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P2‐289: PREVALENCE AND CORRELATES OF SUBJECTIVE MEMORY IMPAIRMENT IN A RURAL ITALIAN POPULATION OF SUBJECTS AGED 50 YEARS AND OVER: DATA FROM THE ZABUT AGING PROJECT
Author(s) -
Monastero Roberto,
Aronica Angela,
Camarda Cecilia,
Conticelli Maria,
Sardo Salvatore Sutera,
Camarda Rosolino
Publication year - 2014
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2014.05.967
Subject(s) - dementia , medicine , odds ratio , epidemiology , population , depression (economics) , gerontology , demography , psychology , disease , sociology , environmental health , economics , macroeconomics
Background: Neuropathology related to dementia slowly accumulates over decades. Consequently, identifying persons at a higher risk of dementia could postpone or prevent dementia by timely targeting modifiable risk factors. In this light, mild cognitive impairment (MCI) has been identified as the transitional stage between normal aging and dementia. So far, the understanding of MCI in thegeneral population remains limited. Therefore,we investigated determinants, MRI-correlates, and prognosis of MCI within the populationbasedRotterdamStudy.Methods:A total of 4198 participants were included in this study. Firstly, we studied age, APOE4 carriership, waist circumference, hypertension, diabetes mellitus, total and HDL-cholesterol levels, smoking, and stroke as potential determinants of MCI. Determinants were assessed cross-sectionally at baseline (2002-2005) and up to 7 years prior to baseline (1997-2001). Secondly, in a subset of 682 participants, we compared volumetric, microstructural, and focal MRI-correlates in persons with and withoutMCI. Thirdly, we followed participants for incident dementia and mortality until 2012 and assessed associations between MCI and the risk of dementia, Alzheimer’s disease, and mortality. Results: 417 Participants had MCI, of whom 254 non-amnestic and 163 amnestic MCI. At baseline, older age (OR 1.20, 95%-CI 1.11;1.29), APOE -e4 carriership (OR 1.26, 95%-CI 1.00;1.59), lower total cholesterol levels (OR 0.87, 95%-CI 0.78;0.98), and stroke (OR 2.12, 95%-CI 1.40;3.19) were related to MCI. Additionally, lower HDL-cholesterol levels (OR 0.86, 95%-CI 0.75;0.98) and current smoking (OR 1.49, 95%-CI 1.06;2.09) were associated with MCI when assessed 7 years prior to baseline. Persons with MCI, particularly thosewith non-amnestic MCI, had larger white matter lesion volumes, worse microstructural integrity of normal-appearing white matter, and higher prevalence of lacunes, compared to cognitively healthy participants. MCI was associated with an increased risk of dementia (HR 3.98, 95%-CI 2.97;5.33), Alzheimer’s disease (HR 4.03, 95% CI 2.92;5.56), and mortality (HR 1.54, 95%-CI 1.28;1.85). Figure shows cumulative incidence curves of dementia, Alzheimer’s disease, and mortality of persons without MCI and those with non-amnestic and amnestic MCI. Conclusions: We found that several vascular risk factors and MRI-correlates of cerebrovascular disease related to MCI in the general population. Participants with MCI had an increased risk of dementia, including Alzheimer’s disease, and mortality.