Clinical Predictors for Mild Cognitive Impairment Progression in a Korean Cohort
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Background and Purpose Patients with mild cognitive impairment (MCI) and their caregivers are concerned with the likelihood andtime course of progression to dementia. This study was performed to identify the clinical predictors of the MCI progression in a Korean registry,and investigated the effects of medications without evidence, frequently prescribed in clinical practice. Methods Using a Korean cohort that included older adults with MCI who completed at least one follow-up visit, clinical characteristics andtotal medical expenses including prescribed medications were compared between two groups: progressed to dementia or not. Cox proportionalhazards regression analysis was conducted. Results During the mean 1.42±0.72 years, 215 (27.63%) of 778 participants progressed to dementia. The best predictors were age [hazardratio (HR), 1.036; 95% confidence interval (CI), 1.006–1.067; p=0.018], apolipoprotein ε4 allele (HR, 2.247; 95% CI, 1.512–3.337; p<0.001),Clinical Dementia Rating scale-sum of boxes scores (HR, 1.367; 95% CI, 1.143–1.636; p=0.001), Instrumental Activities of Daily Living scores(HR, 1.035; 95% CI, 1.003–1.067; p=0.029), and lower Mini-Mental State Examination scores (HR, 0.892; 95% CI, 0.839–0.949; p<0.001). Totalmedical expenses were not different. Conclusions Our data are in accordance with previous reports about clinical predictors for the progression from MCI to dementia. Totalmedical expenses were not different between groups with and without progression.
Abstract
Background and Purpose Patients with mild cognitive impairment (MCI) and their caregivers are concerned with the likelihood andtime course of progression to dementia. This study was performed to identify the clinical predictors of the MCI progression in a Korean registry,and investigated the effects of medications without evidence, frequently prescribed in clinical practice. Methods Using a Korean cohort that included older adults with MCI who completed at least one follow-up visit, clinical characteristics andtotal medical expenses including prescribed medications were compared between two groups: progressed to dementia or not. Cox proportionalhazards regression analysis was conducted. Results During the mean 1.42±0.72 years, 215 (27.63%) of 778 participants progressed to dementia. The best predictors were age [hazardratio (HR), 1.036; 95% confidence interval (CI), 1.006–1.067; p=0.018], apolipoprotein ε4 allele (HR, 2.247; 95% CI, 1.512–3.337; p<0.001),Clinical Dementia Rating scale-sum of boxes scores (HR, 1.367; 95% CI, 1.143–1.636; p=0.001), Instrumental Activities of Daily Living scores(HR, 1.035; 95% CI, 1.003–1.067; p=0.029), and lower Mini-Mental State Examination scores (HR, 0.892; 95% CI, 0.839–0.949; p<0.001). Totalmedical expenses were not different. Conclusions Our data are in accordance with previous reports about clinical predictors for the progression from MCI to dementia. Totalmedical expenses were not different between groups with and without progression.
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