Skip to main content Accessibility help
×
Home

Cognitive predictors for five-year conversion to dementia in community-dwelling Chinese older adults

  • Candy H. Y. Wong (a1), Grace T. Y. Leung (a1), Ada W. T. Fung (a2), W. C. Chan (a3) and Linda C. W. Lam (a2)...

Abstract

Background: This study evaluates which cognitive measure is best for predicting incident dementia in a population-based random sample of Chinese older adults without dementia over a five-year period.

Methods: A total of 787 community-dwelling Chinese older adults without dementia in Hong Kong were assessed at baseline (T0), at two years (T1), and at five years (T2).

Results: The annual conversion rate to dementia was 1.6% and 6.3% for baseline normal participants and baseline mild cognitive impairment (MCI) participants, respectively. The Cantonese version of Mini-mental State Examination (CMMSE) scores declined significantly over time. In participants who progressed to dementia, Category Verbal Fluency Test (CVFT) scores dropped significantly from T0 to T1. A 1-SD drop of either CMMSE or CVFT in two years predicted dementia at five years with 91.5% sensitivity and 62.0% specificity. A stable CMMSE and CVFT at two years predicted a 91% chance of not progressing to clinical dementia at five years.

Conclusion: In this community sample of Chinese older adults, a decline in cognitive screening tests in short term (two years) offered useful information in predicting dementia conversion over a longer period.

Copyright

Corresponding author

Correspondence should be addressed to: Dr Candy H. Y. Wong, Department of Psychiatry, Tai Po Hospital, 9 Chuen On Road, Tai Po, N. T., Hong Kong. Phone: +(852) 26076026. Email: whycandy@gmail.com.

