Hostname: page-component-78c5997874-m6dg7 Total loading time: 0 Render date: 2024-11-13T06:52:45.622Z Has data issue: false hasContentIssue false
  • English
  • Français

Cognitive predictors for five-year conversion to dementia in community-dwelling Chinese older adults

Published online by Cambridge University Press:  02 April 2013

Candy H. Y. Wong ,
Grace T. Y. Leung ,
Ada W. T. Fung ,
W. C. Chan  and
Linda C. W. Lam
Candy H. Y. Wong*
Affiliation:
Department of Psychiatry, Tai Po Hospital, Tai Po, Hong Kong
Grace T. Y. Leung
Affiliation:
Department of Psychiatry, Tai Po Hospital, Tai Po, Hong Kong
Ada W. T. Fung
Affiliation:
Department of Psychiatry, The Chinese University of Hong Kong, Tai Po Hospital, Tai Po, Hong Kong
W. C. Chan
Affiliation:
Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong
Linda C. W. Lam
Affiliation:
Department of Psychiatry, The Chinese University of Hong Kong, Tai Po Hospital, Tai Po, Hong Kong
*
Correspondence should be addressed to: Dr Candy H. Y. Wong, Department of Psychiatry, Tai Po Hospital, 9 Chuen On Road, Tai Po, N. T., Hong Kong. Phone: +(852) 26076026. Email: whycandy@gmail.com.
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: This study evaluates which cognitive measure is best for predicting incident dementia in a population-based random sample of Chinese older adults without dementia over a five-year period.

Methods: A total of 787 community-dwelling Chinese older adults without dementia in Hong Kong were assessed at baseline (T0), at two years (T1), and at five years (T2).

Results: The annual conversion rate to dementia was 1.6% and 6.3% for baseline normal participants and baseline mild cognitive impairment (MCI) participants, respectively. The Cantonese version of Mini-mental State Examination (CMMSE) scores declined significantly over time. In participants who progressed to dementia, Category Verbal Fluency Test (CVFT) scores dropped significantly from T0 to T1. A 1-SD drop of either CMMSE or CVFT in two years predicted dementia at five years with 91.5% sensitivity and 62.0% specificity. A stable CMMSE and CVFT at two years predicted a 91% chance of not progressing to clinical dementia at five years.

Conclusion: In this community sample of Chinese older adults, a decline in cognitive screening tests in short term (two years) offered useful information in predicting dementia conversion over a longer period.

