1. 1 A follow up study of mild cognitive impairment in Beijing ----finding from 10/66 study Zhaorui Liu, Chuanjun Zhuo, Yueqin Huang, Shuran Li, Institute of Mental Health, Peking University Martin Prince Institute of Psychiatry, King’s College London

2. 2 Background  A new dementia case every 7 seconds  Cost of dementia: 1% of Global GDP  Early intervention: crucial  MCI - early dementia?

3. 3 Background  Incidence study on MCI: (65+) Ravaglia ： 4-year cumulative incidence 22.6% Larrieu ： 99/1000 person year Solfrizzi ： incidence: 2.76% Zhu ： 5-year cumulative incidence:8.0%  Transition MCI-dementia : 10% ～ 15% every year Normal-dementia: 1.6% ～ 3% every year

4. 4 Objectives  To describe the incidence of mild cognitive impairment (MCI)  To analyze the transition from MCI to dementia  To explore risk factors of MCI incidence and the transition

5. 5 Design  Part of 10/66 study in China  Two settings: Rural-Daxing, Urban- Xicheng  Baseline: 2004  Follow-up study: 2009  2012 older persons

6. 6 Subjects  Incidence part: 1859 older persons with normal cognitive function elderly at the baseline  Transition part: 166 MCI patients at the baseline

7. 7 Measurements  Cognitive Test: CSID  Geriatric Mental State-B3 version  Informant Interview Questionnaire  Background Socio- demographic and Risk factor Questionnaire  Self-report chronic diseases, physical examination

8. 8 Diagnose  MCI were diagnosed according to the general MCI criteria developed by Stockholm international conference.  Cognitive impairment, not dementia  Self-report or informant-report cognitive impairment  independent activities of daily life, complex task slightly affected

9. 9 Flow chart  Incidence part Baseline 2162 Dementia 137 MCI 166 Normal cognitive function 1859 Missing 190 Died 428 New MCI case 193

10. 10 Results  Incidence of MCI 5-year cumulative incidence 10.38% Average annual incidence rate was 2.17% (95%CI: 1.76~2.30%) Age groups Male Female

11. 11 Results  Incidence of MCI 5-year cumulative incidence 10.38% Average annual incidence rate was 2.17% (95%CI: 1.76~2.30%) Urban Rural No-education Primary Secondary Tertiary

12. 12 Results  Cox regression  Risk factors of MCI  older age  living in a rural area  lower education  history of stroke  history of diabetes  larger Waist Hip Ratio  Protective factors of MCI  having spouse  physical exercise

13. 13 Flow chart  Transition part Baseline MCI 166 Missing 7 found 159 Died 54 Normal 10 Dementia 74

14. 14 Results  MCI to dementia 5-year cumulative transition rate 43.97%, Average annual transition rate was 10.94% （ 95%CI: 7.30-12.18% ）  Protective factors of the transition  having spouse  physical exercise  Risk factors of the transition  older age  living in a rural area  lower education  history of stroke  hypertension  heart disease

15. 15 Contribution  Similar risk factors are found for the MCI occurrence and conversion as well.  This study provides a foundation for future prevention and intervention of MCI, which are of significant social and clinical value.

16. 16 Corresponding to Prof. Yueqin HUANG huangyq@bjmu.edu.cn