title: Dementia prediction for people with stroke in populations: is mild cognitive impairment a useful concept?
abstract: BACKGROUND
  criteria for mild cognitive impairment (MCI) capture an intermediate cognitive state between normal ageing and dementia, associated with increased dementia risk. Whether criteria for MCI are applicable in the context of stroke and can be used to predict dementia in stroke cases is not known.
  
  
  OBJECTIVE
  to determine the prevalence of MCI in individuals with stroke and identify predictors of 2-year incident dementia in stroke cases.
  
  
  METHODS
  individuals were from the Medical Research Council Cognitive Function and Ageing Study. MCI prevalence in individuals with stroke was determined. Logistic regression, with receiver operating characteristic curve analysis, was used to identify variables associated with risk of dementia in stroke cases including MCI criteria, demographic, health and lifestyle variables.
  
  
  RESULTS
  of 2,640 individuals seen at the first assessment, 199 reported stroke with no dementia. In individuals with stroke, criteria for MCI are not appropriate, with less than 1% of stroke cases being classified as having MCI. However, in individuals with stroke two components of the MCI definition, subjective memory complaint and cognitive function (memory and praxis scores) predicted 2-year incident dementia (area under the curve = 0.85, 95% CI: 0.77-0.94, n = 113).
  
  
  CONCLUSIONS
  criteria for MCI do not appear to capture risk of dementia in the context of stroke in the population. In stroke cases, subjective and objective cognitive performance predicts dementia and these variables could possibly be incorporated into dementia risk models for stroke cases. Identifying individuals with stroke at greatest risk of dementia has important implications for treatment and intervention.
authors.affiliation: Institute of Health and Society, Newcastle University, The Baddiley-Clark Building, Richardson Road Newcastle upon Tyne, NE2 4AX, UK.
authors.forename: Blossom C M
authors.initials: BC
authors.lastname: Stephan
authors.affiliation: Department of Public Health and Primary Care, Institute of Public Health, Cambridge University, Forvie Site, Robinson Way, Cambridge CB2 0SR, UK.
authors.forename: Thais
authors.initials: T
authors.lastname: Minett
authors.affiliation: MRC Lifelong Health and Ageing Unit at UCL, 33 Bedford Place, London, WC1B 5JU, UK.
authors.forename: Graciela Muniz
authors.initials: GM
authors.lastname: Terrera
authors.affiliation: MRC Biostatistics Unit, Cambridge Institute of Public Health, Cambridge University, Cambridge CB2 0SR, UK.
authors.forename: Fiona E
authors.initials: FE
authors.lastname: Matthews
authors.affiliation: Department of Public Health and Primary Care, Institute of Public Health, Cambridge University, Forvie Site, Robinson Way, Cambridge CB2 0SR, UK.
authors.forename: Carol
authors.initials: C
authors.lastname: Brayne
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D003071:Cognition; D060825:Cognitive Dysfunction / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D003704:Dementia / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D015995:Prevalence; D011379:Prognosis; D012372:ROC Curve; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D013997:Time Factors; D006113:United Kingdom / Q000453:epidemiology
keywords: dementia; epidemiology; mild cognitive impairment; older people; risk; stroke