title: Estimating the risk for conversion from mild cognitive impairment to Alzheimer's disease in an elderly Arab community.
abstract: BACKGROUND
  Vascular risk factors and lack of formal education may increase the risk of Alzheimer's disease (AD).
  
  
  OBJECTIVE
  To determine the contribution of vascular risk factors and education to the risk of mild cognitive impairment (MCI) and AD and to estimate the risk for conversion from MCI to AD.
  
  
  METHODS
  This door-to-door survey was performed by an Arab-speaking team in Wadi Ara villages in Israel. All consenting residents aged ≥ 65 years were interviewed for medical history and underwent neurological and cognitive examinations. Individuals were cognitively classified as normal (CN), MCI, AD, vascular dementia, or unclassifiable. MCI patients were re-examined at least one year later to determine conversion to AD. The contributions of age, gender, school years, and vascular risk factors to the probability of conversion were estimated using logistic regression models.
  
  
  RESULTS
  Of the 906 participants, 297 (33%) had MCI and 95 (10%) had AD. Older age (p = 0.0008), female gender (p = 0.023), low schooling (p < 0.0001), and hypertension (p = 0.0002) significantly accounted for risk of MCI versus CN, and diabetes was borderline (p = 0.051). The risk of AD versus CN was significantly associated with age (p < 0.0001), female gender (p < 0.0001), low schooling (p = 0.004) and hypertension (p = 0.049). Of the 231 subjects with MCI that were re-examined, 65 converted to AD.
  
  
  CONCLUSIONS
  In this population, age, female gender, lack of formal education, and hypertension are risk factors for both AD and MCI. Conversion risk from MCI to AD could be estimated as a function of age, time interval between examinations, and hypertension.
authors.affiliation: Department of Neurology, Sackler Faculty of Medicine, Tel Aviv University, Israel The Sagol Neuroscience Center, Department of Neurology, Sheba Medical Center, Israel.
authors.forename: Rivka
authors.initials: R
authors.lastname: Inzelberg
authors.affiliation: Department of Neurology, Hillel Yaffe Medical Center, Hadera, Israel.
authors.forename: Magda
authors.initials: M
authors.lastname: Massarwa
authors.affiliation: Department of Industrial Engineering and Management, Ben-Gurion University of the Negev, Beer Sheva, Israel.
authors.forename: Edna
authors.initials: E
authors.lastname: Schechtman
authors.affiliation: The Sagol Neuroscience Center, Department of Neurology, Sheba Medical Center, Israel.
authors.forename: Rosa
authors.initials: R
authors.lastname: Strugatsky
authors.affiliation: Departments of Medicine (Genetics Program), Neurology, Ophthalmology, Genetics & Genomics, Epidemiology, and Biostatistics, Boston University Schools of Medicine and Public Health, Boston, USA.
authors.forename: Lindsay A
authors.initials: LA
authors.lastname: Farrer
authors.affiliation: Department of Neurology, University of Louisville, Kentucky, USA.
authors.forename: Robert P
authors.initials: RP
authors.lastname: Friedland
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000150:complications* / Q000453:epidemiology* / Q000208:ethnology; D018912:Arabs; D001794:Blood Pressure; D003072:Cognition Disorders / Q000453:epidemiology* / Q000208:ethnology / Q000209:etiology*; D018450:Disease Progression; D004522:Educational Status; D005260:Female; D006801:Humans; D007557:Israel; D016015:Logistic Models; D008297:Male; D011336:Probability; D012111:Residence Characteristics; D012307:Risk Factors; D012737:Sex Factors
keywords: Aging; Alzheimer's disease; Arab; mild cognitive impairment; neuroepidemiology; prevalence; risk factors