- Email: [email protected]
Determinants of course patterns of Mild Cognitive Impairment (MCI)
Poster Presentations P3 shared dementia risk) husband’s education and occupation. Results: Incident dementia was diagnosed in 255 subjects (221 of whom had dementia-free spouse and 34 of whom had spouse with incident dementia) . In an age-stratified model with all covariates included, a subject whose spouse experienced incident dementia onset had a six-fold (HR¼6.01, 95% CI: 2.23-16.17, p¼.0004) increase in the hazard for incident dementia in relation to subjects whose spouses were dementia free, with equivalent findings for men and women. Few subjects (0 men, 4 women) with spouses without dementia became widowed, both precluding the ability and obviating the need to adjust for the potential confounding effects of widowhood. Conclusions: These results suggest that dementia caregiving increases dementia risk in spouse caregivers, net of the effect of key factors associated with dementia risk and socioeconomic status shared by both spouses. Future work will examine the effects of the rapidity of clinical course in spouse’s dementia and ameliorating effects of caregiver stress, personality and coping strategies, to inform potential caregiver interventions.
4.8) years and 74.1% were women. Some 32% lived alone and 11.5% in an institution. In the whole population, mean education was 5.1 (2.5) years, mean MMSE score 21.4 (7.6), and mean percentage of dependence on IADL 48.5% (36.9%). Prevalence of dementia standardized on the 2008 Italian population was 22.9% (95% CI: 21.1-24.7) and was higher in women 25.8% (95% CI: 23.7-28.1) than in men 17.1% (95% CI: 14.0-20.5). Prevalence increased with advancing age: 13.5% at 80-84 years, 30.8% at 85-89, 39.5% at 90-94, and 52.8% over 94. The number of person-years of observation was 3,110. The estimated annual incidence of dementia standardized on the 2008 Italian population was 8.6% (95%CI: 7.6-9.7) and was higher in women 9.2% (95% CI: 8.0-10.6) than in men 7.2% (95% CI: 5.5-9.2). Incidence as well rose with increasing age: 6.0% at 80-84 years, 12.4% at 85-89, 13.1% at 90-94, and 20.7% over 94. Conclusions: Although not exponentially, the overall prevalence and incidence rates of dementia continue to rise also in very old age. P3-126
P3-124
CLASSIFICATION MODELS FOR EARLY IDENTIFICATION OF PERSONS AT RISK FOR DEMENTIA
Tessa N. Van Den Kommer1, Daniel E. Bontempo2, Hannie C. Comijs1, Scott M. Hofer2, Miranda G. Dik1, Andrea M. Piccinin2, Cees Jonker1, Dorly J. H. Deeg1, Boo Johansson3, 1VU University Medical Center, Amsterdam, Netherlands; 2Oregon State University, Corvallis, OR, USA; 3Department of Psychology, Gothenburg, Sweden. Contact e-mail: tn. [email protected] Background: The goal of the present study is to develop a classification model for use in primary care using markers which are relatively easy to determine to aid early identification of persons at risk for dementia. Methods: Data were used from the Origins of Variance in the Old-Old (OCTO-Twin) study. The baseline sample included 521 non-demented subjects aged 80 and older. Relevant predictors on dementia were collected two years prior to dementia diagnosis. Dementia diagnosis was based on DSM-III-R criteria. Data were analyzed using generalized estimating equations and Cox survival analyses. Results: Overall, the two-year incidence of dementia was 6.9%. Reporting memory complaints was the strongest predictor of dementia. Memory complaints and a MMSE score 25 resulted in a predictive value for dementia of 28.8%. No memory complaints, drinking no alcohol and a MMSE score 24 resulted in a predictive value of 18.0%. Reporting no memory complaints, drinking alcohol, having functional limitations and a MMSE score 24 resulted in a percentage of 24.7% identified with dementia after two years of follow-up. Conclusions: The developed classification tree could contribute to early identification of persons at risk for dementia in primary care in a feasible and cost-effective way. P3-125
