Ten-year risk of dementia in subjects with mild cognitive impairment

Objective: To investigate the 10-year risk of dementia in subjects with mild cognitive impairment (MCI) ages 40 to 85 years. Methods: We selected subjects from a memory clinic if they met one of the following definitions of MCI: cognitive complaints (n = 181), aging-associated cognitive decline (AACD) (n = 163), mild functional impairment (n = 86), or amnestic MCI (n = 64). Subjects were reassessed after 2, 5, and 10 years. The risk of dementia was calculated with Kaplan-Meier statistics. Analyses were conducted in the entire sample and in subgroups of subjects aged 40 to 54 years, 55 to 69 years, and 70 to 85 years. Results: The 10-year risk of dementia was 0.27 (95% CI 0.20 to 0.34) in subjects with cognitive complaints, 0.28 (95% CI 0.21 to 0.35) in subjects with AACD, 0.44 (95% CI 0.32 to 0.56) in subjects with mild functional impairment, and 0.48 (95% CI 0.35 to 0.61) in subjects with amnestic MCI. Ninety-one percent of the demented subjects had probable AD. The risk of dementia increased with increasing age for all MCI definitions (p <0.001). Depending on the MCI definition used, the risk for dementia ranged from 0 to 0.06 in subjects aged 40 to 54 years, from 0.37 to 0.52 in subjects aged 55 to 69 years, and from 0.77 to 1.0 in subjects aged 70 to 85 years. Conclusions: The majority of subjects with MCI do not progress to dementia at the long term. Age strongly influences the dementia risk. MCI often represents the predementia stage of a neurodegenerative disorder in elderly subjects but rarely in younger subjects.