title: Factors predicting reversion from mild cognitive impairment to normal cognitive functioning: a population-based study.
abstract: BACKGROUND
  Mild cognitive impairment (MCI) is associated with an increased risk of developing dementia. However, many individuals diagnosed with MCI are found to have reverted to normal cognition on follow-up. This study investigated factors predicting or associated with reversion from MCI to normal cognition.
  
  
  METHODS
  Our analyses considered 223 participants (48.9% male) aged 71-89 years, drawn from the prospective, population-based Sydney Memory and Ageing Study. All were diagnosed with MCI at baseline and subsequently classified with either normal cognition or repeat diagnosis of MCI after two years (a further 11 participants who progressed from MCI to dementia were excluded). Associations with reversion were investigated for (1) baseline factors that included diagnostic features, personality, neuroimaging, sociodemographics, lifestyle, and physical and mental health; (2) longitudinal change in potentially modifiable factors.
  
  
  RESULTS
  There were 66 reverters to normal cognition and 157 non-reverters (stable MCI). Regression analyses identified diagnostic features as most predictive of prognosis, with reversion less likely in participants with multiple-domain MCI (p = 0.011), a moderately or severely impaired cognitive domain (p = 0.002 and p = 0.006), or an informant-based memory complaint (p = 0.031). Reversion was also less likely for participants with arthritis (p = 0.037), but more likely for participants with higher complex mental activity (p = 0.003), greater openness to experience (p = 0.041), better vision (p = 0.014), better smelling ability (p = 0.040), or larger combined volume of the left hippocampus and left amygdala (p<0.040). Reversion was also associated with a larger drop in diastolic blood pressure between baseline and follow-up (p = 0.026).
  
