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MCI Conversion to Dementia: Clinic and Community-Based Studies

MCI Conversion to Dementia: Clinic and Community-Based Studies. Ranjan Duara, M.D. Wien Center for Alzheimer’s Disease & Memory Disorders, Miami Beach. Collaborators. Wien Center, Mount Sinai, Miami Beach Ranjan Duara, MD, David Loewenstein, PhD Amarilis Acevedo, PhD, Warren Barker, MS

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MCI Conversion to Dementia: Clinic and Community-Based Studies

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  1. MCI Conversion to Dementia:Clinic and Community-Based Studies Ranjan Duara, M.D. Wien Center for Alzheimer’s Disease & Memory Disorders, Miami Beach

  2. Collaborators • Wien Center, Mount Sinai, Miami Beach • Ranjan Duara, MD, David Loewenstein, PhD • Amarilis Acevedo, PhD, Warren Barker, MS • Debbie Hurwitz, MSW, Marina Bravo, MSW • Mercy Luis, MSW, Cheryl Luis, PhD • Roskamp Institute, USF, Tampa • Michael Mullan, MD, PhD, Fiona Crawford, PhD • University of Toronto • Peter St. George-Hyslop, MD

  3. MCI to Dementia ConversionDemographics of Clinic Sample

  4. MCI Study: Non-AD Diagnoses

  5. Criteria for MCI • History of cognitive impairment (subjective, collateral, or both) • Objective cognitive deficits on memory  other cognitive domains • Lacking DSM III criteria for dementia • Preserved functional capacity

  6. Criteria for MCI (AD) • Meets criteria for MCI • Meeting NINCDS-ADRDA criteria for AD, but lacking DSM III criteria for dementia

  7. Criteria for Conversion of MCI to Dementia in Clinic Sample • Worsening of cognitive function by collateral report • Worsening of objective cognitive deficits • Meets DSM III criteria for dementia

  8. APOE e4 Allele Frequencyin Clinic Samples

  9. Conversion to DementiaEffect of AD Diagnosis 2=6.8 (p=.009)

  10. MCI to DementiaConversion Rates in Clinic Sample 2=6.8 (p=.009) for survival curve difference of AD vs non-AD

  11. Conversion to DementiaEffect of APOE 2=3.6 (p=.06) 2=3.6 (p=.06)

  12. Conversion to DementiaEffect of Age 2=0.4 (p=.83)

  13. Factors Influencing Follow-Up Rate in MCI Patients

  14. No Association Age of onset Use of Aricept Education Gender Increased Risk Diagnosis of AD APOE e4 (trend) MCI to DementiaRisk Factors in Clinic Sample

  15. Classification of Screening Sample

  16. MCI to Dementia Conversion 11% 15% 20%

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