Tobias Luck1, Francisca S Then2, Matthias L Schroeter3, Veronica Witte4, Christoph Engel5, Markus Loeffler5, Joachim Thiery6, Arno Villringer3, Steffi G Riedel-Heller7. 1. Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany; LIFE-Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany. Electronic address: tobias.luck@medizin.uni-leipzig.de. 2. Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany; LIFE-Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany. 3. Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany; Day Clinic for Cognitive Neurology, University Hospital Leipzig, Leipzig, Germany. 4. Collaborative Research Centre 1052 "Obesity Mechanisms", University of Leipzig, Leipzig, Germany; Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany. 5. Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany. 6. Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Hospital Leipzig, Leipzig, Germany. 7. Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany.
Abstract
OBJECTIVE: The DSM-5 introduces mild neurocognitive disorder (miNCD) as a syndrome that recognizes the potential clinical importance of acquired cognitive deficits being too mild to qualify for diagnosis of dementia. We provide new empirical data on miNCD including total, age-, and sex-specific prevalence rates; number and types of neurocognitive domains being impaired; and diagnostic overlap with the well-established mild cognitive impairment (MCI) concept. DESIGN: Cross-sectional results of an observational cohort study (LIFE-Adult-Study). SETTING: General population. PARTICIPANTS: A total of 1,080 dementia-free individuals, aged 60-79 years. MEASUREMENTS: We calculated weighted point prevalence rates with confidence intervals (95% CI) for miNCD and analyzed diagnostic overlap between miNCD and MCI by calculating overall percentage agreement and Cohen's kappa coefficient. RESULTS: Weighted total prevalence of miNCD was 20.3% (95% CI: 17.8-23.0). Prevalence was similar in both sexes, but significantly higher in older age. Two-thirds (66.2%) of the individuals with miNCD showed impairment restricted to only one out of six possible neurocognitive domains. Learning and memory was the most frequently (38.3%) impaired domain in all miNCD-cases, followed by social cognition (26.1%). Analysis of diagnostic overlap with MCI yielded an overall agreement of 98.6% and a kappa of 0.959. CONCLUSIONS: By considering all six predefined neurocognitive domains, our study observed a substantial proportion of dementia-free older adults having miNCD. Provision of information on the underlying etiology/ies may be of prime importance in future studies aiming at evaluating the clinical relevance of the miNCD syndrome.
OBJECTIVE: The DSM-5 introduces mild neurocognitive disorder (miNCD) as a syndrome that recognizes the potential clinical importance of acquired cognitive deficits being too mild to qualify for diagnosis of dementia. We provide new empirical data on miNCD including total, age-, and sex-specific prevalence rates; number and types of neurocognitive domains being impaired; and diagnostic overlap with the well-established mild cognitive impairment (MCI) concept. DESIGN: Cross-sectional results of an observational cohort study (LIFE-Adult-Study). SETTING: General population. PARTICIPANTS: A total of 1,080 dementia-free individuals, aged 60-79 years. MEASUREMENTS: We calculated weighted point prevalence rates with confidence intervals (95% CI) for miNCD and analyzed diagnostic overlap between miNCD and MCI by calculating overall percentage agreement and Cohen's kappa coefficient. RESULTS: Weighted total prevalence of miNCD was 20.3% (95% CI: 17.8-23.0). Prevalence was similar in both sexes, but significantly higher in older age. Two-thirds (66.2%) of the individuals with miNCD showed impairment restricted to only one out of six possible neurocognitive domains. Learning and memory was the most frequently (38.3%) impaired domain in all miNCD-cases, followed by social cognition (26.1%). Analysis of diagnostic overlap with MCI yielded an overall agreement of 98.6% and a kappa of 0.959. CONCLUSIONS: By considering all six predefined neurocognitive domains, our study observed a substantial proportion of dementia-free older adults having miNCD. Provision of information on the underlying etiology/ies may be of prime importance in future studies aiming at evaluating the clinical relevance of the miNCD syndrome.
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