ABSTRACT
Mild cognitive impairment (MCI) is regarded as a precursor to dementia, but not all patients with MCI develop dementia. We followed up 165 elderly outpatients with MCI for a mean of 3 years. The aims were (1) to investigate the risk of conversion to dementia for different MCI subtypes diagnosed according to standardized criteria (amnestic; impairment of memory plus other cognitive domains; nonamnestic); (2) to assess whether the risk of conversion was affected by several established and emerging vascular risk factors. Forty-eight subjects (29%) converted to dementia, and the risk of conversion was doubled for amnestic MCI with respect to the other subtypes. Independently of MCI subtype, risk of conversion was associated with atrial fibrillation and low serum folate levels. Our results show that current diagnostic criteria for MCI define heterogeneous populations, but some potentially treatable vascular risk factors may be of help in predicting conversion to dementia.
Subject(s)
Alzheimer Disease/diagnosis , Amnesia/diagnosis , Cognition Disorders/diagnosis , Dementia, Vascular/diagnosis , Aged , Alzheimer Disease/epidemiology , Alzheimer Disease/psychology , Amnesia/epidemiology , Amnesia/psychology , Atrial Fibrillation/complications , Atrial Fibrillation/epidemiology , Cognition Disorders/epidemiology , Cognition Disorders/psychology , Dementia, Vascular/psychology , Disease Progression , Folic Acid/blood , Follow-Up Studies , Humans , Prognosis , Risk FactorsABSTRACT
Patients with autoimmune thyroiditis (AT) have an increased prevalence of coeliac disease (CD), an immune-mediated enteropathy. It is unknown, however, whether prevalence of CD in AT is affected by age. Sera from 514 patients with AT aged <65 yr (46+/-12 yr), 223 patients with AT aged >or=65 yr (71+/-5 yr), 300 controls aged <65 yr (45+/-12 yr), and 300 controls aged >or=65 yr (71+/-6 yr) were tested for IgA anti-tissue transglutaminase (anti-tTG) and antiendomysial antibodies (EmA). If anti-tTG or EmA IgA were positive, jejunal biopsy was performed to confirm CD diagnosis. Prevalence of CD was significantly higher in patients with AT aged >or=65 yr (3.6%, P=0.024) than in patients with AT aged <65 yr (0.6%), controls aged <65 yr and controls aged >or=65 yr (both 0.3%). Prevalence of CD did not significantly differ across patients with AT aged <65 yr, controls aged <65 yr and controls aged >or=65 yr. In conclusion, prevalence of CD is increased in AT but the association is limited to patients aged 65 years or older. Serological screening including anti-tTG-IgA is recommended in these patients.
