Prevalence of cognitive impairment without dementia in the United States.

TitlePrevalence of cognitive impairment without dementia in the United States.
Publication TypeJournal Article
Year of Publication2008
AuthorsPlassman, BL, Langa, KM, Fisher, GG, Heeringa, SG, Weir, DR, Ofstedal, MBeth, Burke, JR, Hurd, MD, Potter, GG, Rodgers, WL, Steffens, DC, McArdle, JJ, Willis, RJ, Wallace, RB
JournalAnn Intern Med
Volume148
Issue6
Pagination427-34
Date Published2008 Mar 18
ISSN Number1539-3704
Call Numbernewpubs20080528_AnnIntMed.pdf
KeywordsAged, Aged, 80 and over, Cognition Disorders, Dementia, disease progression, Humans, Longitudinal Studies, Prevalence, United States
Abstract

BACKGROUND: Cognitive impairment without dementia is associated with increased risk for disability, increased health care costs, and progression to dementia. There are no population-based prevalence estimates of this condition in the United States.

OBJECTIVE: To estimate the prevalence of cognitive impairment without dementia in the United States and determine longitudinal cognitive and mortality outcomes.

DESIGN: Longitudinal study from July 2001 to March 2005.

SETTING: In-home assessment for cognitive impairment.

PARTICIPANTS: Participants in ADAMS (Aging, Demographics, and Memory Study) who were age 71 years or older drawn from the nationally representative HRS (Health and Retirement Study). Of 1770 selected individuals, 856 completed initial assessment, and of 241 selected individuals, 180 completed 16- to 18-month follow-up assessment.

MEASUREMENTS: Assessments, including neuropsychological testing, neurologic examination, and clinical and medical history, were used to assign a diagnosis of normal cognition, cognitive impairment without dementia, or dementia. National prevalence rates were estimated by using a population-weighted sample.

RESULTS: In 2002, an estimated 5.4 million people (22.2%) in the United States age 71 years or older had cognitive impairment without dementia. Prominent subtypes included prodromal Alzheimer disease (8.2%) and cerebrovascular disease (5.7%). Among participants who completed follow-up assessments, 11.7% with cognitive impairment without dementia progressed to dementia annually, whereas those with subtypes of prodromal Alzheimer disease and stroke progressed at annual rates of 17% to 20%. The annual death rate was 8% among those with cognitive impairment without dementia and almost 15% among those with cognitive impairment due to medical conditions.

LIMITATIONS: Only 56% of the nondeceased target sample completed the initial assessment. Population sampling weights were derived to adjust for at least some of the potential bias due to nonresponse and attrition.

CONCLUSION: Cognitive impairment without dementia is more prevalent in the United States than dementia, and its subtypes vary in prevalence and outcomes.

DOI10.7326/0003-4819-148-6-200803180-00005
User Guide Notes

http://www.ncbi.nlm.nih.gov/pubmed/18347351?dopt=Abstract

Endnote Keywords

Cognitive Functioning/Dementia/Health Risk/PREVALENCE

Endnote ID

18530

Alternate JournalAnn Intern Med
Citation Key7201
PubMed ID18347351
PubMed Central IDPMC2670458
Grant ListR01 AG027010-01 / AG / NIA NIH HHS / United States
K08 AG019180 / AG / NIA NIH HHS / United States
U01 AG09740 / AG / NIA NIH HHS / United States
R01 AG027010 / AG / NIA NIH HHS / United States
AG019180 / AG / NIA NIH HHS / United States
U01 AG009740 / AG / NIA NIH HHS / United States
K08 AG019180-05 / AG / NIA NIH HHS / United States