Aguilar-Navarro Sara G, Mimenza-Alvarado Alberto J, Ávila-Funes José Alberto, Juárez-Cedillo Teresa, Bernal-López Carolina, Hernández-Favela Celia G
Geriatrics Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
Epidemiology and Health Services Research Unit, Area of Aging, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social and Faculty of Superior Studies (FES) Zaragoza, Universidad Nacional Autónoma de México, Mexico City, Mexico.
Rev Invest Clin. 2017 Jan-Feb;69(1):33-39. doi: 10.24875/ric.17002064.
Mild cognitive impairment (MCI) is considered a clinical stage between normal cognitive aging and dementia. The clinical course of MCI is heterogeneous, with a significant number of cases progressing to dementia or reverting back to normal.
To determine the predictors of conversion from mild cognitive impairment to dementia among Mexican older adults.
A sample of 175 persons underwent clinical and neuropsychological evaluation to establish mild cognitive impairment diagnosis. These patients were followed-up for a mean 3.5 years.
Mean age was 81.7 (± 6.9) years, 57% were women, and mean education level was 9.5 (± 6.1) years. Sixty-one percent of mild cognitive impairment participants progressed to dementia. Multivariate Cox regression analysis showed that progression to dementia was associated with age (HR: 4.95; 95% CI: 1.96-12.46; p = 0.001), low education level (HR: 5.81; 95% CI: 1.90-7.78; p < 0.002), history of stroke (HR: 3.92; 95% CI: 1.37-11.16; p < 0.012) and cognitive decline (HR: 1.31; 95% CI: 1.18-1.45; p = 0.000).
Age, poor education, cognitive decline, and a history of stroke were predictors of conversion to dementia. The identification and control of modifiable risk factors could influence conversion to dementia.
轻度认知障碍（MCI）被认为是正常认知老化与痴呆之间的一个临床阶段。MCI的临床病程具有异质性，相当数量的病例会进展为痴呆或恢复正常。
确定墨西哥老年人群中从轻度认知障碍转变为痴呆的预测因素。
对175人进行了临床和神经心理学评估，以确立轻度认知障碍的诊断。对这些患者进行了平均3.5年的随访。
平均年龄为81.7（±6.9）岁，57%为女性，平均教育水平为9.5（±6.1）年。61%的轻度认知障碍参与者进展为痴呆。多变量Cox回归分析显示，进展为痴呆与年龄（风险比：4.95；95%置信区间：1.96 - 12.46；p = 0.001）、低教育水平（风险比：5.81；95%置信区间：1.90 - 7.78；p < 0.002）、中风病史（风险比：3.92；95%置信区间：1.37 - 11.16；p < 0.012）和认知衰退（风险比：1.31；95%置信区间：1.18 - 1.45；p = 0.000）有关。
年龄、低教育水平、认知衰退和中风病史是转变为痴呆的预测因素。可改变风险因素的识别与控制可能会影响向痴呆的转变。
