INS NYC 2024 Program

Poster	Poster Session 06 Program Schedule 02/15/2024 04:00 pm - 05:15 pm Room: Majestic Complex (Posters 61-120) Poster Session 06: Aging \| MCI \| Neurodegenerative Disease - PART 2 Final Abstract #60 Mild Cognitive Impairment Over Time: Stability, Reversion, and Decline Among Older Mexican Adults Kayle Karcher, Columbia University, New York, United States Silvia Mejia-Arango, University of Texas Rio Grande Valley - School of Medicine, Edinburg, United States Joseph Saenz, Arizona State University, Tempe, United States Iris Strangmann, Columbia University, New York, United States Alice Gavarrete Olvera, Queens College at the City University of New York, New York, United States Rebeca Wong, The University of Texas Medical Branch, Galveston, United States Emily Briceño, University of Michigan, Ann Arbor, United States Miguel Arce Rentería, Columbia University, New York, United States Category: MCI (Mild Cognitive Impairment) Keyword 1: mild cognitive impairment Keyword 2: dementia - Alzheimer's disease Objective: By 2050, two-thirds of older adults with dementia will be residing in low- and middle-income countries (LMICs), highlighting the importance of identifying people at risk such as those with mild cognitive impairment (MCI). However, there is substantial variability in the prognosis of MCI with studies indicating that around 10-58% of individuals with MCI revert to cognitively normal. Moreover, most knowledge regarding risk factors for MCI and its prognosis come primarily from high-income countries while little is known among LMICs such as Mexico. Thus, we aimed to investigate the sociodemographic, health, and cognitive predictors of progression to dementia or reversion to cognitively normal at 5-year follow-up among a sample of older Mexican adults with prevalent MCI. Participants and Methods: Data came from the Mexican Health and Aging Study (MHAS) Ancillary Study on Cognitive Aging (Mex-Cog). Analyses included participants who completed Wave 1 and Wave 2 of Mex-Cog and were classified as MCI at baseline (N=173). MCI and dementia were classified using an algorithm based on standard diagnostic criteria and comparing test performance to a robust normative sample. Participants completed a comprehensive cognitive assessment assessing the domains of memory, language, visuospatial, executive functioning, and orientation. Multinomial logistic regression analyses evaluated the association between sociodemographic and health factors and risk of progression to dementia or reversion to normal from prevalent MCI. Inverse probability weights were used to account for death and lost to follow-up. General linear models evaluated differences in baseline cognitive domain scores between MCI course groups (stable, revert to normal, and progressed to dementia). Results: At baseline, participants were on average 67 years old (SD=9.14), 66% female, with 5 years of education (SD=5.05), 60% residing in rural communities, and 49% reported hypertension while 26% reported diabetes. Among 173 participants with prevalent MCI at baseline, 51% remained stable MCI, 25% progressed to dementia, and 24% reverted to cognitively normal at follow-up. Older age (OR=1.10 [1.05, 1.15] was associated with a greater likelihood of declining to dementia. Greater likelihood of reverting to cognitively normal was associated with having only one cognitive domain impaired at baseline (OR=4.36 [1.68, 11.31]). Sex, educational attainment, rurality, depression, hypertension, and diabetes were not associated with MCI course (all p’s>.05). Participants who reverted to cognitively normal had better memory (B=4.30 [0.84,7.77]) compared to those who remained stable MCI or declined, and better executive functioning (B=2.77 [0.41,5.13]) compared to those who remained stable MCI. MCI course groups did not differ on any other cognitive domain score. Conclusions: Over the course of 5 years, among a sample of older Mexican adults with MCI, we found that about only a quarter progressed to dementia and a quarter reverted to cognitively normal. Older age was a useful predictor of incident dementia, whereas impairment in only one cognitive domain was associated with reversion to normal. These findings provide insight into sociodemographic and cognitive predictors of MCI course among older adults in Mexico. Future studies should evaluate whether modifying the MCI algorithm improves sensitivity and specificity to cognitive decline.

