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Risk of dementia and mild cognitive impairment in older people with subjective memory complaints: meta-analysis
A J Mitchell1, H Beaumont, D Ferguson
1Leicestershire Partnership Trust, Department of Cancer Studies and Molecular Medicine, Leicester Royal Infirmary, Leicester, UK.
Objective:
To investigate whether people with subjective memory complaints (SMC) but no objective deficits are at increased risk of developing mild cognitive impairment (MCI) and dementia.
Method:
Major electronic databases were searched till 03/2014, and a meta-analysis was conducted using inception cohort studies.
Results:
Across 28 studies, there were 29,723 unique individuals (14,714 with SMC and 15,009 without SMC) (mean 71.6 years) followed on average for 4.8 years through to dementia. The annual conversion rate (ACR) of SMC to dementia was 2.33% (95% CI = 1.93%-2.78%) a relative risk (RR) of 2.07 (95% CI = 1.76-2.44) compared with those without SMC (n = 15,009). From 11 studies the ACR of developing MCI was 6.67% (95% CI = 4.70-8.95%). In long-term studies over 4 years, 14.1% (9.67-19.1%) of people with SMC developed dementia and 26.6% (95% CI = 5.3-39.7) went on to develop MCI. The ACR from SMC to dementia and MCI were comparable in community and non-community settings.
Conclusion:
Older people with SMC but no objective complaints are twice as likely to develop dementia as individuals without SMC. Approximately 2.3% and 6.6% of older people with SMC will progress to dementia and MCI per year.
Insights
Older adults with subjective memory complaints (SMC) but no objective deficits are twice as likely to develop dementia. Annually, about 2.3% with SMC progress to dementia and 6.6% to mild cognitive impairment (MCI).
Area of Science:
- Neurology
- Gerontology
- Cognitive Science
Background:
- Subjective memory complaints (SMC) in older adults, without objective cognitive deficits, are a growing concern.
- Understanding the progression of SMC to mild cognitive impairment (MCI) and dementia is crucial for early intervention.
Purpose of the Study:
- To determine if individuals experiencing SMC without objective deficits face an elevated risk of developing MCI and dementia.
- To quantify the risk and annual conversion rates from SMC to MCI and dementia.
Main Methods:
- A meta-analysis of inception cohort studies was performed, searching major electronic databases up to March 2014.
- Included data from 28 studies encompassing 29,723 individuals (14,714 with SMC, 15,009 without), with a mean age of 71.6 years, followed for an average of 4.8 years.
Main Results:
- Individuals with SMC demonstrated a relative risk (RR) of 2.07 for developing dementia compared to those without SMC.
- The annual conversion rate (ACR) from SMC to dementia was 2.33%, and to MCI was 6.67%.
- Over 4 years, 14.1% of individuals with SMC developed dementia, and 26.6% developed MCI.
Conclusions:
- Older adults with SMC but no objective deficits are at double the risk of developing dementia.
- The annual progression rate from SMC to dementia is approximately 2.3%, and to MCI is approximately 6.6%.
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