03994nas a2200493 4500008004100000022001400041245010700055210006900162260001300231300001100244490000700255520261100262653000902873653002202882653002202904653001002926653002802936653002402964653001902988653002403007653001103031653001103042653002003053653002503073653003103098653000903129653001903138653001703157653001503174653001703189100002003206700002303226700002103249700002103270700002303291700002503314700001903339700002603358700001903384700001903403700002203422700002103444856003503465 2003 eng d a0003-994200aRisk factors for mild cognitive impairment in the Cardiovascular Health Study Cognition Study: part 2.0 aRisk factors for mild cognitive impairment in the Cardiovascular c2003 Oct a1394-90 v603 a

OBJECTIVE: To examine the risk factors for mild cognitive impairment (MCI) in a longitudinal population study-the Cardiovascular Health Study Cognition Study.

DESIGN: We examined the factors that in the period 1991 through 1994 predicted the development of MCI in all participants of the Cardiovascular Health Study Cognition Study. Further examination was conducted in the Pittsburgh, Pa, cohort (n = 927), where participants with MCI were classified as having either the MCI amnestic-type or the MCI multiple cognitive deficits-type.

SETTING: Multicenter population study.

PATIENTS: This study includes all participants of the Cardiovascular Health Study Cognition Study (n = 3608) who had a magnetic resonance imaging (MRI) scan of the brain between 1991 and 1994, and detailed neuropsychological, neurological, and medical evaluations to identify the presence of MCI or dementia in the period 1998 to 1999. The mean time between the closest clinical examination to the MRI and the diagnostic evaluation for cognitive disorders was 5.8 years for the Cardiovascular Health Study Cognition Study cohort and 6.0 years for the Pittsburgh cohort.

MAIN OUTCOME MEASURES: Risk factors for MCI at the time of the MRI were identified using logistic regression, controlling for age, race, educational level, baseline Modified Mini-Mental State Examination and Digit Symbol Test scores, measurements of depression, MRI findings (atrophy, ventricular volume, white matter lesions, and infarcts), the presence of the apolipoprotein E (APOE) epsilon4 allele, hypertension, diabetes mellitus, and heart disease.

RESULTS: Mild cognitive impairment (n = 577) was associated with race (African American), low educational level, low Modified Mini-Mental State Examination and Digit Symbol Test scores, cortical atrophy, MRI-identified infarcts, and measurements of depression. The MCI amnestic-type was associated with MRI-identified infarcts, the presence of the APOE epsilon4 allele, and low Modified Mini-Mental State Examination scores. The MCI multiple cognitive deficits-type was associated with low Modified Mini-Mental State Examination and Digit Symbol Test scores.

CONCLUSIONS: The development of MCI is associated with measurements of cognition and depression, racial and constitutional factors, and cerebrovascular disease. Early cognitive deficits seem to be a common denominator for the 2 forms of MCI; the presence of cerebrovascular disease and the APOE epsilon4 allele is associated with the amnestic type of MCI.

10aAged10aApolipoprotein E410aApolipoproteins E10aBrain10aCardiovascular Diseases10aCognition Disorders10aCohort Studies10aDepressive Disorder10aFemale10aHumans10aLogistic Models10aLongitudinal Studies10aMagnetic Resonance Imaging10aMale10aMood Disorders10aPennsylvania10aPopulation10aRisk Factors1 aLopez, Oscar, L1 aJagust, William, J1 aDulberg, Corinne1 aBecker, James, T1 aDeKosky, Steven, T1 aFitzpatrick, Annette1 aBreitner, John1 aLyketsos, Constantine1 aJones, Beverly1 aKawas, Claudia1 aCarlson, Michelle1 aKuller, Lewis, H uhttps://chs-nhlbi.org/node/756