G Marcos1,2, J Santabárbara1,2, R Lopez-Anton2,3, C De-la-Cámara2,4,5, P Gracia-García2,4,5, E Lobo1,2, G Pírez4, J M Menchón6,7, T Palomo7,8, B C M Stephan9, C Brayne10, A Lobo2,5,7. 1. Department of Microbiology, Preventive Medicine and Public Health, Universidad de Zaragoza, Zaragoza, Spain. 2. Instituto de Investigación Sanitaria, IIS-Aragon, Zaragoza, Spain. 3. Department of Psychology and Sociology, Universidad de Zaragoza, Zaragoza, Spain. 4. Psychiatry Service, Hospital Clínico Universitario, Zaragoza, Spain. 5. Department of Medicine and Psychiatry, Universidad de Zaragoza, Zaragoza, Spain. 6. Department of Psychiatry, Bellvitge University Hospital-IDIBELL, University of Barcelona, Barcelona, Spain. 7. Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation, Madrid, Spain. 8. Department of Psychiatry, Universidad Complutense, Madrid, Spain. 9. Institute of Healthy and Society, Newcastle University Institute for Ageing, Newcastle University, Newcastle Upon Tyne, UK. 10. Cambridge Institute of Public Health, University of Cambridge School of Clinical Medicine, Cambridge, UK.
Abstract
OBJECTIVE: In a background of revision of criteria for states of increased risk for progression to dementia, we compare the conversion rate to dementia and Alzheimer's disease (AD) of mild cognitive impairment (MCI) as diagnosed using DSM-5 (DSM-5-MCI) and Petersen's (P-MCI) criteria. METHOD: A population representative cohort of 4057 dementia-free individuals 55+ years of age was followed up at 2.5 and 4.5 years in Zaragoza, Spain (ZARADEMP). Using the Geriatric Mental State- AGECAT for assessment, research psychiatrists diagnosed DSM-5-MCI and P-MCI following operationalized criteria. 'Conversion rate' (CR), 'annual conversion rate' (ACR), and incidence rate (IR) were calculated along with incidence rate ratio (IRR) to compare the performance of the intermediate cognitive definitions. RESULTS: At 4.5-year follow-up, in individuals aged 65+ years, ACRs for non-cases, P-MCI, and DSM-5-MCI were 0.8, 1.9 and 3.4, respectively, for global dementia. The IRRs were 2.9 and 5.3 for P-MCI and DSM5-MCI, respectively, being the non-cases the reference category. The corresponding values were slightly lower for AD. CONCLUSION: Conversion rate to dementia and AD was higher using DSM-5-MCI criteria than using Petersen's criteria. However, prediction of the construct still has some way to go, as most MCI individuals did not convert at 4.5-year follow-up.
OBJECTIVE: In a background of revision of criteria for states of increased risk for progression to dementia, we compare the conversion rate to dementia and Alzheimer's disease (AD) of mild cognitive impairment (MCI) as diagnosed using DSM-5 (DSM-5-MCI) and Petersen's (P-MCI) criteria. METHOD: A population representative cohort of 4057 dementia-free individuals 55+ years of age was followed up at 2.5 and 4.5 years in Zaragoza, Spain (ZARADEMP). Using the Geriatric Mental State- AGECAT for assessment, research psychiatrists diagnosed DSM-5-MCI and P-MCI following operationalized criteria. 'Conversion rate' (CR), 'annual conversion rate' (ACR), and incidence rate (IR) were calculated along with incidence rate ratio (IRR) to compare the performance of the intermediate cognitive definitions. RESULTS: At 4.5-year follow-up, in individuals aged 65+ years, ACRs for non-cases, P-MCI, and DSM-5-MCI were 0.8, 1.9 and 3.4, respectively, for global dementia. The IRRs were 2.9 and 5.3 for P-MCI and DSM5-MCI, respectively, being the non-cases the reference category. The corresponding values were slightly lower for AD. CONCLUSION: Conversion rate to dementia and AD was higher using DSM-5-MCI criteria than using Petersen's criteria. However, prediction of the construct still has some way to go, as most MCI individuals did not convert at 4.5-year follow-up.
Authors: Margarete Klein; Maria Aparecida Silva; Gabriel Okawa Belizario; Cristiana Castanho de Almeida Rocca; Antonio De Padua Serafim; Mario R Louzã Journal: Front Psychol Date: 2019-05-28