Prevalence of mild cognitive impairment by multiple classifications: The Monongahela-Youghiogheny Healthy Aging Team (MYHAT) project.
OBJECTIVE
To estimate and compare the frequency and prevalence of mild cognitive impairment (MCI) and related entities using different classification approaches at the population level.


METHODS
Cross-sectional epidemiologic study of population-based cohort recruited by age-stratified random sampling from electoral rolls.


METHODS
Small-town communities in western Pennsylvania.


METHODS
Of 2,036 individuals aged 65 years and older, 1,982 participants with normal or mildly impaired cognition (age-education-corrected Mini-Mental State scores ≥ 21).


METHODS
Demographics, neuropsychological assessment expressed as cognitive domains, functional ability, and subjective reports of cognitive difficulties; based on these measurements, operational criteria for the Clinical Dementia Rating (CDR) scale, the 1999 criteria for amnestic MCI, the 2004 Expanded criteria for MCI, and new, purely cognitive criteria for MCI.


RESULTS
A CDR rating of 0.5 (uncertain/very mild dementia) was obtained by 27.6% of participants, whereas 1.2% had CDR ≥ 1 (mild or moderate dementia). Among those with CDR <1, 2.27% had amnestic MCI and 17.66% had expanded MCI, whereas 35.17% had MCI by purely cognitive classification. Isolated executive function impairment was the least common, whereas impairment in multiple domains including executive function was the most common. Prevalence estimates weighted against the U.S. Census are also provided.


CONCLUSIONS
The manner in which criteria for MCI are operationalized determines the proportion of individuals who are thus classified and the degree of overlap with other criteria. Prospective follow-up is needed to determine progression from MCI to dementia and thus empirically develop improved MCI criteria with good predictive value.
Ganguli
Mary
M
Department of Psychiatry, University of Pittsburgh School of Medicine, PA, USA. gangulim@upmc.edu
Chang
Chung-Chou H
CC
Snitz
Beth E
BE
Saxton
Judith A
JA
Vanderbilt
Joni
J
Lee
Ching-Wen
CW
D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D003704:Dementia / Q000175:diagnosis / Q000453:epidemiology; D018450:Disease Progression; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D010414:Pennsylvania / Q000453:epidemiology; D015995:Prevalence