RISK OF DEMENTIA CONTINUES TO RISE IN THE OLDEST OLD: THE MONZINO 80-PLUS STUDY
Ugo Lucca, Mariateresa Garrı`, Alessandro Nobili, Luca Pasina, Francesca Gandini, Emma Riva, Mauro Tettamanti, Istituto di Ricerche Farmacologiche Mario Negri, Milano, Italy. Contact e-mail: lucca@ marionegri.it Background: Most dementia sufferers are eighty years or older, the fastest growing segment of the elderly population in western countries. Because of the small number of persons in this age class usually included in populationbased studies, prevalence and incidence estimates fluctuate widely in the oldest old, making it hard to establish whether the risk of dementia (and Alzheimer’s disease) continues to rise also at very high ages. Objective: to estimate the prevalence and incidence of dementia (mild+) in a prospective, door-to-door population-based study of all eighty years or older residents in eight municipalities of Varese province, Italy (the Monzino 80-plus Study). Methods: Among the 2,436 eligible residents, information could be gathered for 2,138 individuals (response rate: 87.8%). Of the 1,085 survivors non-demented at baseline, 995 (91.7%) were re-evaluated after an average followup period of 3 years. Diagnosis of dementia was based on DSM-IV criteria. Results: Mean age of the population at baseline evaluation was 87.5 (SD:
P381
DETERMINANTS OF COURSE PATTERNS OF MILD COGNITIVE IMPAIRMENT (MCI)
Hanna Kaduszkiewicz1, Marion Eisele1, Wolfgang Maier2, Birgitt Wiese1, Hendrik van den Bussche1, AgeCoDe Study Group, 1University Medical Center Hamburg-Eppendorf, Hamburg, Germany; 2University of Bonn, Bonn, Germany. Contact e-mail: [email protected] Background: The concept of MCI was developed to gain a predictor for future dementia. Annual conversion rates differ in short- and long term studies and the lack of a linear trend between both suggest that MCI subsumes a heterogenic group of more than one disorder, which may be stable, improve or progress to dementia. To distinguish progressive MCI from stable or remittent MCI, this study investigates indicators predicting the course of MCI and allowing a prognosis of the risk of future dementia. Methods: 357 subjects from the AgeCoDe cohort with MCI at baseline were followed up for 36 months by interviews and cognitive testing. Groups of remittent, unstable, stable and progressive MCI were built and analysed by multivariate and CART analysis for possible baseline-predictors for future course. Results: The group of progressive MCI consisted of 22.4% of all subjects with MCI. The following variables were found to predict the conversion to dementia in a statistically significant manner (p<0.01): MCI subtype, Hypercholesterolemia, history of TIA, renal insufficiency, and a poor score of 14.5 points or lower in the CERAD Wordlist learning and recall subtest. The latter alone increases the risk of conversion to dementia from 22.3% to 48.6%. A score of more than 14.5 points decreases the risk of progressive MCI to 10.8%. No clear determinants were found for courses of unstable and stable MCI. Conclusions: In persons with MCI a poor score of 14.5 points or lower in the CERAD Wordlist learning and recall subtest is the best predictor of progression to dementia. For courses of unstable and stable MCI no clear predictors were found. P3-127
POPULATION-BASED SURVEY IN GREECE: COGNITIVE PERFORMANCE VS DEMOGRAPHIC, MEDICAL HISTORY AND MEMORY COMPLAINTS
