+1 Recommend
0 collections
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      The Prevalence of Mild Cognitive Impairment in Diverse Geographical and Ethnocultural Regions: The COSMIC Collaboration

      1 , 2 , * , 1 , 1 , 1 , 1 , 1 , 3 , 4 , 5 , 5 , 6 , 7 , 6 , 8 , 9 , 10 , 8 , 9 , 8 , 9 , 11 , 12 , 11 , 13 , 13 , 13 , 14 , 15 , 16 , 17 , 18 , 14 , 19 , 19 , 19 , 20 , 20 , 1 , 1 , 2 , 21 , 22 , 23 , 21 , 22 , 24 , 21 , 22 , 24 , 25 , 26 , 25 , 27 , 25 , 28 , Cohort Studies of Memory in an International Consortium (COSMIC)

      PLoS ONE

      Public Library of Science

      Read this article at

          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.



          Changes in criteria and differences in populations studied and methodology have produced a wide range of prevalence estimates for mild cognitive impairment (MCI).


          Uniform criteria were applied to harmonized data from 11 studies from USA, Europe, Asia and Australia, and MCI prevalence estimates determined using three separate definitions of cognitive impairment.


          The published range of MCI prevalence estimates was 5.0%–36.7%. This was reduced with all cognitive impairment definitions: performance in the bottom 6.681% (3.2%–10.8%); Clinical Dementia Rating of 0.5 (1.8%–14.9%); Mini-Mental State Examination score of 24–27 (2.1%–20.7%). Prevalences using the first definition were 5.9% overall, and increased with age ( P < .001) but were unaffected by sex or the main races/ethnicities investigated (Whites and Chinese). Not completing high school increased the likelihood of MCI ( P ≤ .01).


          Applying uniform criteria to harmonized data greatly reduced the variation in MCI prevalence internationally.

          Related collections

          Most cited references 38

          • Record: found
          • Abstract: found
          • Article: not found

          The Alzheimer's Disease Centers' Uniform Data Set (UDS): the neuropsychologic test battery.

          The neuropsychologic test battery from the Uniform Data Set (UDS) of the Alzheimer's Disease Centers (ADC) program of the National Institute on Aging consists of brief measures of attention, processing speed, executive function, episodic memory, and language. This paper describes development of the battery and preliminary data from the initial UDS evaluation of 3268 clinically cognitively normal men and women collected over the first 24 months of utilization. The subjects represent a sample of community-dwelling, individuals who volunteer for studies of cognitive aging. Subjects were considered "clinically cognitively normal" based on clinical assessment, including the Clinical Dementia Rating scale and the Functional Assessment Questionnaire. The results demonstrate performance on tests sensitive to cognitive aging and to the early stages of Alzheimer disease in a relatively well-educated sample. Regression models investigating the impact of age, education, and sex on test scores indicate that these variables will need to be incorporated in subsequent normative studies. Future plans include: (1) determining the psychometric properties of the battery; (2) establishing normative data, including norms for different ethnic minority groups; and (3) conducting longitudinal studies on cognitively normal subjects, individuals with mild cognitive impairment, and individuals with Alzheimer disease and other forms of dementia.
            • Record: found
            • Abstract: found
            • Article: not found

            Prevalence of mild cognitive impairment is higher in men. The Mayo Clinic Study of Aging.

            We investigated the prevalence of mild cognitive impairment (MCI) in Olmsted County, MN, using in-person evaluations and published criteria. We evaluated an age- and sex-stratified random sample of Olmsted County residents who were 70-89 years old on October 1, 2004, using the Clinical Dementia Rating Scale, a neurologic evaluation, and neuropsychological testing to assess 4 cognitive domains: memory, executive function, language, and visuospatial skills. Information for each participant was reviewed by an adjudication panel and a diagnosis of normal cognition, MCI, or dementia was made using published criteria. Among 1,969 subjects without dementia, 329 subjects had MCI, with a prevalence of 16.0% (95% confidence interval [CI] 14.4-17.5) for any MCI, 11.1% (95% CI 9.8-12.3) for amnestic MCI, and 4.9% (95% CI 4.0-5.8) for nonamnestic MCI. The prevalence of MCI increased with age and was higher in men. The prevalence odds ratio (OR) in men was 1.54 (95% CI 1.21-1.96; adjusted for age, education, and nonparticipation). The prevalence was also higher in subjects who never married and in subjects with an APOE epsilon3epsilon4 or epsilon4epsilon4 genotype. MCI prevalence decreased with increasing number of years of education (p for linear trend <0.0001). Our study suggests that approximately 16% of elderly subjects free of dementia are affected by MCI, and amnestic MCI is the most common type. The higher prevalence of MCI in men may suggest that women transition from normal cognition directly to dementia at a later age but more abruptly.
              • Record: found
              • Abstract: found
              • Article: not found

              Clinical dementia rating: a reliable and valid diagnostic and staging measure for dementia of the Alzheimer type.