References

Hide All
Acvarsson, O. and Skoog, I. (2000). A longitudinal population study of the mini-mental state examination in the very old: relation to dementia and education. Dementia and Geriatric Cognitive Disorders, 11, 166175.
Alexopoulos, G. S., Abrams, R. C., Young, R. C. and Shamoian, C. A. (1988). Cornell Scale for Depression in Dementia. Biological Psychiatry, 23, 271284.
American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders, 4rth edn, Text Revision (DSM-IV-TR). Washington, DC: American Psychiatric Association.
Amieva, H.et al. (2004). Annual rate and predictors of conversion to dementia in participants presenting mild cognitive impairment criteria defined according to a population-based study. Dementia and Geriatric Cognitive Disorders, 18, 8793.
Bowie, C. R. and Harvey, P. D. (2006). Administration and interpretation of the trail making test. Nature Protocols, 1, 22772281.
Busse, A., Angermeyer, M. C. and Riedel-Heller, S. G. (2006). Progression of mild cognitive impairment to dementia: a challenge to current thinking. The British Journal of Psychiatry, 189, 399404.
Chen, P., Ratcliff, G., Belle, S. H., Cauley, J. A., DeKosky, S. T. and Ganguli, M. (2001). Cognitive tests that best discriminate between presymptomatic AD and those who remain nondemented. Neurology, 55, 18471853.
Chiu, H. F. K., Lee, H. C. B., Chung, D. and Kwong, P. K. (1994). Reliability and validity of the Cantonese version of the Mini-Mental State Examination: a preliminary study. Journal of Hong Kong College of Psychiatrists, 4 (Suppl. 2), 2528.
Chiu, H. F. K.et al. (1997). The modified fuld verbal fluency test: a validation study in Hong Kong. Journals of Gerontology, Series B, Psychological Sciences and Social Sciences, 52B, 247250.
Chu, L. W., Chiu, K. C., Hui, S. L., Yu, G. K., Tsui, W. J. and Lee, P. W. (2000). The reliability and validity of the Alzheimer's Disease Assessment Scale Cognitive Subscale (ADAS-Cog) among the elderly Chinese in Hong Kong. Annals of the Academy of Medicine, Singapore, 29, 474485.
Conwell, Y., Forbes, N. T., Cox, C. and Caine, E. D. (1993). Validation of a measure of physical illness burden at autopsy: the Cumulative Illness Rating Scale. Journal of American Geriatric Society, 41, 3841.
Ebly, E., Hogan, D. and Parhad, I. (1995). Cognitive impairment in the non-demented elderly: results from the Canadian study of health and aging. Archives of Neurology, 52, 612619.
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189198.
Galvin, J. E.et al. (2005). Predictors of preclinical Alzheimer's disease and dementia: a clinicopathologic study. Archives of Neurology, 62, 758765.
Grober, E., Hall, C. B., Lipton, R. B., Zonderman, A. B., Resnick, S. M. and Kawas, C. (2008). Memory impairment, executive dysfunction, and intellectual decline in preclinical Alzheimer's disease. Journal of International Neuropsychological Society, 14, 266278.
Hall, C. B., Lipton, R. B., Sliwinski, M. and Stewart, W. F. (2000). A change point model for estimating the onset of cognitive decline in preclinical Alzheimer's disease. Statistics in Medicine, 19, 15551566.
Hensel, A., Luck, T., Luppa, M., Glaesmer, H., Angermeyer, M. C. and Riedel-Heller, S. G. (2009). Does a reliable decline in Mini Mental State Examination total score predict dementia? Diagnostic accuracy of two reliable change indices. Dementia and Geriatric Cognitive Disorders, 27, 5058.
Howieson, D. B., Dame, A., Camicioli, R., Sexton, G., Payami, H. and Kaye, J. A. (1997). Cognitive markers preceding Alzheimer's dementia in the healthy oldest old. Journal of American Geriatrics Society, 45, 584589.
Johnson, D. K., Storandt, M., Morris, J. C. and Gavin, J. E. (2009). Longitudinal study of the transition from healthy aging to Alzheimer disease. Archives of Neurology, 66, 12541259.
Lam, L. C. W.et al. (2008a). Prevalence of very mild and mild dementia in community-dwelling older Chinese people in Hong Kong. International Psychogeriatrics, 20, 135148.
Lam, L. C. W.et al. (2008b). Use of clinical dementia rating in detecting early cognitive deficits in a community-based sample of Chinese older persons in Hong Kong. Alzheimer Disease and Associated Disorders, 22, 153157.
Lam, L. C. W.et al. (2008c). Screening of mild cognitive impairment in Chinese older adults – a multistage validation of the Chinese abbreviated mild cognitive impairment test. Neuroepidemiology, 30, 612.
Lam, L. C. W.et al. (2010). Combined clinical and cognitive criteria to identify mild cognitive impairment in a Southern Chinese Community. Alzheimer Disease and Associated Disorders, 24, 343347.
Leung, G. T. Y. (2008). Examining the association between participation in late-life leisure activities and cognitive function in community-swelling elderly Chinese in Hong Kong. Research dissertation, the Hong Kong College of Psychiatrists.
Petersen, R. C. (2003). Mild Cognitive Impairment. Oxford: Oxford University Press.
Ritchie, K., Artero, S. and Touchon, J. (2001). Classification criteria for mild cognitive impairment. A population-based validation study. Neurology, 56, 3742.
Rosen, W. G., Mohs, R. C. and Davis, K. L. (1984). A new rating scale for Alzheimer's disease. American Journal of Psychiatry, 141, 13561364.
Rubin, E. H., Storandt, M., Miller, J. P., Kinscherf, D. A., Grant, E. A. C. and Berg, L. (1998). A Prospective study of cognitive function and onset of dementia in cognitively healthy elders. Archives of Neurology, 55, 395401.
Schmand, B., Lindeboom, J., Launer, L., Dinkgreve, M., Hooijer, C. and Jonker, C. (1995). What is a significant score change on the Mini-Mental State examination? International Journal of Geriatric Psychiatry, 10, 411414.
Small, B. J., Fratiglioni, L., von Strauss, E. and Bäckman, L. (2003). Terminal decline and cognitive performance in very old age: does cause of death matter? Psychology and Aging, 18, 193202.
Wilson, R. S., Beckett, L. A., Bienias, J. L., Evans, D. A. and Bennett, D. A. (2003). Terminal decline in cognitive function. Neurology, 60, 17821787.

Keywords

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed