Journal
AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY
Volume 25, Issue 4, Pages 328-339Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jagp.2016.07.001
Keywords
mild neurocognitive disorder; prevalence; mild cognitive impairment; dementia; diagnostic and statistical manual of mental disorders (DSM-5)
Categories
Funding
- LIFE - Leipzig Research Center for Civilization Diseases, Universitat Leipzig
- European Union
- European Regional Development Fund (ERDF)
- European Social Fund
- Free State of Saxony
- German Federal Ministry of Education and Research (German Consortium for Frontotemporal Lobar Degeneration)
- Parkinson's Disease Foundation [PDF-IRG-1307]
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Objective: The DSM-5 introduces mild neurocognitive disorder (miNCD) as a syndrome that recognizes the potential clinical importance of acquired cognitive deficits being too mild to qualify for diagnosis of dementia. We provide new empirical data on miNCD including total, age-, and sex-specific prevalence rates; number and types of neurocognitive domains being impaired; and diagnostic overlap with the well-established mild cognitive impairment (MCI) concept. Design: Cross-sectional results of an observational cohort study (LIFE-Adult-Study). Setting: General population. Participants: A total of 1,080 dementia-free individuals, aged 60-79 years. Measurements: We calculated weighted point prevalence rates with confidence intervals (95% CI) for miNCD and analyzed diagnostic overlap between miNCD and MCI by calculating overall percentage agreement and Cohen's kappa coefficient. Results: Weighted total prevalence of miNCD was 20.3% (95% CI: 17.8-23.0). Prevalence was similar in both sexes, but significantly higher in older age. Two-thirds (66.2%) of the individuals with miNCD showed impairment restricted to only one out of six possible neurocognitive domains. Learning and memory was the most frequently (38.3%) impaired domain in all miNCD-cases, followed by social cognition (26.1%). Analysis of diagnostic overlap with MCI yielded an overall agreement of 98.6% and a kappa of 0.959. Conclusions: By considering all six predefined neurocognitive domains, our study observed a substantial proportion of dementia-free older adults having miNCD. Provision of information on the underlying etiology/ies may be of prime importance in future studies aiming at evaluating the clinical relevance of the miNCD syndrome.
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