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Neurology: A lot of cognitive reserve, or beneficial to reverse mild cognitive impairment!

 Last Update: 2022-04-21
 Source: Internet
 Author: User

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Cognition is fluid, and cognitive status can improve or decline over time
.

Patients with mild cognitive impairment (MCI) usually progress to dementia, but some return to normal cognition (NC)

Cognition is fluid, and cognitive status can improve or decline over time

A study published in Neurology sought to jointly model the instantaneous conversion rates from MCI to NC and from MCI to dementia, taking into account the transition from MCI to death, and to determine age, apolipoprotein E, and cognitive reserve.
The effect of indicators (educational level, academic performance, and written language skills) on relative transfer rates of recovery and progression
.

Transient transfer rates between NC, MCI, and dementia were estimated in the NUN study, a study of religious sisters over 75 years old, after accounting for the transition to death, and up to 12 assessments.
cohort study
.

Age, APOE, and underlying measures of cognitive reserve were estimated: RRs of regression and progression for education, academic performance (high school grades), and written language skills (idea density, grammatical complexity)

Of the 619 subjects, 472 underwent MCI assessments during the study
.
Of these 472, 143 (30.
3%) experienced at least one reverse transition to NC, while 120 of 143 (83.
9%) never developed dementia (mean follow-up = 8.
6 years)
.
In models adjusted for age group and APOE, higher education levels more than doubled the RR ratio for reversal versus progression
.
The new measures of cognitive reserve were significantly associated with higher regression- and progress-adjusted RRs (high versus low English grades: RR=1.
83; idea density: RR=3.
93; grammatical complexity: RR=5.
78)
.
Knowledge of frequent regressions from MCI to NC may alleviate concerns about the inevitable cognitive decline in MCI patients
.

Of the 619 subjects, 472 underwent MCI assessments during the study
.

Of these 472, 143 (30.
3%) experienced at least one reverse transition to NC, while 120 of 143 (83.
9%) never developed dementia (mean follow-up = 8.
6 years)
.

In models adjusted for age group and APOE, higher education levels more than doubled the RR ratio for reversal versus progression
.

The new measures of cognitive reserve were significantly associated with higher regression- and progress-adjusted RRs (high versus low English grades: RR=1.

Predicting recurrence rates from MCI to NC and identifying features of progression from MCI to dementia may guide population-level interventions targeting these features to prevent or delay MCI and dementia

Iraniparast M, Shi Y, Wu Y, et al.
Cognitive Reserve and Mild Cognitive Impairment: Predictors and Rates of Reversion to Intact Cognition vs Progression to Dementia.
Neurology.
2022;98(11):e1114-e1123.
doi:10.
1212/WNL .
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