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Mild cognitive impairment: clinical and imaging profile in a memory clinic setting in India
Suvarna Alladi1, Mekala Shailaja, Kandadai Rukmini Mridula
1Department of Neurology, Nizam's Institute of Medical Sciences, Hyderabad, India.
Background:
Despite the increasing burden of dementia in developing countries, mild cognitive impairment (MCI) continues to be underexplored. MCI has conventionally been identified based on clinical profile, but recently, biomarkers suggestive of Alzheimer's disease pathology have been included in the revised National Institute on Aging and the Alzheimer's Association (NIA-AA) criteria. In this study, we evaluated the profile of MCI in a memory clinic in India and explored the applicability of the revised NIA-AA criteria in a limited resource setting.
Methods:
Consecutive subjects evaluated at the memory clinic for mild memory complaints were included and underwent clinical and neuropsychological examination as well as standard brain imaging. A subset of patients was subjected to imaging biomarker studies as a part of routine clinical practice.
Results:
Among the 1,190 patients evaluated during the study period, 226 (19.0%) presented with mild memory complaints. Cerebrovascular disease was a common secondary cause. Nearly half of the patients (109 of 226) had MCI according to the modified Petersen criteria. All MCI subjects were educated and the majority were male. A total of 12% of the cohort was classified by imaging biomarkers as having MCI with intermediate likelihood of AD according to the NIA-AA criteria.
Conclusion:
In the setting of urban India, MCI is an emerging problem; therefore, it was feasible to operationalise the revised NIA-AA criteria in identifying subjects with MCI with intermediate likelihood of AD.
Insights
Mild cognitive impairment (MCI) is an emerging issue in India. The revised National Institute on Aging and Alzheimer's Association (NIA-AA) criteria are feasible for identifying MCI with intermediate likelihood of Alzheimer's disease in this setting.
Area of Science:
- Neurology
- Geriatrics
- Public Health
Background:
- Mild cognitive impairment (MCI) is increasingly recognized globally, particularly in developing nations.
- Traditional MCI diagnosis relies on clinical profiles, but updated criteria incorporate Alzheimer's disease biomarkers.
- Limited research exists on MCI profiles and diagnostic criteria applicability in low-resource settings.
Purpose of the Study:
- To evaluate the clinical profile of MCI patients in an Indian memory clinic.
- To assess the feasibility of applying the revised National Institute on Aging and Alzheimer's Association (NIA-AA) criteria in a limited-resource environment.
- To identify MCI with intermediate likelihood of Alzheimer's disease (AD) using updated criteria.
Main Methods:
- Consecutive patients with mild memory complaints were recruited from a memory clinic.
- Clinical and neuropsychological examinations were performed on all subjects.
- Standard brain imaging and a subset of imaging biomarker studies were utilized.
Main Results:
- Out of 1,190 patients, 226 (19.0%) had mild memory complaints, with cerebrovascular disease being a common secondary cause.
- 109 of 226 MCI patients met the modified Petersen criteria; most were educated males.
- 12% of the cohort met the NIA-AA criteria for MCI with intermediate likelihood of AD based on imaging biomarkers.
Conclusions:
- MCI represents a growing health concern in urban India.
- Operationalizing the revised NIA-AA criteria for identifying MCI with intermediate AD likelihood is feasible in this setting.
- Further research is needed to understand the full scope of MCI in developing countries.
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