Characterizing UDS Participants who Revert from MCI to Normal Cognition 

 
   Lead Investigator:    Tom Koepsell
   Institution      :    University of Washington
   E-Mail           :    koepsell@u.washington.edu
   Proposal ID      :    113


   Publications:


1  Koepsell T, Monsell S
   Characterizing Individuals who Revert from Mild Cognitive Impairment to Normal or Near-Normal Cognition
   Abstract  Alzheimers Dement,7:S532,2011,

   PUBLISHED



2  Koepsell TD, Monsell SE
   Reversion from mild cognitive impairment to normal or near-normal cognition: risk factors and prognosis
   Journal Article  Neurology,79:1591-1598,2012,PMC3475624

   PUBLISHED





   Proposal Description:
   Mild cognitive impairment (MCI) is often regarded as an intermediate state on a one-way path  from normal cognition to dementia. However, several longitudinal epidemiologic studies have  found that transitions from MCI back to normal cognition are fairly common. With increasing  emphasis on the need to treat incipient dementia at a very early stage, it will be important to know  which individuals with MCI actually have a favorable prognosis and may therefore not need to be  treated with potentially costly and risky anti-dementia therapies.  This study has two main aims:  1. To identify characteristics of UDS participants with MCI that are associated with a  relatively high probability of reversion to normal cognition. We hypothesize that:  (a) Factors that have been found to favor the transition from MCI to dementia will have  the opposite association with the transition from MCI to normal  (b) Persons with relatively mild MCI will be more likely to revert to normal  (c) The probability of transitioning from MCI to normal will be greater for subjects in  whom the primary etiology of cognitive impairment is thought to be a transitory  process, such as medication effects or medical illness  2. To determine whether subjects who revert from MCI to normal have a relatively high  probability of re-transitioning into MCI once again. We hypothesize that they will.  For aim 1, subjects will be UDS participants with MCI on an initial or follow-up visit and with at  least one subsequent UDS visit. Log-binomial regression will be used to estimate the probability  of transitioning from MCI to normal, relative to staying in MCI or progressing to dementia, in  relation to candidate risk factors. For aim 2, the probability of transitioning to MCI on visit 3 will  be compared between two groups: (1) normal cognition on visits 1 and 2, and (2) MCI on visit 1  and normal on visit 2.  1