rates in the comparison between rosuvastatin and placebo treatment groups. Cristiano Capurso, MD, PhD Department of Geriatrics University of Foggia Foggia, Italy Vincenzo Solfrizzi, MD, PhD Alessia D’Introno, PhD Anna M. Colacicco, PhD Annamaria Gadaleta, MD Vincenza Frisardi, MD Department of Geriatrics Center for Lipoprotein Metabolism and Atherosclerosis University of Bari Bari, Italy Andrea Santamato, MD Department of Physical Medicine and Rehabilitation University of Foggia Foggia, Italy Antonio Capurso, MD Francesco Panza, MD, PhD Department of Geriatrics Center for Lipoprotein Metabolism and Atherosclerosis University of Bari Bari, Italy ACKNOWLEDGMENTS Conflict of Interest: The editor in chief has reviewed the conflict of interest checklist provided by the author and has determined that the author has no financial or any other kind of personal conflicts with this letter. This work was supported by the Italian Longitudinal Study on Aging (Ital- ian National Research CouncilFCNR-Targeted Project on AgingFGrants 9400419PF40 and 95973PF40; Dr. Panza, Dr. C. Capurso, Dr. D’Introno, Dr. Colacicco, Pr. A. Cap- urso, and Dr. Solfrizzi). Author Contributions: Dr. Panza and Dr. Solfrizzi con- tributed to concept, interpretation, and manuscript prepa- ration.Dr. C. Capurso, Dr.D’Introno, Dr.Colacicco,Dr. Gadaleta, Dr. Frisardi, Dr. Santamato, and Pr. A. Capurso contributed to interpretation and manuscript preparation. Sponsor’s Role: The funding agencies had no role in the design or conduct of the study. REFERENCES 1. Smith SC Jr, Allen J, Blair SN et al. AHA/ACC guidelines for secondary pre- vention for patients with coronary and other atherosclerotic vascular disease: 2006 update: Endorsed by the National Heart, Lung, and Blood Institute. Cir- culation 2006;113:236372 [Erratum, Circulation 2006;113:e847]. 2. Panza F, Solfrizzi V, Colacicco AM et al. Cerebrovascular disease in the elderly: Lipoprotein metabolism and cognitive decline. Aging Clin Exp Res 2006;18: 144–148. 3. Amarenco P, Bogousslavsky J, Callahan A III et al.Stroke prevention by ag- gressive reduction in cholesterol levels (SPARCL) investigators. High-dose at- orvastatin after stroke or transient ischemic attack. N Engl J Med 2006;355: 549–559. 4. Panza F, D’Introno A, Colacicco AM et al. Lipid metabolism in cognitive decline and dementia. Brain Res Rev 2006;51:275–292. 5. Cleland JG, Loh H, Windram J et al. Threats, opportunities, and statins in the modern management of heart failure. Eur Heart J 2006;27:641–643. 6. Tavazzi L, Tognoni G, Franzosi MG et al. On behalf of the GISSI investigators. Rationale and design of the GISSI heart failure trial: A large trial to assess the effectsof n-3 polyunsaturated fatty acids and rosuvastatin in symptomatic congestive heart failure. Eur J Heart Fail 2004, 635–641. 7. Kjekshus J,ApetreiE for the CORONA Group et al. Rosuvastatin in older patients with systolic heart failure. N Engl J Med 2007;357:2248–2261. 8. Corti MC, Guralnik JM, Salive ME et al. Clarifying the direct relation between total cholesterol levels and death from coronary heart disease in older persons. Ann Intern Med 1997;126:753–760. MILD COGNITIVE IMPAIRMENT: DEMENTIA RISK FACTOR OR HIGH-RISK STATE FOR PROGRESSION TO DEMENTIA? To the Editor:We read with great interest the report of Ravaglia and colleagues in which 1,016 subjects who un- derwent baseline evaluation in 1999/2000 were studied as part of the Conselice Study of Brain Ageing (CSBA), a pop- ulation-based study of individuals aged 65 and older res- ident in an Italian municipality. 1 Furthermore, in 2003/04, information about cognitive outcome of 745 participants who were free of dementia atbaselinewas collected. The authors reported a prevalence rate of mild cognitive impairment(MCI) of 7.7% for overallMCI, 4.1% for MCI with memory impairment (m1MCI), and 3.6% for MCI without memory impairment (m-MCI). 1 Furthermore, during 4 years of follow-up, incidence was 76.8 per 1,000 person-years for overall MCI, 40.6 per 1,000 person-years for m1MCI, and 36.3 per 1,000 person-years for m-MCI. 1 Finally, adjusted risk of overall dementiain subjects with MCI was three times the risk in those with normal cognition. Adjusted risks of any dementia and Alzheimer’s disease(AD) in m1MCI subjectswere five and three times,respectively, the corresponding risk in those with normal cognition.No association with dementiarisk was found for m-MCI,and no association with vascular dementia (VaD)risk was found for MCI, m1MCI, or m-MCI. 1 The CSBA was the second population-based Italian study with a longitudinal component focused on MCI. In fact, in the Italian Longitudinal Study on Aging (ILSA), a population-based study with a 3.5-year follow-up involving 2,963 individuals aged 65 to 84, a prevalence rate of 3.2% was found for MCI and an incidence of 21.5 person-years. 2 A more general concept of MCI was used, selecting MCI patients on the basis of memory loss. Therefore, they may be well represented by amnestic MCI 3,4 or by the m1MCI group of the CSBA, 1 but as the authors acknowledged in the Discussion section, the choice of further testing only the subjects with a Mini-Mental State Examination (MMSE) score less than 24 could have selected a sample of subject cognitively unimpaired that comprised five incident cases mild dementia and other possible undiagnosed MCI cases. Furthermore, these diagnostic criteria of the CSBA identi- fied a predementia syndrome more similar to the category ‘‘cognitive impairment no dementia’’ (CIND) introduced in the Canadian Study of Health and Aging (CSHA) than a LETTERS TO THE EDITOR 1367 JAGS JULY 2008–VOL. 56, NO. 7