This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
Abstract
Objective To examine the temporal changes in the likelihood of dementia and mild cognitive impairment (MCI) between 1993 and 2012 using a short battery of cognitive tests.
Methods A cohort of 10,342 participants underwent a short battery of cognitive tests collected during triennial in-home interviews with 2,794 of those evaluated for the clinical diagnosis of dementia and MCI. We used a generalized logit regression model to estimate the likelihood of dementia and MCI, and a quasibinomial regression model to examine the temporal changes in those likelihood scores.
Results A short battery of cognitive tests—delayed story recall test, Symbol Digit Modalities Test, and the Mini-Mental State Examination—were associated with the clinical diagnosis of dementia and MCI. The classification accuracy of likelihood scores was 0.92 for dementia and 0.85 for MCI. After adjusting for age, race/ethnicity, and education, the likelihood of dementia in the population decreased from 21.6% (95% confidence interval [CI] 20.9%–22.3%) to 18.9% (95% CI 18.1%–19.7%) between 1993–1996 and 2000–2002 and showed no significant decline between 2000–2002 and 2009–2012 (−0.2%, 95% CI −1.1% to 0.7%). The estimated likelihood of MCI remained similar between 1993–1996 and 2009–2012 (29.0%, 95% CI 27.9%–30.1%), but showed a nonsignificant decrease in 2000–2002.
Conclusion The likelihood scores based on a short battery of cognitive tests can serve as a measure of dementia and MCI in epidemiologic studies. The decline in the likelihood of dementia and MCI over earlier years was not sustained in later years.
Glossary
- AA=
- African American;
- CI=
- confidence interval;
- DLS=
- dementia likelihood score;
- EA=
- European American;
- MCI=
- mild cognitive impairment;
- MMSE=
- Mini-Mental State Examination;
- NCI=
- no cognitive impairment;
- NINCDS-ADRDA=
- National Institute of Neurological and Communicative Disorders and Stroke–Alzheimer’s Disease and Related Disorders Association;
- OR=
- odds ratio;
- SDMT=
- Symbol Digit Modalities Test
Footnotes
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
- Received July 20, 2018.
- Accepted in final form July 18, 2019.
- © 2019 American Academy of Neurology
AAN Members
We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.
AAN Non-Member Subscribers
Purchase access
Letters: Rapid online correspondence
REQUIREMENTS
You must ensure that your Disclosures have been updated within the previous six months. Please go to our Submission Site to add or update your Disclosure information.
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
You May Also be Interested in
Topics Discussed
Alert Me
Recommended articles
Medial temporal lobe atrophy on MRI scans and the diagnosis of Alzheimer disease
Cognitive impairment 18 years before clinical diagnosis of Alzheimer disease dementia
Synaptic alterations in CA1 in mild Alzheimer disease and mild cognitive impairment
Restriction in complex activities of daily living in MCI