Factors associated with cognition recovery among elders with mild cognitive impairment in Korea

Factors affecting reversion from mild cognitive impairment to normal cognition in midlife to later life in Korea: A national population study

AIM

The purpose of this study was to identify the midlife and later life factors affecting reversion from mild cognitive impairment to normal cognition after 4 years.

METHODS

We analyzed data from the 2012 and 2016 Korean Longitudinal Study of Aging. The participants of this study were Korean community-dwelling adults aged ≥45 years who showed mild cognitive impairment in 2012. They were divided into midlife (<65 years) and later life (≥65 years) based on their age in 2012. Cognitive function was assessed by the Korean Mini-Mental State Examination in 2016. Multiple logistic regression analysis was carried out to determine the factors affecting reversion by age group.

RESULTS

Among participants with mild cognitive impairment, 52.0% in midlife and 26.6% in later life reverted to normal cognition after 4 years. In midlife, higher education (OR 1.97, 95% CI 1.15-3.36), fewer chronic diseases (OR 0.78, 95% CI 0.61-0.99), lower levels of depressive symptoms (OR 0.95, 95% CI 0.90-0.99) and higher participation in social activities (OR 1.91, 95% CI 1.27-2.87) were significantly associated with reversion. In later life, higher baseline cognitive function (OR 1.30, 95% CI 1.14-1.47) and higher participation in social activities (OR 1.35, 95% CI 1.02-1.79) were significantly associated with reversion.

CONCLUSIONS

The reversion rate in midlife was higher than that of later life. More modifiable factors affecting reversion were found in midlife, suggesting that assessment and intervention at an early age should be considered. Geriatr Gerontol Int 2019; 19: 1129-1135.

Factors for predicting reversion from mild cognitive impairment to normal cognition: A meta-analysis

OBJECTIVE

Subjects with mild cognitive impairment (MCI) may revert to normal cognition (NC), but predictive factors are under study. We therefore sought to identify factors which could help in predicting reversion from MCI to NC.

METHODS

Relevant studies were retrieved from PubMed, EMBASE, Cochrane Library, MEDLINE, Web of Science, EBSCO, and OVID. According to the inclusion and exclusion criteria, high-quality assessments of relevant literatures were conducted, followed by data extraction and meta-analysis with Stata 12.0 software.

RESULTS

A total of 17 studies with 6829 participants were included in the meta-analysis. The overall reversion rate is 27.57%. Positive predictive factors were found in younger age (SMD = -0.345, 95% CI, -0.501 to -0.189), higher education level (SMD = 0.337, 95% CI, 0.117-0.558), no APOE ε4 allele (OR = 0.728, 95% CI, 0.575-0.922), no hypertension (OR = 0.826, 95% CI, 0.692-0.987), no stroke (OR = 0.696, 95% CI, 0.507-0.953), and higher Mini-Mental State Examination (MMSE) score (SMD = 0.707, 95% CI, 0.461-0.953).

CONCLUSION

Individuals who are at young age, have higher education level and MMSE score, and have no APOEe4 allele, no hypertension, and no stroke had a high probability to revert from MCI to NC.

Quality of Life and Its Factors in Korean Elderly With Mild Cognitive Impairment

Based on the secondary data analysis, this study aimed to identify quality of life and factors that affect quality of life among Korean elderly with mild cognitive impairment. Demographic characteristics, physical factors, and psychosocial factors as well as quality of life of the elderly with mild cognitive impairment were comprehensively measured. The research subjects consisted of 348 home-resident elderly and their quality of life scores were relatively high at 29.86. Their quality of life varied according to education and gender, and instrumental activities of daily living (actual, latent), somatic symptoms, sleep quality, depression, and social support affected their quality of life. Depression and social support were predictors of quality of life. The most powerful predictor was depression (β = −.583, p < .001). To improve the quality of life among elderly with mild cognitive impairment, nursing interventions to alleviate depression and to enhance social support from family, friends, and relevant neighbors are needed.