Paraskevi Sakka, Kostas Nikolaou, Olga Lymperopoulou, Areti Efthymiou, Eleni Margioti, Athens Association of Alzheimer’s Disease and Related Disorders, Athens, Greece. Contact e-mail: vsakka@ath. forthnet.gr Background: A campaign to raise awareness on Alzheimer’s disease, took place in 2007, in Athens. On the occasion of the Alzheimer’s day 2007 free memory testing was offered to the elderly public. Our objective was firstly to investigate whether performance in cognitive tests is correlated to demographics and medical history and secondly to explore the relation between cognitive performance and subjective memory complaints. Methods: A group of neurologists and cognitive psychologists interviewed each person. Demographics, medical history, medication taken, reason for taking the examination, specific memory dysfunction complaints were recorded for each participant. Cognitive tests performed were Mini Mental State Examination, Clock Drawing Test, Verbal Fluency, immediate and delayed recall of simple verbal material and the Geriatric Depression Scale (GDS). Participants were
4.8) years and 74.1% were women. Some 32% lived alone and 11.5% in an institution. In the whole population, mean education was 5.1 (2.5) years, mean MMSE score 21.4 (7.6), and mean percentage of dependence on IADL 48.5% (36.9%). Prevalence of dementia standardized on the 2008 Italian population was 22.9% (95% CI: 21.1-24.7) and was higher in women 25.8% (95% CI: 23.7-28.1) than in men 17.1% (95% CI: 14.0-20.5). Prevalence increased with advancing age: 13.5% at 80-84 years, 30.8% at 85-89, 39.5% at 90-94, and 52.8% over 94. The number of person-years of observation was 3,110. The estimated annual incidence of dementia standardized on the 2008 Italian population was 8.6% (95%CI: 7.6-9.7) and was higher in women 9.2% (95% CI: 8.0-10.6) than in men 7.2% (95% CI: 5.5-9.2). Incidence as well rose with increasing age: 6.0% at 80-84 years, 12.4% at 85-89, 13.1% at 90-94, and 20.7% over 94. Conclusions: Although not exponentially, the overall prevalence and incidence rates of dementia continue to rise also in very old age. P3-126
P3-124
CLASSIFICATION MODELS FOR EARLY IDENTIFICATION OF PERSONS AT RISK FOR DEMENTIA
Tessa N. Van Den Kommer1, Daniel E. Bontempo2, Hannie C. Comijs1, Scott M. Hofer2, Miranda G. Dik1, Andrea M. Piccinin2, Cees Jonker1, Dorly J. H. Deeg1, Boo Johansson3, 1VU University Medical Center, Amsterdam, Netherlands; 2Oregon State University, Corvallis, OR, USA; 3Department of Psychology, Gothenburg, Sweden. Contact e-mail: tn. [email protected] Background: The goal of the present study is to develop a classification model for use in primary care using markers which are relatively easy to determine to aid early identification of persons at risk for dementia. Methods: Data were used from the Origins of Variance in the Old-Old (OCTO-Twin) study. The baseline sample included 521 non-demented subjects aged 80 and older. Relevant predictors on dementia were collected two years prior to dementia diagnosis. Dementia diagnosis was based on DSM-III-R criteria. Data were analyzed using generalized estimating equations and Cox survival analyses. Results: Overall, the two-year incidence of dementia was 6.9%. Reporting memory complaints was the strongest predictor of dementia. Memory complaints and a MMSE score 25 resulted in a predictive value for dementia of 28.8%. No memory complaints, drinking no alcohol and a MMSE score 24 resulted in a predictive value of 18.0%. Reporting no memory complaints, drinking alcohol, having functional limitations and a MMSE score 24 resulted in a percentage of 24.7% identified with dementia after two years of follow-up. Conclusions: The developed classification tree could contribute to early identification of persons at risk for dementia in primary care in a feasible and cost-effective way. P3-125
RISK OF DEMENTIA CONTINUES TO RISE IN THE OLDEST OLD: THE MONZINO 80-PLUS STUDY
