center on Aging, 800 S. Limestone St., Lexington, KY 40536-0230; e-mail: kryscio{at}uky.edu
Objective: To identify risk factors associated with transitions from cognitively normal to various forms of mild cognitive impairment (MCI) and then from MCI into early dementia with death as a competing state.
Methods: Cognitive assessments from 554 subjects participating in a longitudinal study at the University of Kentucky AD Center were used to classify individuals into one of three transient states at any visit: cognitively normal, amnestic MCI, or mixed MCI. Between visits subjects could die or become demented. A series of polytomous logistic models were used to model transitions among these states over time and to determine how the log odds of these transitions vary with age, education, sex, family history of dementia, and APOE status.
Results: Age affects all transitions among transient states as well as those to dementia or death. Presence of at least one apolipoprotein 4 allele affects transitions from cognitively normal into amnestic MCI or into dementia. At most 12 years of education affects transitions into mixed MCI. Transitions do not vary with sex or family history.
Conclusion: Aside from age, the usual risk factors associated with conversion from cognitively normal into dementia are likely risk factors for transitions into mild cognitive impairment.
Additional material related to this article can be found on the Neurology Web site. Go to www.neurology.org and scroll down the Table of Contents for the March 28 issue to find the title link for this article.
Supported by National Institute on Aging ADRC grants P50 AG05144 and R01 AG19241, by National Center for Research Resources GCRC grant M01-RR02602, and a grant from the Abercrombie Foundation.
Disclosure: The authors report no conflicts of interest.
Received April 11, 2005. Accepted in final form November 28, 2005.
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Neurology 2006 66: 790-791.
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