  
  CONCLUSIONS
  Numerous factors are associated with reversion from MCI to normal cognition. Assessing these factors could facilitate more accurate prognosis of individuals with MCI. Participation in cognitively enriching activities and efforts to lower blood pressure might promote reversion.
authors.affiliation: Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales Medicine, Sydney, New South Wales, Australia. p.sachdev@unsw.edu.au
authors.forename: Perminder S
authors.initials: PS
authors.lastname: Sachdev
authors.forename: Darren M
authors.initials: DM
authors.lastname: Lipnicki
authors.forename: John
authors.initials: J
authors.lastname: Crawford
authors.forename: Simone
authors.initials: S
authors.lastname: Reppermund
authors.forename: Nicole A
authors.initials: NA
authors.lastname: Kochan
authors.forename: Julian N
authors.initials: JN
authors.lastname: Trollor
authors.forename: Wei
authors.initials: W
authors.lastname: Wen
authors.forename: Brian
authors.initials: B
authors.lastname: Draper
authors.forename: Melissa J
authors.initials: MJ
authors.lastname: Slavin
authors.forename: Kristan
authors.initials: K
authors.lastname: Kang
authors.forename: Ora
authors.initials: O
authors.lastname: Lux
authors.forename: Karen A
authors.initials: KA
authors.lastname: Mather
authors.forename: Henry
authors.initials: H
authors.lastname: Brodaty
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use; D003071:Cognition / Q000502:physiology*; D060825:Cognitive Dysfunction / Q000175:diagnosis / Q000503:physiopathology*; D003710:Demography; D005260:Female; D005500:Follow-Up Studies; D006262:Health; D006801:Humans; D008019:Life Style; D008297:Male
chemical_list: D000959:Antihypertensive Agents
references.citation: Arch Neurol. 2009 Sep;66(9):1151-7
references.pmid: 19752306
references.citation: Pain. 2002 Apr;96(3):279-284
references.pmid: 11973000
references.citation: J Am Geriatr Soc. 1965 Mar;13:243-7
references.pmid: 14270631
references.citation: J Clin Exp Neuropsychol. 2008 Feb;30(2):151-6
references.pmid: 18938667
references.citation: Arch Intern Med. 2002 Oct 14;162(18):2046-52
references.pmid: 12374512
references.citation: J Neurol Neurosurg Psychiatry. 2001 Sep;71(3):296-302
references.pmid: 11511700
references.citation: Brain Struct Funct. 2012 Jan;217(1):115-25
references.pmid: 21667303
references.citation: JAMA. 2003 May 21;289(19):2560-72
references.pmid: 12748199
references.citation: Neuroimage. 2007 Oct 15;38(1):95-113
references.pmid: 17761438
references.citation: J Clin Epidemiol. 1996 Dec;49(12):1373-9
references.pmid: 8970487
references.citation: Int Psychogeriatr. 2010 Dec;22(8):1248-64
references.pmid: 20637138
references.citation: Nat Rev Cardiol. 2010 Dec;7(12):686-98
references.pmid: 20978471
references.citation: Brain Res Rev. 2007 Nov;56(1):198-213
references.pmid: 17870176
references.citation: N Engl J Med. 2011 Jun 9;364(23):2227-34
references.pmid: 21651394
references.citation: J Psychiatr Res. 1975 Nov;12(3):189-98
references.pmid: 1202204
references.citation: Neurology. 2001 Jan 9;56(1):37-42
references.pmid: 11148233
references.citation: Am J Alzheimers Dis Other Demen. 2010 Nov;25(7):592-603
references.pmid: 20858651
references.citation: Int Psychogeriatr. 2009 Dec;21(6):1088-95
references.pmid: 19691909
references.citation: Dement Geriatr Cogn Disord. 2009;27(2):173-81
references.pmid: 19202336
references.citation: Dement Geriatr Cogn Disord. 2009;27(5):418-23
references.pmid: 19365121
references.citation: J Am Geriatr Soc. 2008 Aug;56(8):1424-33
references.pmid: 18662209
references.citation: Psychol Aging. 2010 Mar;25(1):60-73
references.pmid: 20230128
references.citation: Psychol Med. 2006 Aug;36(8):1065-73
references.pmid: 16650343
references.citation: Am J Geriatr Psychiatry. 2007 Jun;15(6):467-76
references.pmid: 17545447
references.citation: Dement Geriatr Cogn Disord. 2009;28(1):70-4
references.pmid: 19648748
references.citation: Neuroimage. 2010 Jul 15;51(4):1345-59
references.pmid: 20230901
references.citation: Arch Neurol. 1999 Mar;56(3):303-8
references.pmid: 10190820
references.citation: J Neurol Neurosurg Psychiatry. 2010 May;81(5):541-6
references.pmid: 19965857
references.citation: Am J Geriatr Psychiatry. 2009 Mar;17(3):175-8
references.pmid: 19225275
references.citation: Methods Find Exp Clin Pharmacol. 2004 Jun;26(5):339-43
references.pmid: 15319812
references.citation: Neuroimage. 2002 Jan;15(1):273-89
references.pmid: 11771995
references.citation: Dement Geriatr Cogn Disord. 1998;9 Suppl 2:20-6
references.pmid: 9718231
references.citation: Int Psychogeriatr. 2006 Sep;18(3):471-80
references.pmid: 16466589
references.citation: J Alzheimers Dis. 2012;31(3):669-76
references.pmid: 22647255
references.citation: Neuropsychology. 2012 Mar;26(2):209-223
references.pmid: 22251311
references.citation: Am J Geriatr Psychiatry. 2010 Aug;18(8):701-10
references.pmid: 21491631
references.citation: Hum Brain Mapp. 2009 Apr;30(4):1155-67
references.pmid: 18465744
references.citation: Dement Geriatr Cogn Disord. 2009;27(3):224-31
references.pmid: 19225236
references.citation: Ann Neurol. 2008 Apr;63(4):494-506
references.pmid: 18300306
references.citation: Fam Pract. 2011 Aug;28(4):385-92
references.pmid: 21402661
references.citation: Neurobiol Aging. 2010 Aug;31(8):1375-85
references.pmid: 20447732
references.citation: J Psychiatr Res. 1982-1983;17(1):37-49
references.pmid: 7183759
references.citation: Int J Geriatr Psychiatry. 2012 Dec;27(12):1218-38
references.pmid: 22396249
references.citation: Neurology. 2012 Oct 9;79(15):1591-8
references.pmid: 23019264
references.citation: Am J Geriatr Psychiatry. 2010 Aug;18(8):711-22
references.pmid: 21491632
references.citation: Arch Neurol. 2011 Jun;68(6):761-7
references.pmid: 21670400
references.citation: J Am Geriatr Soc. 2012 Jan;60(1):24-33
references.pmid: 22142389
references.citation: BMJ. 1988 Oct 8;297(6653):897-9
references.pmid: 3140969
references.citation: Lancet. 1990 Apr 28;335(8696):1037
references.pmid: 1970087
references.citation: Ann N Y Acad Sci. 2009 Jul;1170:730-5
references.pmid: 19686220
references.citation: J Intern Med. 2004 Sep;256(3):240-6
references.pmid: 15324367
references.citation: Alzheimers Dement. 2013 May;9(3):310-317.e1
references.pmid: 23110866
references.citation: Laryngoscope. 1996 Mar;106(3 Pt 1):353-6
references.pmid: 8614203