               J. D. Morris (1996)
              Global staging measures for dementia of the Alzheimer type (DAT) assess the influence of cognitive loss on the ability to conduct everyday activities and represent the "ultimate test" of efficacy for antidementia drug trials. They provide information about clinically meaningful function and behavior and are less affected by the "floor" and "ceiling" effects commonly associated with psychometric tests. The Washington University Clinical Dementia Rating (CDR) is a global scale developed to clinically denote the presence of DAT and stage its severity. The clinical protocol incorporates semistructured interviews with the patient and informant to obtain information necessary to rate the subject's cognitive performance in six domains: memory, orientation, judgment and problem solving, community affairs, home and hobbies, and personal care. The CDR has been standardized for multicenter use, including the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) and the Alzheimer's Disease Cooperative Study, and interrater reliability has been established. Criterion validity for both the global CDR and scores on individual domains has been demonstrated, and the CDR also has been validated neuropathologically, particularly for the presence or absence of dementia. Standardized training protocols are available. Although not well suited as a brief screening tool for population surveys of dementia because the protocol depends on sufficient time to conduct interviews, the CDR has become widely accepted in the clinical setting as a reliable and valid global assessment measure for DAT.

                Author and article information

                Role: Editor
                PLoS One
                PLoS ONE
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                5 November 2015
                : 10
                : 11
                [1 ]Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia
                [2 ]Dementia Collaborative Research Centre, University of New South Wales, Sydney, Australia
                [3 ]Department of Public Health and Primary Care, Cambridge University, Cambridge, United Kingdom
                [4 ]MRC Biostatistics Unit, Institute of Public Health, Cambridge, United Kingdom
                [5 ]Institute of Health and Society, Newcastle University, Newcastle upon Tyne, United Kingdom
                [6 ]Saul B. Korey Department of Neurology, Albert Einstein College of Medicine, Yeshiva University, New York City, New York, United States of America
                [7 ]Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Yeshiva University, New York City, New York, United States of America
                [8 ]Inserm, U1061 Nervous System Pathologies: Epidemiological and Clinical Research, La Colombière Hospital, Montpellier Cedex 5, France
                [9 ]Université de Montpellier 1, Montpellier, France
                [10 ]Faculty of Medicine, Imperial College, St Mary’s Hospital, London, United Kingdom
                [11 ]Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
                [12 ]Department of Psychiatry, Tai Po Hospital, Hong Kong Special Administrative Region, China
                [13 ]GolgiCenci Foundation, Abbiategrasso (Milan), Italy
                [14 ]Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States of America
                [15 ]Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States of America
                [16 ]Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, United States of America
                [17 ]Department of Neurology, Oregon Health and Science University, Portland, Oregon, United States of America
                [18 ]Department of Neurology, University of Michigan, Ann Arbor, Michigan, United States of America
                [19 ]Centre for Research on Ageing, Health and Wellbeing, College of Medicine, Biology and Environment, The Australian National University, Canberra, Australia
                [20 ]Gerontology Research Programme, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
                [21 ]The Taub Institute for Research in Alzheimer’s Disease and the Aging Brain, Columbia University, New York City, New York, United States of America
                [22 ]The Gertrude H. Sergievsky Center, Columbia University, New York City, New York, United States of America
                [23 ]The Division of Epidemiology, Joseph P. Mailman School of Public Health, Columbia University, New York City, New York, United States of America
                [24 ]The Department of Neurology, Columbia University, New York City, New York, United States of America
                [25 ]Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation, Madrid, Spain
                [26 ]Department of Medicine and Psychiatry, Universidad de Zaragoza, Zaragoza, Spain
                [27 ]Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spanish Ministry of Economy and Competitiveness, Madrid, Spain
                [28 ]Department of Microbiology, Preventive Medicine and Public Health, University of Zaragoza, Zaragoza, Spain
                University of Leipzig, GERMANY
                Author notes