Ugo Lucca, Mariateresa Garrı`, Alessandro Nobili, Luca Pasina, Francesca Gandini, Emma Riva, Mauro Tettamanti, Istituto di Ricerche Farmacologiche Mario Negri, Milano, Italy. Contact e-mail: lucca@ marionegri.it Background: Most dementia sufferers are eighty years or older, the fastest growing segment of the elderly population in western countries. Because of the small number of persons in this age class usually included in populationbased studies, prevalence and incidence estimates fluctuate widely in the oldest old, making it hard to establish whether the risk of dementia (and Alzheimer’s disease) continues to rise also at very high ages. Objective: to estimate the prevalence and incidence of dementia (mild+) in a prospective, door-to-door population-based study of all eighty years or older residents in eight municipalities of Varese province, Italy (the Monzino 80-plus Study). Methods: Among the 2,436 eligible residents, information could be gathered for 2,138 individuals (response rate: 87.8%). Of the 1,085 survivors non-demented at baseline, 995 (91.7%) were re-evaluated after an average followup period of 3 years. Diagnosis of dementia was based on DSM-IV criteria. Results: Mean age of the population at baseline evaluation was 87.5 (SD:
P381
DETERMINANTS OF COURSE PATTERNS OF MILD COGNITIVE IMPAIRMENT (MCI)
Hanna Kaduszkiewicz1, Marion Eisele1, Wolfgang Maier2, Birgitt Wiese1, Hendrik van den Bussche1, AgeCoDe Study Group, 1University Medical Center Hamburg-Eppendorf, Hamburg, Germany; 2University of Bonn, Bonn, Germany. Contact e-mail: [email protected] Background: The concept of MCI was developed to gain a predictor for future dementia. Annual conversion rates differ in short- and long term studies and the lack of a linear trend between both suggest that MCI subsumes a heterogenic group of more than one disorder, which may be stable, improve or progress to dementia. To distinguish progressive MCI from stable or remittent MCI, this study investigates indicators predicting the course of MCI and allowing a prognosis of the risk of future dementia. Methods: 357 subjects from the AgeCoDe cohort with MCI at baseline were followed up for 36 months by interviews and cognitive testing. Groups of remittent, unstable, stable and progressive MCI were built and analysed by multivariate and CART analysis for possible baseline-predictors for future course. Results: The group of progressive MCI consisted of 22.4% of all subjects with MCI. The following variables were found to predict the conversion to dementia in a statistically significant manner (p<0.01): MCI subtype, Hypercholesterolemia, history of TIA, renal insufficiency, and a poor score of 14.5 points or lower in the CERAD Wordlist learning and recall subtest. The latter alone increases the risk of conversion to dementia from 22.3% to 48.6%. A score of more than 14.5 points decreases the risk of progressive MCI to 10.8%. No clear determinants were found for courses of unstable and stable MCI. Conclusions: In persons with MCI a poor score of 14.5 points or lower in the CERAD Wordlist learning and recall subtest is the best predictor of progression to dementia. For courses of unstable and stable MCI no clear predictors were found. P3-127
POPULATION-BASED SURVEY IN GREECE: COGNITIVE PERFORMANCE VS DEMOGRAPHIC, MEDICAL HISTORY AND MEMORY COMPLAINTS
Paraskevi Sakka, Kostas Nikolaou, Olga Lymperopoulou, Areti Efthymiou, Eleni Margioti, Athens Association of Alzheimer’s Disease and Related Disorders, Athens, Greece. Contact e-mail: vsakka@ath. forthnet.gr Background: A campaign to raise awareness on Alzheimer’s disease, took place in 2007, in Athens. On the occasion of the Alzheimer’s day 2007 free memory testing was offered to the elderly public. Our objective was firstly to investigate whether performance in cognitive tests is correlated to demographics and medical history and secondly to explore the relation between cognitive performance and subjective memory complaints. Methods: A group of neurologists and cognitive psychologists interviewed each person. Demographics, medical history, medication taken, reason for taking the examination, specific memory dysfunction complaints were recorded for each participant. Cognitive tests performed were Mini Mental State Examination, Clock Drawing Test, Verbal Fluency, immediate and delayed recall of simple verbal material and the Geriatric Depression Scale (GDS). Participants were