title: Trajectory of mild cognitive impairment onset.
abstract: The objective was to identify the trajectories of onset of memory and other cognitive loss in persons destined to develop mild cognitive impairment (MCI) or dementia. Healthy, community dwelling, cognitively intact elders (n = 156, mean age at entry = 83 years) were examined annually for an average of greater than 7 years. Those who developed at least two consecutive Clinical Dementia Ratings >or= 0.5 were classified as having MCI. Longitudinal mixed effects models with a change point were used to model the aging process in those with and without an MCI diagnosis during follow-up and to model the rate of change relative to the age of onset of MCI. MCI had a preclinical stage of accelerated cognitive loss that was observed 3 to 4 years before the diagnosis of MCI on tests of verbal memory, animal fluency, and visuospatial constructions. Evidence from memory performance before the change point suggests that a slow decline in memory precedes the period of accelerated decline in the development of MCI. Aging transitions leading to MCI and dementia are characterized by unique linear and nonlinear cognitive changes in several domains that precede the diagnosis of MCI and dementia by at least several years.
authors.affiliation: Department of Neurology, Oregon Health & Science University, Portland, Oregon 97239, USA. howiesod@ohsu.edu
authors.forename: Diane B
authors.initials: DB
authors.lastname: Howieson
authors.forename: Nichole E
authors.initials: NE
authors.lastname: Carlson
authors.forename: M Milar
authors.initials: MM
authors.lastname: Moore
authors.forename: Dara
authors.initials: D
authors.lastname: Wasserman
authors.forename: Cena D
authors.initials: CD
authors.lastname: Abendroth
authors.forename: Jessica
authors.initials: J
authors.lastname: Payne-Murphy
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Kaye
mesh_terms: D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D003072:Cognition Disorders / Q000473:pathology / Q000503:physiopathology*; D016001:Confidence Intervals; D003704:Dementia / Q000473:pathology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007361:Intelligence Tests; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008568:Memory / Q000502:physiology*; D009460:Neurologic Examination; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies