Prognosis of Mild Cognitive Impairment in General Practice: Results of the German AgeCoDe Study
The Article in Brief
Prognosis of Mild Cognitive Impairment in General Practice: Results of the German AgeCoDe Study
Marion Eisele , and colleagues
Background Mild cognitive impairment, a transitional state between normal and illness-related cognitive decline, is a common condition in the elderly. As part of the German Study on Aging, Cognition and Dementia in Primary Care Patients, this study investigated determinants of the course of mild cognitive impairment (MCI) in primary care patients.
What This Study Found Among 357 primary care patients aged 75 years or older with a diagnosis of MCI without dementia, 42% had a remittent course (remission of symptoms and normal cognitive function at 1.5 and 3 years later) 21% had a fluctuating course (status changed between MCI and normal cognitive function), 15% had a stable course (impairment neither worsened to dementia nor improved to normal cognitive function), and 22% had a progressive course (developed to dementia). Patients were at higher risk of advancing from one course to the next along this spectrum if they had symptoms of depression, impairment in more than one cognitive domain, more severe cognitive impairment, and were older. Patients' performance on learning new material and the Geriatric Depression Scale helped predict a progressive versus a remittent course.
Implications
- In a 3-year period, about one-quarter of patients with MCI progress to dementia, while three-quarters of patients stay cognitively stable or improve. As a result, the authors suggest that patients should not be alarmed unnecessarily by a diagnosis of MCI.