Life expectancy with and without dementia in persons with mild cognitive impairment in the community

• Published in: Journal of the American Geriatrics Society (JAGS) 2022-02, Vol.70 (2), p.481-489
• Main Authors: Mooldijk, Sanne S., Yaqub, Amber, Wolters, Frank J., Licher, Silvan, Koudstaal, Peter J., Ikram, M. Kamran, Ikram, M. Arfan
• Format: Article
• Language: English
• Subjects: Age; Aged; Aged, 80 and over; Clinical Investigation; Cognitive ability; Cognitive Dysfunction - epidemiology; Dementia; Dementia - epidemiology; Dementia disorders; education; Educational Status; Female; Humans; Independent Living; Life expectancy; Life Expectancy - trends; Life span; Life tables; Male; Middle Aged; mild cognitive impairment; multistate model; Netherlands; Population studies; Primary care; Regular Issue Content; Risk Factors; Sex Factors
• ISSN: 0002-8614; 1532-5415
• DOI: 10.1111/jgs.17520

Background Various clinical studies have provided estimates of life expectancy of patients with mild cognitive impairment (MCI) from outpatient clinics, but whether these apply to community‐dwelling individuals at home or in primary care is uncertain. Methods Within the population‐based Rotterdam Study, we studied life expectancy with and without dementia in 648 community‐dwelling persons with MCI and 6410 without MCI. Participants aged 60 years and older were assessed for MCI at baseline (2002–2014) and subsequently followed for the onset of dementia and death. We used multistate life tables to determine age‐specific life expectancy with and without dementia by sex, educational attainment, and MCI subtype. Results Total life expectancy for MCI ranged from 21.4 years (95% CI: 19.0–23.6) at age 60 to 2.6 years (1.6–3.6) at age 95. With advancing age, an increasing proportion of these years was lived with dementia (2.9 years [1.8–4.0] at age 60; 1.2 [0.2–2.2] at age 95). Women and higher educated individuals lived longer and lived more years with dementia. No differences in total life expectancy were observed by MCI subtype, although individuals with amnestic MCI lived a larger proportion of those years with dementia. Conclusions Prognosis of MCI, in terms of life years lived with and without dementia, is more favorable in the general population than described in prior clinical observations, due likely to a substantial proportion of individuals with MCI in the clinic not seeking medical attention in an earlier stage.