Keywords

cognitive predictorsdementiamild cognitive impairment
Type
Research Article
Information
International Psychogeriatrics , Volume 25 , Issue 7 , July 2013 , pp. 1125 - 1134
Copyright
Copyright © International Psychogeriatric Association 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Acvarsson, O. and Skoog, I. (2000). A longitudinal population study of the mini-mental state examination in the very old: relation to dementia and education. Dementia and Geriatric Cognitive Disorders, 11, 166–175.CrossRefGoogle Scholar
Alexopoulos, G. S., Abrams, R. C., Young, R. C. and Shamoian, C. A. (1988). Cornell Scale for Depression in Dementia. Biological Psychiatry, 23, 271–284.CrossRefGoogle ScholarPubMed
American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders, 4rth edn, Text Revision (DSM-IV-TR). Washington, DC: American Psychiatric Association.Google Scholar
Amieva, H.et al. (2004). Annual rate and predictors of conversion to dementia in participants presenting mild cognitive impairment criteria defined according to a population-based study. Dementia and Geriatric Cognitive Disorders, 18, 87–93.CrossRefGoogle Scholar
Bowie, C. R. and Harvey, P. D. (2006). Administration and interpretation of the trail making test. Nature Protocols, 1, 2277–2281.CrossRefGoogle ScholarPubMed
Busse, A., Angermeyer, M. C. and Riedel-Heller, S. G. (2006). Progression of mild cognitive impairment to dementia: a challenge to current thinking. The British Journal of Psychiatry, 189, 399–404.CrossRefGoogle ScholarPubMed
Chen, P., Ratcliff, G., Belle, S. H., Cauley, J. A., DeKosky, S. T. and Ganguli, M. (2001). Cognitive tests that best discriminate between presymptomatic AD and those who remain nondemented. Neurology, 55, 1847–1853.CrossRefGoogle Scholar
Chiu, H. F. K., Lee, H. C. B., Chung, D. and Kwong, P. K. (1994). Reliability and validity of the Cantonese version of the Mini-Mental State Examination: a preliminary study. Journal of Hong Kong College of Psychiatrists, 4 (Suppl. 2), 25–28.Google Scholar
Chiu, H. F. K.et al. (1997). The modified fuld verbal fluency test: a validation study in Hong Kong. Journals of Gerontology, Series B, Psychological Sciences and Social Sciences, 52B, 247–250.CrossRefGoogle Scholar
Chu, L. W., Chiu, K. C., Hui, S. L., Yu, G. K., Tsui, W. J. and Lee, P. W. (2000). The reliability and validity of the Alzheimer's Disease Assessment Scale Cognitive Subscale (ADAS-Cog) among the elderly Chinese in Hong Kong. Annals of the Academy of Medicine, Singapore, 29, 474–485.Google ScholarPubMed
Conwell, Y., Forbes, N. T., Cox, C. and Caine, E. D. (1993). Validation of a measure of physical illness burden at autopsy: the Cumulative Illness Rating Scale. Journal of American Geriatric Society, 41, 38–41.CrossRefGoogle ScholarPubMed
Ebly, E., Hogan, D. and Parhad, I. (1995). Cognitive impairment in the non-demented elderly: results from the Canadian study of health and aging. Archives of Neurology, 52, 612–619.CrossRefGoogle Scholar
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.CrossRefGoogle Scholar
Galvin, J. E.et al. (2005). Predictors of preclinical Alzheimer's disease and dementia: a clinicopathologic study. Archives of Neurology, 62, 758–765.CrossRefGoogle ScholarPubMed
Grober, E., Hall, C. B., Lipton, R. B., Zonderman, A. B., Resnick, S. M. and Kawas, C. (2008). Memory impairment, executive dysfunction, and intellectual decline in preclinical Alzheimer's disease. Journal of International Neuropsychological Society, 14, 266–278.CrossRefGoogle ScholarPubMed
Hall, C. B., Lipton, R. B., Sliwinski, M. and Stewart, W. F. (2000). A change point model for estimating the onset of cognitive decline in preclinical Alzheimer's disease. Statistics in Medicine, 19, 1555–1566.3.0.CO;2-3>CrossRefGoogle ScholarPubMed
Hensel, A., Luck, T., Luppa, M., Glaesmer, H., Angermeyer, M. C. and Riedel-Heller, S. G. (2009). Does a reliable decline in Mini Mental State Examination total score predict dementia? Diagnostic accuracy of two reliable change indices. Dementia and Geriatric Cognitive Disorders, 27, 50–58.CrossRefGoogle ScholarPubMed
Howieson, D. B., Dame, A., Camicioli, R., Sexton, G., Payami, H. and Kaye, J. A. (1997). Cognitive markers preceding Alzheimer's dementia in the healthy oldest old. Journal of American Geriatrics Society, 45, 584–589.CrossRefGoogle ScholarPubMed
Johnson, D. K., Storandt, M., Morris, J. C. and Gavin, J. E. (2009). Longitudinal study of the transition from healthy aging to Alzheimer disease. Archives of Neurology, 66, 1254–1259.CrossRefGoogle ScholarPubMed
Lam, L. C. W.et al. (2008a). Prevalence of very mild and mild dementia in community-dwelling older Chinese people in Hong Kong. International Psychogeriatrics, 20, 135–148.CrossRefGoogle ScholarPubMed
Lam, L. C. W.et al. (2008b). Use of clinical dementia rating in detecting early cognitive deficits in a community-based sample of Chinese older persons in Hong Kong. Alzheimer Disease and Associated Disorders, 22, 153–157.CrossRefGoogle Scholar
Lam, L. C. W.et al. (2008c). Screening of mild cognitive impairment in Chinese older adults – a multistage validation of the Chinese abbreviated mild cognitive impairment test. Neuroepidemiology, 30, 6–12.CrossRefGoogle ScholarPubMed
Lam, L. C. W.et al. (2010). Combined clinical and cognitive criteria to identify mild cognitive impairment in a Southern Chinese Community. Alzheimer Disease and Associated Disorders, 24, 343–347.CrossRefGoogle Scholar
Leung, G. T. Y. (2008). Examining the association between participation in late-life leisure activities and cognitive function in community-swelling elderly Chinese in Hong Kong. Research dissertation, the Hong Kong College of Psychiatrists.Google Scholar
Petersen, R. C. (2003). Mild Cognitive Impairment. Oxford: Oxford University Press.CrossRefGoogle ScholarPubMed
Ritchie, K., Artero, S. and Touchon, J. (2001). Classification criteria for mild cognitive impairment. A population-based validation study. Neurology, 56, 37–42.CrossRefGoogle ScholarPubMed
Rosen, W. G., Mohs, R. C. and Davis, K. L. (1984). A new rating scale for Alzheimer's disease. American Journal of Psychiatry, 141, 1356–1364.Google ScholarPubMed
Rubin, E. H., Storandt, M., Miller, J. P., Kinscherf, D. A., Grant, E. A. C. and Berg, L. (1998). A Prospective study of cognitive function and onset of dementia in cognitively healthy elders. Archives of Neurology, 55, 395–401.CrossRefGoogle ScholarPubMed
Schmand, B., Lindeboom, J., Launer, L., Dinkgreve, M., Hooijer, C. and Jonker, C. (1995). What is a significant score change on the Mini-Mental State examination? International Journal of Geriatric Psychiatry, 10, 411–414.CrossRefGoogle Scholar
Small, B. J., Fratiglioni, L., von Strauss, E. and Bäckman, L. (2003). Terminal decline and cognitive performance in very old age: does cause of death matter? Psychology and Aging, 18, 193–202.CrossRefGoogle ScholarPubMed
Wilson, R. S., Beckett, L. A., Bienias, J. L., Evans, D. A. and Bennett, D. A. (2003). Terminal decline in cognitive function. Neurology, 60, 1782–1787.CrossRefGoogle ScholarPubMed