title: [Progression of Mild Cognitive Impairment to Dementia of Patients in German Primary Care Practices: A Retrospective Database Analysis].
abstract: AimTo estimate the rate of progression of mild cognitive impairment (MCI) to dementia and to identify potential risk factors in patients in German primary-care practices.MethodologyFrom those seen at 723 general physicians' practices, this study included 4057 patients aged 40 years and above who were initially diagnosed with MCI between 2000 and 2014. The primary outcome was diagnosis of all-cause dementia recorded between the index date and the end of the five-year follow-up. Cox regression models were performed to examine MCI progression to dementia when adjusted for confounders (age, sex and health insurance type).ResultsThe mean age was 73.9 years. There were 43.9 % of men and 5.2 % of individuals with private health insurance coverage. There were 27.4 % of women and 25.7 % of men with dementia after the five-year follow-up (P = 0.192). The proportion of dementia increased with age from 6.6 % in the age group of ≤ 60 years to 39.0 % in the age group of > 80 years, with the hazard ratio increasing every additional year (HR = 1.06).ConclusionAbout one out of four patients developed dementia in the five years following MCI diagnosis. Age but not sex or type of health insurance was associated with this higher risk.
authors.affiliation: Berufsverband Deutscher Nervenärzte (BVDN), Praxis Bohlken, Berlin, Germany.
authors.forename: Jens
authors.initials: J
authors.lastname: Bohlken
authors.affiliation: Epidemiologie, IMS Health, Frankfurt am Main, Germany.
authors.forename: Karel
authors.initials: K
authors.lastname: Kostev
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D060825:Cognitive Dysfunction / Q000175:diagnosis* / Q000453:epidemiology; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D003704:Dementia / Q000175:diagnosis* / Q000453:epidemiology; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000706:statistics & numerical data; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors