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The presence of mild cognitive impairment (MCI) in individuals 75 and older is greater than expected and affects approximately 22 percent of those in the age group, according to two articles published in Archives of Neurology by researchers at the University of Pittsburgh. The studies were part of the Cardiovascular Health Study (CHS) and involved 3, 608 people aged 75 and older. It was suggested that the majority of cognitive difficulties were not from Alzheimer's disease but resulted rather from several problems including such as small "silent" ischemic lesions in the brain, depression, use of psychiatric medications, or other disease processes that can affect the brain (including chronic liver and kidney failure).
Individuals in the CHS were evaluated with detailed neurological, neuropsychological, neuroradiological, and psychiatric testing to identify dementia and MCI. The overall prevalence of MCI was 19% and prevalence increased with age from 19% in participants younger than 75 years to 29% in those older than 85 years. The overall prevalence of MCI at the Pittsburgh center was 22% prevalence of the MCI amnesic-type was 6% and of the MCI multiple cognitive deficits–type was 16%.
Mild cognitive impairment 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 4 allele, and low Modified Mini-Mental State Examination scores. The study's primary author pointed out that it is important to note that African Americans have more cardiovascular disease and cerebrovascular disease risk factors than whites, which may explain the increased prevalence of MCI in this group of subjects.
CHS study Part I
CHS study Part II
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