                Competing Interests: The authors have read the journal's policy and the authors of this manuscript have the following competing interests: Each of Novartis and Eisai provided funding to one of eleven studies that subsequently contributed their data to the present study. Neither Novartis or Eisai funded this specific study. RBL declares grants and personal fees from Boston Scientific, Allergan and Novartis, personal fees from BMS, Labrys Technologies, Electrocore and Alder Biopharmaceuticals, and grants, personal fees and stock options from eNeura. HB declares being an investigator for and on the advisory board of Janssen, an investigator for Lilly, Medivation, Merck, Sanofi, Servier and Tau Therapeutics, an advisory board member of Pfizer, Novartis, and Lundbeck, a consultant for Baxter, Lilly and Merck, and a consultant for and advisory board member of Nutricia. AL declares being a consultant for Janssen and honoraria or travel fees from Eli Lilly and Bial. There are no patents, products in development or marketed products to declare. This does not alter the authors' adherence to all the PLOS ONE policies on sharing data and materials, as detailed online in the guide for authors.

                Wrote the paper: PSS DML. Conceptualized, initiated, obtained funding for and is the head of the COSMIC consortium, and planned the study: PSS. Managed the collection of data: DML. Harmonized the data: DML JDC NAK PSS. Analyzed the harmonized data: DML JDC PSS. Performed the multiple imputations: AT. Analyzed and provided results from CFAS: BCMS FEM. Analyzed and provided results from Invece.Ab: AG. Contributed to revising the manuscript for important intellectual content: PSS DML NAK JDC AT GA CB FEM BCMS RBL MJK KR IC MLA LCWL CHYW AWTF AG RV AD MG HD TH KJA NC PB TPN QG SR HB NS JM YS AL RLA JS. Approved the final version of the manuscript for submission: PSS DML NAK JDC AT GA CB FEM BCMS RBL MJK KR IC MLA LCWL CHYW AWTF AG RV AD MG HD TH KJA NC PB TPN QG SR HB NS JM YS AL RLA JS.

                ¶ Membership of the Cohort Studies of Memory in an International Consortium (COSMIC) is provided in the Acknowledgments.


                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

                Page count
                Figures: 2, Tables: 3, Pages: 19
                National Health and Medical Research Council of Australia Program Grant (ID 568969; PSS). For the contributing studies: Major awards from the UK Medical Research Council and the Department of Health (CB, FEM, BCMS); National Institute on Health/National Institute on Aging grants (5P01 AG003949, 1R03 AG045474; RBL, MJK); Novartis (KR, MLA, IC); Mr. Lai Seung Hung & Mrs. Lai Chan Pui Ngong Dementia in Hong Kong Research Fund, and an educational fund from Eisai (LCWL, CHYW, AWTF); Fondazione Golgi Cenci and Federazione Alzheimer Italia (AG, RV, AD); National Institute on Aging, National Institutes of Health, United States Department of Health and Human Services (Grant # R01AG07562; MG, HD, TH); National Health and Medical Research Council of Australia (Grants 973302, 179805, 157125 and 1002160; KJA, NC, PB); Research grants (No. 03/121/17/214 and No. 08/1/21/19/567) from the Biomedical Research Council, Agency for Science, Technology and Research (A*STAR) in Singapore (TPN, QG); National Health & Medical Research Council of Australia Program Grant (ID 350833; PSS, DML, NAK, JDC, AT, GA, SR, HB); National Institute of Health/National Institute on Aging (Grants # R01 AG037212, P01 AG07232; NS, JM, YS); Fondo de Investigación Sanitaria, Instituto de Salud Carlos III, Spanish Ministry of Health, Madrid, Spain (Grants 94/1562, 97/1321E, 98/0103, 01/0255, 03/0815, 06/0617, and G03/128) and Pfizer Foundation, Madrid (AL, RLA, JS). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Research Article
                Custom metadata
                Data were provided by the contributing studies to COSMIC on the understanding and proviso that the relevant study leaders be contacted for any further use of their data. Author affiliations with the contributing studies are listed in the Acknowledgments, and contact details can be found on the COSMIC website ( http://cheba.unsw.edu.au/group/cosmic).



                Comment on this article