Transitions to mild cognitive impairments, dementia, and death: findings from the Nun Study
Open accessAbstract
The potential of early interventions for dementia has increased interest in cognitive impairments less severe than dementia. However, predictors of the trajectory from intact cognition to dementia have not yet been clearly identified. The purpose of this study was to determine whether known risk factors for dementia increased the risk of mild cognitive impairments or progression from mild cognitive impairments to dementia. A polytomous logistic regression model was used, with parameters governing transitions within transient states (intact cognition, mild cognitive impairments, global impairment) estimated separately from parameters governing the transition from transient to absorbing state (dementia or death). Analyses were based on seven annual examinations (1991-2002) of 470 Nun Study participants aged > or = 75 years at baseline and living in the United States. Odds of developing dementia increased with age primarily for those with low educational levels. In these women, presence of an apolipoprotein E gene *E4 allele increased the odds more than fourfold by age 95 years. Age, education, and the apolipoprotein E gene were all significantly associated with mild cognitive impairments. Only age, however, was associated with progression to dementia. Thus, risk factors for dementia may operate primarily by predisposing individuals to develop mild cognitive impairments; subsequent progression to dementia then depends on only time and competing mortality.
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The Nun Study found discordance between cognition and pathology.
“For example, the Nun Study has shown discordance of cognition with pathology as well as the important effects of education, diet, linguistic ability, and childhood positive emotion on cognitive function in late life (Iacono, et al., 2009,Tyas, et al., 2007).”
From Cellular, synaptic, and biochemical features of resilient cognition in Alzheimer’s disease (2013) · cites this paper as Tyas, et al., 2007
The Nun Study found that education, diet, linguistic ability, and childhood positive emotion affect late-life cognitive function.
“For example, the Nun Study has shown discordance of cognition with pathology as well as the important effects of education, diet, linguistic ability, and childhood positive emotion on cognitive function in late life (Iacono, et al., 2009,Tyas, et al., 2007).”
From Cellular, synaptic, and biochemical features of resilient cognition in Alzheimer’s disease (2013) · cites this paper as Tyas, et al., 2007
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- Authors
- Tyas, S. L., Salazar, J. C., Snowdon, D. A., Desrosiers, M. F., Riley, K. P., Mendiondo, M. S., & Kryscio, R. J.
- Affiliations
- University of Waterloo (CA)
- University of Kentucky (US)
- Venue
- American Journal of Epidemiology
- Publisher
- Oxford University Press (OUP)
- Published
- 2007-04-02
- Volume
- 165
- Issue
- 11
- Pages
- 1231-1238
- ISSN
- 0002-9262 (ISSN-L)
- 1476-6256
- PMC
- PMC2516202
- OpenAlex
- W2138319363
- Cited by
- 163
- References
- 53
- Citations by year
- 2025: 2 · 2024: 5 · 2023: 6 · 2022: 5 · 2021: 6 · 2020: 7 · 2019: 9 · 2018: 5 · 2017: 7 · 2016: 10 · 2015: 6 · 2014: 16 · 2013: 15 · 2012: 11
- FWCI
- 8.88
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- American Journal of Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Robert J. Kleberg, Jr. and Helen C. Kleberg Foundation
- National Institutes of Health (5k04ag000553-02)
- National Institute on Aging (R01AG009862, P50AG005144, P50AG-05144, K04 AG00553, R01AG09862)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cancer-related cognitive impairment studies
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Keywords
- mild cognitive impairment, dementia, dementia progression, cognitive decline trajectories, apolipoprotein E ε4 allele, educational attainment, aging, mortality, older women, dementia risk factors, Nun Study
- MeSH terms
- Age Factors, Aged, Aged, 80 and over, Cognition Disorders, Dementia, Educational Status, Female, Humans, Markov Chains, Risk Factors, United States, Cohort Studies, Likelihood Functions, Logistic Models, Age Distribution, Disease Progression, Genetic Predisposition to Disease, Apolipoprotein E4
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