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CIND and MCI in the Italian elderly

Frequency, vascular risk factors, progression to dementia

From the Institute of Neurosciences, Italian Longitudinal Study on Aging (ILSA) Study, Italian National Research Council, Florence, Italy (A.D.C., M.B.); Department of Neurological and Psychiatric Sciences, University of Florence, Italy (M.L., D.I.); Department of Critical Care Medicine and Surgery, Unit of Gerontology and Geriatrics, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy (M.I.); and Laboratorio di Epidemiologia e Biostatistica, Istituto Superiore di Sanità, Rome, Italy (E.S., G.F.).

Address correspondence and reprint requests to Dr. Antonio Di Carlo, Institute of Neurosciences, ILSA Study, Italian National Research Council, Viale Morgagni 46/48, 50134 Firenze, Italy dicarlo{at}in.cnr.it

Objective: To estimate prevalence and progression to dementia of cognitive impairment, no dementia (CIND), mild cognitive impairment (MCI), and relative subtypes, evaluating the relationships with daily functioning, cardiovascular diseases and vascular risk factors.

Methods: We evaluated CIND and MCI in the Italian Longitudinal Study on Aging. The neuropsychological battery assessed global cognitive function, memory and attention. Two thousand eight hundred thirty participants were examined at baseline and after a mean follow-up of 3.9 ± 0.7 years.

Results: The prevalence was 9.5% for CIND and 16.1% for MCI. Prevalence rates for CIND subtypes were 1.8% for amnestic, 2.3% for single nonmemory, 1.5% for multidomain, and 3.9% for CIND defined only on global cognitive function. The prevalence was 7.0% for amnestic, 7.8% for single nonmemory, and 1.3% for multidomain MCI. Incidence of dementia (per 1,000 person-years) was 7.63 in the total sample, 21.37 in CIND, and 13.59 in MCI. In MCI, rates ranged from 8.74 in amnestic to 40.60 in multidomain subtype. The highest incidence of 56.02 per 1,000 person-years was found in multidomain CIND. Both CIND and MCI increased by almost three times the risk of dementia at follow-up. Among baseline variables, only previous stroke and impairment in instrumental activities of daily living significantly increased the risk of dementia at follow-up.

Conclusions: Both cognitive impairment, no dementia and mild cognitive impairment are frequent in the Italian elderly (2,955,000 prevalent cases expected) and significantly predict progression to dementia. Individuation of subgroups with different risk factors and transition rates to dementia is required to plan early and cost-effective interventions.

Supplemental data at www.neurology.org

As part of the Progetto Finalizzato Invecchiamento, the ILSA was supported by the Italian National Research Council, with annual grants to each research unit from 1991 through 1995.

Disclosure: The authors report no conflicts of interest.

Received July 26, 2006. Accepted in final form February 1, 2007.

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