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Impact of impairment in instrumental activities of daily living and mild cognitive impairment on time to incident dementia: results of the Leipzig Longitudinal Study of the Aged

Published online by Cambridge University Press:  29 July 2010

T. Luck ,
M. Luppa ,
M. C. Angermeyer ,
A. Villringer ,
H.-H. König  and
S. G. Riedel-Heller
T. Luck*
Affiliation:
Department of Social Medicine, University of Leipzig, Leipzig, Germany LIFE Center, Universität Leipzig, Leipzig, Germany
M. Luppa
Affiliation:
Department of Social Medicine, University of Leipzig, Leipzig, Germany
M. C. Angermeyer
Affiliation:
Center for Public Mental Health, Gösing a. W., Austria Department of Public Health, University of Cagliary, Italy
A. Villringer
Affiliation:
Max Planck Institute for Human Cognitive and Brain Sciences and Day Clinic of Cognitive Neurology, University of Leipzig, Leipzig, Germany
H.-H. König
Affiliation:
Department of Medical Sociology and Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
S. G. Riedel-Heller
Affiliation:
Department of Social Medicine, University of Leipzig, Leipzig, Germany
*
*Address for correspondence: Dr T. Luck, Public Health Research Unit, Department of Social Medicine, University of Leipzig, Leipzig, Philipp-Rosenthal-Str. 55, D-04103 Leipzig, Germany. (Email: tobias.luck@medizin.uni-leipzig.de)
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Abstract

Background

Early diagnosis of dementia requires knowledge about associated predictors. The aim of this study was to determine the impact of mild cognitive impairment (MCI) and impairment in instrumental activities of daily living (IADL) on the time to an incident dementia diagnosis.

Method

Data were derived from the Leipzig Longitudinal Study of the Aged (LEILA75+), a population-based study of individuals aged ⩾75 years. Kaplan-Meier survival analysis was used to determine time to incident dementia. Cox proportional hazards models were applied to determine the impact of MCI and IADL impairment on the time to incident dementia.

Results

In total, 180 (22.0%) of 819 initially dementia-free subjects developed dementia by the end of the study. Mean time to incident dementia was 6.7 years [95% confidence interval (CI) 6.5–6.9]. MCI combined with IADL impairment was associated with a higher conversion rate to dementia, a shorter time to clinically manifest diagnosis and a lower chance of reversibility to cognitive normal. The highest risk for a shorter time to incident dementia was found for amnestic MCI combined with IADL impairment. The mean time to incident dementia was 3.7 years (95% CI 2.9–4.4) and thus half as long as in subjects without MCI and IADL impairment.

Conclusions

Subjects with MCI and IADL impairment constitute a high-risk population for future dementia. The consideration of both – MCI and IADL impairment – might help to improve the prediction of dementia.

Keywords

Dementiainstrumental activities of daily living (IADL)mild cognitive impairment (MCI)
Type
Original Articles
Information
Psychological Medicine , Volume 41 , Issue 5 , May 2011 , pp. 1087 - 1097
Copyright
Copyright © Cambridge University Press 2010

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