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Journal of Geriatric Psychiatry and Neurology, Vol. 20, No. 4, 215-226 (2007)
DOI: 10.1177/0891988707308804
© 2007 SAGE Publications

Mild Cognitive Dysfunction: An Epidemiological Perspective With an Emphasis on African Americans

Frederick W. Unverzagt, PhD

Department of Psychiatry Indiana University School of Medicine, and Regenstrief Institute, Indiana University Center for Aging Research Indianapolis, funverza{at}iupui.edu

Sujuan Gao, PhD

Division of Biostatistics Indiana University School of Medicine, and Regenstrief Institute, Indiana University Center for Aging Research Indianapolis

Kathleen A. Lane, MS

Division of Biostatistics Indiana University School of Medicine, and Regenstrief Institute, Indiana University Center for Aging Research Indianapolis

Christopher Callahan, MD

Division of Geriatric Medicine Indiana University School of Medicine, and Regenstrief Institute, Indiana University Center for Aging Research Indianapolis, Department of Medicine, Indiana University School of Medicine, and Regenstrief Institute, Indiana University Center for Aging Research Indianapolis

Adesola Ogunniyi, MD

Department of Medicine Ibadan College of Medicine, Nigeria

Olusegun Baiyewu, MD

Department of Psychiatry Ibadan College of Medicine, Nigeria

Oye Gureje, MD

Department of Psychiatry Ibadan College of Medicine, Nigeria

Kathleen S. Hall, PhD

Department of Psychiatry Indiana University School of Medicine, and Regenstrief Institute, Indiana University Center for Aging Research Indianapolis

Hugh C. Hendrie, MB, ChB, DSc

Department of Psychiatry Indiana University School of Medicine, and Regenstrief Institute, Indiana University Center for Aging Research Indianapolis, Department of Medicine, Indiana University School of Medicine, and Regenstrief Institute, Indiana University Center for Aging Research Indianapolis

This review begins with a historical accounting of the evolution of the concept of mild cognitive dysfunction, including nomenclature and criteria from Kral to Petersen. A critical analysis of the main elements relating to assessment and diagnosis of mild cognitive dysfunction is provided. Methodological limitations in design, measurement, and characterization, especially as they relate to older African Americans, are identified. Data from a 15-year longitudinal study of community-dwelling African Americans in Indianapolis, Indiana, indicate a 23% prevalence of all-cause mild cognitive dysfunction, with approximately 25% progressing to dementia in 2 years and another 25% reverting to normal cognition in the same interval. Factors contributing to this longitudinal variability in outcomes are reviewed, including the role of medical health factors. The review closes with suggestions for next steps in the epidemiological research of mild cognitive impairment. (J Geriatr Psychiatry Neurol 2007;20:215—226)

Key Words: cognition • memory • mild cognitive impairment • dementia • aging • epidemiology


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