title: Reversible Mild Cognitive Impairment: The Role of Comorbidities at Baseline Evaluation.
abstract: The prognostic value of mild cognitive impairment (MCI) is being questioned, with some MCI subjects reverting to normal cognition (NC). The reversion rate varies mostly depending on the study design, the setting, and both MCI and NC definitions. Previous studies have focused on the profile of subjects who revert to NC, but the role of comorbidities has not been entirely investigated. We aimed to evaluate the proportion of MCI subjects who revert to NC in a memory clinic context, focusing on the role of comorbidities. Between 2004 and 2013, 374 MCI subjects were recruited. During a mean time of 32 ± 25.5 months, 21 subjects (5.6%) reverted to NC. Subjects who reverted to NC were younger (p = 0.0001), more educated (p = 0.0001), had a better global cognition (p = 0.0001), as assessed by the Mini-Mental State Examination (MMSE) and suffered from more comorbidities (p = 0.002), as assessed by Cumulative Illness Rating Scale (CIRS) than those who developed dementia. The Cox Regression Model, constructed to adjust for the confounders, showed that the higher were the MMSE (HR = 1.83, CI 95%: 1.07-3.11) and the CIRS score (HR = 1.3, CI 95% 0.88-1.92) at baseline, the higher was the probability of returning to NC than developing dementia, though the last association was not significant. Subjects who reverted to NC were more frequently affected by respiratory (p = 0.002), urologic (p = 0.012), and psychiatric (p = 0.012) diseases. The cognitive performance of subjects with medical comorbidities could benefit from preventive strategies aimed at treating the underlying diseases.
authors.affiliation: Center for Research and Treatment on Cognitive Dysfunctions, Biomedical and Clinical Sciences Department, "Luigi Sacco" Hospital, University of Milan, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Grande
authors.affiliation: Center for Research and Treatment on Cognitive Dysfunctions, Biomedical and Clinical Sciences Department, "Luigi Sacco" Hospital, University of Milan, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Cucumo
authors.affiliation: Center for Research and Treatment on Cognitive Dysfunctions, Biomedical and Clinical Sciences Department, "Luigi Sacco" Hospital, University of Milan, Italy.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Cova
authors.affiliation: Center for Research and Treatment on Cognitive Dysfunctions, Biomedical and Clinical Sciences Department, "Luigi Sacco" Hospital, University of Milan, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Ghiretti
authors.affiliation: Center for Research and Treatment on Cognitive Dysfunctions, Biomedical and Clinical Sciences Department, "Luigi Sacco" Hospital, University of Milan, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Maggiore
authors.affiliation: National Centre of Epidemiology, National Institute of Health, Rome, Italy.
authors.forename: Eleonora
authors.initials: E
authors.lastname: Lacorte
authors.affiliation: Department of Pathophysiology and Transplantation, University of Milan, Fondazione Cà Granda, IRCCS Ospedale Policlinico, Milan, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Galimberti
authors.affiliation: Department of Pathophysiology and Transplantation, University of Milan, Fondazione Cà Granda, IRCCS Ospedale Policlinico, Milan, Italy.
authors.forename: Elio
authors.initials: E
authors.lastname: Scarpini
authors.affiliation: Center for Research and Treatment on Cognitive Dysfunctions, Biomedical and Clinical Sciences Department, "Luigi Sacco" Hospital, University of Milan, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Clerici
authors.affiliation: Center for Research and Treatment on Cognitive Dysfunctions, Biomedical and Clinical Sciences Department, "Luigi Sacco" Hospital, University of Milan, Italy.
authors.forename: Simone
authors.initials: S
authors.lastname: Pomati
authors.affiliation: National Centre of Epidemiology, National Institute of Health, Rome, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Vanacore
authors.affiliation: Center for Research and Treatment on Cognitive Dysfunctions, Biomedical and Clinical Sciences Department, "Luigi Sacco" Hospital, University of Milan, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Mariani
mesh_terms: D000704:Analysis of Variance; D060825:Cognitive Dysfunction / Q000453:epidemiology*; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008568:Memory; D008609:Mental Status Schedule; D009483:Neuropsychological Tests; D012016:Reference Values; D014706:Verbal Learning
keywords: Comorbidity; dementia; mild cognitive impairment; prevention