Poster

02/15/2024
04:00 pm - 05:15 pm
Room: Majestic Complex (Posters 61-120)

Poster Session 06: Aging | MCI | Neurodegenerative Disease - PART 2

Final Abstract #60

Mild Cognitive Impairment Over Time: Stability, Reversion, and Decline Among Older Mexican Adults

Kayle Karcher, Columbia University, New York, United States
Silvia Mejia-Arango, University of Texas Rio Grande Valley - School of Medicine, Edinburg, United States
Joseph Saenz, Arizona State University, Tempe, United States
Iris Strangmann, Columbia University, New York, United States
Alice Gavarrete Olvera, Queens College at the City University of New York, New York, United States
Rebeca Wong, The University of Texas Medical Branch, Galveston, United States
Emily Briceño, University of Michigan, Ann Arbor, United States
Miguel Arce Rentería, Columbia University, New York, United States

Category: MCI (Mild Cognitive Impairment)

Keyword 1: mild cognitive impairment
Keyword 2: dementia - Alzheimer's disease

Objective:

By 2050, two-thirds of older adults with dementia will be residing in low- and middle-income countries (LMICs), highlighting the importance of identifying people at risk such as those with mild cognitive impairment (MCI). However, there is substantial variability in the prognosis of MCI with studies indicating that around 10-58% of individuals with MCI revert to cognitively normal. Moreover, most knowledge regarding risk factors for MCI and its prognosis come primarily from high-income countries while little is known among LMICs such as Mexico. Thus, we aimed to investigate the sociodemographic, health, and cognitive predictors of progression to dementia or reversion to cognitively normal at 5-year follow-up among a sample of older Mexican adults with prevalent MCI.

Participants and Methods:

Data came from the Mexican Health and Aging Study (MHAS) Ancillary Study on Cognitive Aging (Mex-Cog). Analyses included participants who completed Wave 1 and Wave 2 of Mex-Cog and were classified as MCI at baseline (N=173). MCI and dementia were classified using an algorithm based on standard diagnostic criteria and comparing test performance to a robust normative sample. Participants completed a comprehensive cognitive assessment assessing the domains of memory, language, visuospatial, executive functioning, and orientation. Multinomial logistic regression analyses evaluated the association between sociodemographic and health factors and risk of progression to dementia or reversion to normal from prevalent MCI. Inverse probability weights were used to account for death and lost to follow-up. General linear models evaluated differences in baseline cognitive domain scores between MCI course groups (stable, revert to normal, and progressed to dementia).

Results:

At baseline, participants were on average 67 years old (SD=9.14), 66% female, with 5 years of education (SD=5.05), 60% residing in rural communities, and 49% reported hypertension while 26% reported diabetes. Among 173 participants with prevalent MCI at baseline, 51% remained stable MCI, 25% progressed to dementia, and 24% reverted to cognitively normal at follow-up. Older age (OR=1.10 [1.05, 1.15] was associated with a greater likelihood of declining to dementia. Greater likelihood of reverting to cognitively normal was associated with having only one cognitive domain impaired at baseline (OR=4.36 [1.68, 11.31]). Sex, educational attainment, rurality, depression, hypertension, and diabetes were not associated with MCI course (all p’s>.05). Participants who reverted to cognitively normal had better memory (B=4.30 [0.84,7.77]) compared to those who remained stable MCI or declined, and better executive functioning (B=2.77 [0.41,5.13]) compared to those who remained stable MCI. MCI course groups did not differ on any other cognitive domain score.

Conclusions:

Over the course of 5 years, among a sample of older Mexican adults with MCI, we found that about only a quarter progressed to dementia and a quarter reverted to cognitively normal. Older age was a useful predictor of incident dementia, whereas impairment in only one cognitive domain was associated with reversion to normal. These findings provide insight into sociodemographic and cognitive predictors of MCI course among older adults in Mexico. Future studies should evaluate whether modifying the MCI algorithm improves sensitivity and specificity to cognitive decline.