Predictores clínicos y neuropsicológicos de progresión a demencia en un estudio de seguimiento de una población de pacientes con deterioro cognitivo leve

Introduction

Several studies relate the progression of mild cognitive impairment (MCI) to dementia with risk factors such as advanced age, vascular disorders, and cognitive and functional deficits, highlighting that the amnesic subtype is more prone to conversion. Annual rates of progression to dementia range from 10% to 25%.

Objective

This study examines the clinical and neuropsychological predictors of the progression of MCI to dementia, differentiating between the amnesic and multidomain subtypes.

Subjects and method

170 patients over 60 years of age with cognitive complaints were included, evaluated with neuropsychological tests that included memory, attention, executive functions, language, visuospatial skills and functional and cognitive reserve scales. MRI scans were performed on 92 patients to assess vascular damage.

Results

The sample had a mean age of 77.94 years and an education of 11.20 years. Of the 170 patients, 140 (82.35%) were diagnosed with MCI. In 24 months, 44.28% of patients with MCI progressed to dementia, with the amnesic subtype being the one with the greatest progression. Significant predictors were performance on memory tests and complex functionality, as well as the presence of vascular risk factors. The main risk factors were hypertension (60.89%), dyslipidemia (51.98%), and smoking (49.29%).

Conclusions

Specific cognitive predictors were identified for each subtype of MCI, underlining the relevance of deficit in complex functionality as a possible indicator of progression to dementia. The need for systematized follow-up neuropsychological evaluations and the importance of guiding patients on preventive measures are emphasized.