title: Mortality in Mild Cognitive Impairment Diagnosed with DSM-5 Criteria and with Petersen's Criteria: A 17-Year Follow-Up in a Community Study.
abstract: To explore the possibility that the mortality risk of mild cognitive impairment (MCI) as diagnosed using Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria (DSM-5-MCI) will be higher than using Petersen's criteria (P-MCI) and to report the population-attributable fraction (PAF) of mortality due to MCI.
  
  
  
  A representative community sample of 4,803 individuals aged 55 or more years was interviewed and then followed for 17 years. Standardized instruments were used in the assessment, including the Geriatric Mental State-AGECAT, and research psychiatrists diagnosed P-MCI and DSM-5-MCI cases following operationalized criteria. Mortality information was obtained from the official population registry. Kaplan-Meier age-adjusted survival curves were built for the MCI diagnostic groups, and Cox proportional hazards regression models were used to calculate the hazard ratio of death in participants with MCI relative to those without. We also estimated the PAF of mortality due to specific MCI diagnostic groups.
  
  
  
  Compared with noncases, the mortality rate ratio was approximately double in DSM-5-MCI individuals (2.3) than in P-MCI individuals (1.2). In the multivariate statistical analysis, a significant association between each diagnostic category and mortality was observed but was only maintained in the final model in DSM-5-MCI cases (hazard ratio: 1.24). The PAF of mortality due to MCI was approximately 1% in both MCI categories.
  
  
  
  The mortality risk in comparison with noncases was higher in DSM-5-MCI than in P-MCI. The PAF of mortality in DSM-5-MCI individuals was ~ 1% over a 17-year period.
authors.affiliation: Department of Preventive Medicine and Public Health, Universidad de Zaragoza, Zaragoza, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Santabárbara
authors.affiliation: Department of Medicine and Psychiatry, Universidad de Zaragoza, Zaragoza, Spain; Psychiatry Service, Universidad de Zaragoza, Zaragoza, Spain.
authors.forename: Patricia
authors.initials: P
authors.lastname: Gracia-García
authors.affiliation: Department of Medicine and Psychiatry, Universidad de Zaragoza, Zaragoza, Spain; Centre Assistencial Sant Joan de Déu d'Almacelles, Lérida, Spain.
authors.forename: Guillermo
authors.initials: G
authors.lastname: Pírez
authors.affiliation: Department of Psychology and Sociology, Universidad de Zaragoza, Zaragoza, Spain.
authors.forename: Raúl
authors.initials: R
authors.lastname: López-Antón
authors.affiliation: Department of Medicine and Psychiatry, Universidad de Zaragoza, Zaragoza, Spain; Psychiatry Service, Universidad de Zaragoza, Zaragoza, Spain; Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain.
authors.forename: Concepcion
authors.initials: C
authors.lastname: De La Cámara
authors.affiliation: Department of Medicine and Psychiatry, Universidad de Zaragoza, Zaragoza, Spain; Psychiatry Service, Universidad de Zaragoza, Zaragoza, Spain; Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain.
authors.forename: Tirso
authors.initials: T
authors.lastname: Ventura
authors.affiliation: Department of Preventive Medicine and Public Health, Universidad de Zaragoza, Zaragoza, Spain.
authors.forename: Marina
authors.initials: M
authors.lastname: Pérez-Sastre
authors.affiliation: Department of Preventive Medicine and Public Health, Universidad de Zaragoza, Zaragoza, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Lobo
authors.affiliation: Department of Medicine and Psychiatry, Universidad de Zaragoza, Zaragoza, Spain.
authors.forename: Pedro
authors.initials: P
authors.lastname: Saz
authors.affiliation: Department of Preventive Medicine and Public Health, Universidad de Zaragoza, Zaragoza, Spain; Medical Records Service, Hospital Clínico Universitario, Zaragoza, Spain; Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain.
authors.forename: Guillermo
authors.initials: G
authors.lastname: Marcos
authors.affiliation: Department of Medicine and Psychiatry, Universidad de Zaragoza, Zaragoza, Spain; Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation, Madrid, Spain. Electronic address: alobo@unizar.es.
authors.forename: Antonio
authors.initials: A
authors.lastname: Lobo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002423:Cause of Death; D060825:Cognitive Dysfunction / Q000175:diagnosis / Q000453:epidemiology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009026:Mortality; D015999:Multivariate Analysis; D016016:Proportional Hazards Models
keywords: DSM-5; ZARADEMP; community study; mild cognitive impairment; mortality; population-attributable fraction