Five-Year Trajectory of Mild Cognitive Impairment: Insights from a Primary Care Memory Clinic.

Abstract

Background: The trajectory of Mild Cognitive Impairment (MCI) to dementia within primary care is not well understood.

Objective: We investigated the 5-year trajectory of patients initially diagnosed with MCI, evaluated their risk of developing dementia considering age, sex, and Montreal Cognitive Assessment (MoCA) test scores and determined the annual conversion rate from MCI to dementia for patients assessed in a MINT (Multispecialty Interprofessional Team) memory clinic.

Methods: We conducted a longitudinal cohort study using a retrospective chart review of 751 patients assessed within a MINT memory clinic in Ontario, Canada. The conversion rate from MCI to dementia was estimated with the Kaplan-Meier method. Cox regression examined time to dementia diagnosis and the association between baseline MoCA scores and dementia risk.

Findings: The observed 5-year conversion rate from MCI to dementia was 28.0%, though with limited follow-up data. Accounting for missing data, the estimated 5-year conversion rate was 48.8% (39.5%, 59.2%) with an average annual rate of 9.8%. Each one-point increase in MoCA score at initial visit was associated with a 10% lower rate of conversion to dementia (aHR: 0.90, 95%CI: 0.85-0.96).

Discussion: Findings highlight the profile of patients assessed in MINT clinics, cognitive trajectory of those diagnosed with MCI, and the importance of primary care-based memory clinics in early detection and intervention.